[Congressional Record Volume 165, Number 76 (Wednesday, May 8, 2019)]
[Senate]
[Pages S2723-S2724]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                           EXECUTIVE CALENDAR

  The PRESIDING OFFICER. The clerk will report the nomination.
  The legislative clerk read the nomination of Michael H. Park, of New 
York, to be United States Circuit Judge for the Second Circuit.
  Mr. CASEY. Mr. President, this week, we know that the Senate is 
considering the nomination of Michael Park, who has been nominated by 
the President to serve on the Court of Appeals for the Second Circuit. 
I have a number of concerns with Mr. Park's nomination and his record. 
I will highlight just one that I think is a major concern for many 
Americans.
  In 2011, Mr. Park submitted an amicus brief to the U.S. Supreme 
Court, arguing that the Affordable Care Act's Medicaid expansion was 
unconstitutional. That is the argument he made. He claimed that the 
Medicaid expansion provision coerced States into accepting a ``greatly 
enlarged Medicaid program.'' I will come back to that later because 
those words are important. The rationale for this, he asserted, was 
that these States could not realistically opt out. Obviously, I 
disagree with his argument, and I disagree with his rationale. Yet I 
want to talk about the program and, more importantly, the people who 
will be affected by his point of view on this policy if he is to be 
successful in his arguments.
  If he is to be confirmed, I have a real concern about how he will 
make decisions as a judge as they relate to healthcare, Medicaid 
expansion, and related topics.
  So I am not going to go through the legal arguments, but I do want to 
talk about Medicaid expansion, the importance of it, and the people it 
helps. Everyone here knows that Medicaid itself has been a program that 
we have enjoyed the benefits of for more than 50 years. Right now, 
about 75 million people are covered by Medicaid. Approximately 17 
million of those individuals are eligible because of Medicaid 
expansion. So millions of people got healthcare because of the Medicaid 
expansion part of the Affordable Care Act.
  Medicaid itself covers 38 percent of the 1.9 million people younger 
than age 65 who are battling an opioid addiction. So 38 percent of the 
1.9 million people are helped who are in the grip of that addiction. 
That affects every State, every community, and, increasingly, virtually 
every family, or at least we all seem to know someone who has been 
adversely impacted by an opioid addiction or a substance use disorder 
issue.
  So 38 percent is almost 4 in 10. So 4 in 10 people who need that help 
are benefiting from Medicaid itself because of Medicaid expansion.
  A lot of politicians in Washington tried to convince people, both 
here and around the country, that Medicaid was about some other person 
over there, some person that you didn't know, some person that you may 
not have to be too concerned about, or so the argument went--that 
Medicaid was not about you or your family. It was about some other 
person. The implicit message was this: Don't worry about them. They 
probably don't need it, and you can vote for repeal and everything will 
be OK for the country.
  Well, we know now better than ever, probably, in the last 2 years 
since that debate and the ongoing debate we had starting in 2017 and a 
debate, frankly, that has been playing out over many years, that 
Medicaid is not a program for someone else. It is an ``us'' program. 
Medicaid is about us, about who we are as a country. It tells us a lot 
about our values--whom we value, for whom we will fight, and whom we 
stand up for.
  Medicaid provides coverage--basically, if you wanted to simplify it--
for three groups of Americans: seniors, kids, and people with 
disabilities.
  In my home State of Pennsylvania, Medicaid could be simplified this 
way. It is an oversimplification, but it is a good way to describe it 
in numerical terms. Medicaid is a 40, 50, 60 program--40, 50, 60, 
pretty easy to remember.
  Forty percent of all the births in Pennsylvania--the national number 
is actually higher--and roughly 40 percent of all the kids in our State 
have Medicaid. The 50 is when you look at this through the lens of 
individuals with disabilities--certainly, for children with 
disabilities. It is actually 54 percent of children with disabilities 
in Pennsylvania who get Medicaid. It is a big number, and those 
families don't want to hear talk of repeal or talk of eliminating 
Medicaid expansion or talk of in any way undermining Medicaid itself.
  How about 60? Where does the 60 come in the 40, 50, 60 equation? The 
60 are people in nursing homes. So there are a lot of families out 
there who may not have realized before but certainly after 2017 and 
2018 that their loved one--their mom or their dad or their grandparent 
or relative, or their grandmother or grandfather--was getting into a 
nursing home in many cases solely--solely--because of the Medicaid 
Program. They couldn't get there any other way. They couldn't afford it 
unless you could shell out tens and tens of thousands of dollars a year 
for long-term care.
  So Medicaid affects that many people just in Pennsylvania--literally 
millions in our State. That is just one State. The numbers are very 
similar across the country.
  The exact numbers for Medicaid expansion in Pennsylvania exceed 
700,000. So after the Affordable Care Act was passed and then 
implemented after 2010, over the course of several years we gained 
coverage in Pennsylvania of over 1.1 million people--a big number.
  Unfortunately, because of the administration's sabotage over the last 
2 years, that number has gone down. It is still above 1.1 million, but 
it is going down.
  The Medicaid expansion part of that, of course, was over 700,000 
people.

[[Page S2724]]

  Now comes the administration's budget--this current budget proposal 
by the administration, which I predict will be rejected by the 
Congress. But we have to make sure it gets rejected because one of the 
proposals in that budget is to cut Medicaid by a trillion and a half--
$1.5 trillion--over 10 years.
  The other reality here is that the official Republican position on 
the Affordable Care Act and related issues is that they, the Republican 
Members of Congress, want to eliminate Medicaid expansion over time--
not just to cut it, not to change it, but to eliminate it. They want to 
eliminate Medicaid expansion, and, of course, based upon the $1.5 
trillion proposed cut, along with other proposals, one after another, 
they want to cut Medicaid itself.
  So when Mr. Park uses words like his concern about the Medicaid 
expansion being greatly enlarged Medicaid programs, or the program 
itself, overall, I worry what he might do as a judge, not just on 
Medicaid expansion, but what he might do and decisions he might make 
based upon Medicaid itself.
  So my original concerns about his arguments about the Affordable Care 
Act are now greatly and significantly increased because of what he has 
said about Medicaid itself, indirectly saying that he is not sure 
whether Medicaid itself would be worthy of the kind of support that it 
is going to require over time.
  So I have real concerns on Medicaid.
  The PRESIDING OFFICER. The Senator from Maryland.