[Congressional Record Volume 141, Number 197 (Tuesday, December 12, 1995)]
[House]
[Pages H14261-H14262]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                AMERICANS NEED MEDICAID WORKING FOR THEM

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentlewoman from North Carolina [Mrs. Clayton] is 
recognized during morning business for 5 minutes.
  Mrs. CLAYTON. Mr. Speaker, the assumptions by the Congressional 
Budget Office give us greater flexibility in reaching a budget 
agreement, and that is indeed great news. However, we know we will not 
be able to use all of that $135 billion that the Republicans have 
found, but one of the places where in the budget we ought to at least 
begin to think about investing those moneys would be Medicaid. Medicaid 
needs those funds for a variety of reasons, because this is the Federal 
program that is indeed provided to provide health care for the most 
vulnerable of our society.
  The Republican plan that was rejected and vetoed by the President 
really ignores the past and hurts senior citizens; it disregards the 
present and neglects the future. It hurts children, as well as women 
who suffer under this program.
  If the Republicans have their way, you must remember that they would 
give 245 billion dollars' worth of tax cuts, but at the same time, they 
would have 163 billion dollars' worth of cuts in Medicaid.
  Now, those are not really cuts; to use their words, this is just 
slowing the growth. Nevertheless, you would have $163 billion less 
resources to provide health care for the elderly, for children, for 
mothers and the disabled who need those programs and who are currently 
using those programs now.
  We should be reminded that some 36 million Americans use Medicaid, 
and that is the only health program that they have available to them; 
26 million of those 36 million people are the very poor. Of that 36 
million, 26 million of those persons are very poor. They are children, 
they are elderly and, again, they are the disabled.
  Again, if the Republican cuts stand, that would mean that they will 

[[Page H14262]]
  underfund a block grant to the States, and those persons who are now 
covered by Medicaid, currently covered by Medicaid, will now have to 
compete among others, if they will be covered at all, in the year 2002.
  So Medicaid as a program, we must understand, is the underpinning for 
at least 26 million very, very poor persons, and at least 36 million 
Americans. Again, who are they? They are the elderly, they are pregnant 
women, they are children, and they are the disabled; no other health 
care do they know other than that. So when we reduce that by $163 
billion over 7 years, choices will have to be made as to who will be 
covered and who will not be covered.
  States will be forced to make some very difficult decisions with 
their limited Medicaid funds. They must choose now, who will they offer 
health care? Which among those who are disabled now will have a health 
care and which will not have health care? Those are difficult choices 
to make between people you are now serving; and why should we have to 
make those difficult choices when there are other options? These 
choices are unnecessary in the very beginning.
  We should remember that when we created Medicaid in the first 
instance, it was indeed to speak to the most vulnerable of those who 
need health care. This is not to suggest that Medicaid does not need to 
be reformed; of course, containment needs to be made. There are ways to 
have cost containment. There are ways to have better health care and 
prevention without denying people the opportunity of having health 
care.
  Again, if you have to choose between $245 billion worth of tax cuts 
at the same time by reducing the growth of $163 billion over 7 years, 
you will have to make choices between millions of disabled persons, 
thousands of elderly persons and an unknown number of persons who are 
covered as mothers and children.
  In my judgment, that is no choice, no choice whatsoever. Again, the 
President has offered a plan that cuts Medicaid by one-third as much as 
the Republican plan and yet balances the budget, cuts Medicaid by one-
third as much and balances the budget. But more important than that, he 
maintains Medicaid as a Federal program, as entitlement to the people, 
not to the States, where the Republican plan would be an entitlement to 
the States. They would say, States, you have a right to this program, 
not people, not those 36 million people.
  We will now be saying, North Carolina, California, Montana, whatever, 
States, you have that right, not people who live in the State.
  So the President's plan would preserve Medicaid as a federally 
sponsored program that would be provided for those who are least among 
us and the poor.
  Medicaid is indeed an important program. We need to know how to make 
it more efficient; we need to make sure we serve as many people as we 
can.
  Again, Medicaid as a block grant with no guarantee of health coverage 
whatsoever will mean that children and older Americans may have no 
place to turn. Indeed, America can do better than that. America can 
find a way to keep this entitlement for all of its citizens.

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