[Congressional Record Volume 165, Number 98 (Wednesday, June 12, 2019)]
[Senate]
[Pages S3347-S3354]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
Medicaid
Mr. CASEY. Madam President, we are on the floor, and I will be joined
by colleagues to talk about the program we know as Medicaid--a program
that I think we are beginning to appreciate more, especially in the
last couple of years--and the impact it has on the American people.
Unfortunately, the debates on healthcare have resulted in Medicaid
becoming a target. Too often, both in the Senate and in the other
body--the other body, the House--the Medicaid Program has been the
subject of attempts to do at least one of three things, if not all
three.
One is attempts to decimate the program by way of funding cuts over
the next 10 years. We know the President's budget has proposed cutting
Medicaid by $1.5 trillion over 10 years--that is with a ``t''--roughly,
$150 billion each and every year for 10 years. That is a bad idea, and
we are going to fight that with all we have.
Other attempts to slash Medicaid have been perpetuated over time,
either to cut it over 10 years or to cut it in a particular year.
The third thing we have seen is sabotage efforts by the
administration when it comes to the exchanges resulting from the
Affordable Care Act but also attempts to sabotage the Medicaid Program
itself. I will develop that in a moment in terms of the attempts by the
administration.
Medicaid is a program that, I think, tells us who we are as a nation.
We are a great nation for a number of reasons. We all know we have the
strongest military and the strongest economy. When we are at our best,
we are an example to the world. We are also the greatest country in the
world because of the way we attempt--don't always do the right thing
and don't always do as much as we should--but because of our attempts
to take care of folks who need help and to give opportunity to folks
who might need a door to be opened or an opportunity to be presented to
them.
Medicaid is one of those examples of American greatness when we get
it right. Medicaid is the program that we know is responsible for
making sure seniors can get into nursing homes. Absent Medicaid,
millions of seniors wouldn't be able to have the benefit of skilled
care in a nursing home. Something on the order of 60 percent of seniors
have an opportunity to get skilled care because of Medicaid. Absent
Medicaid, it is highly likely they wouldn't be able to get that care,
especially when you consider the cost of care to just one family. It
would cost tens and tens of thousands of dollars.
Medicaid is the program that takes care of a huge share of the
Nation's children, and a subset of that, of course, is children with
disabilities. We are told, just in Pennsylvania alone--the most recent
number I have seen--54 percent of children with disabilities have their
healthcare provided to them by Medicaid. Thank goodness that is the
case, and we have to make sure that continues.
Just consider the birth of a child. We know, whether it is
Pennsylvania or the Nation, the number exceeds 40 percent. Forty
percent of all the births in the country--more than 40 percent, I
should say--are paid for by the Medicaid Program. So the Medicaid
Program affects the family in so many different ways: the family, when
it comes to a birth, in very high numbers across the country; the
family, when it comes to providing healthcare for children and to give
children the opportunity not just to have coverage and insurance but to
have early screening, early diagnosis, and testing--the kind of
preventive care, in a sense, that we hope anyone would receive but
especially a young child.
Medicaid, of course, goes from, to use Senator Hubert Humphrey's
line, ``the dawn of life to the twilight of life''--from children all
the way through to older Americans and folks in between there who might
have a disability. Probably every Member of the Senate has received a
letter from a family who has a loved one with a disability, especially
a child, expressing how Medicaid is important to them.
We all know these debates are critically important to what happens to
Medicaid. If we allow the majority in the Senate, and if we allow the
administration to have its way, we would have substantial cuts to
Medicaid--maybe not a trillion and a half, as the administration has
proposed, but substantial cuts that would hurt the American family.
I wanted to highlight some of the ways I mentioned earlier that the
administration has tried to sabotage Medicaid. That is my view of it.
Here are some examples: Starting in January of 2018, the administration
undertook an effort to allow States, for the first time, to take away
Medicaid coverage from people who are not working or who are not
engaged in work-related activities for a specific number of hours each
month. In Arkansas, for example--this was the first State to implement
this new policy by the administration--over 18,000
Medicaid beneficiaries lost coverage in 2018 due to the new
requirements. Almost one in four people were subject to the new rules.
While a Federal district court recently struck down restrictive
waivers in both Arkansas and Kentucky, the Centers for Medicare and
Medicaid Services, the so-called CMS, continues to approve these
policies in additional States.
So that is one attempt to knock people off Medicaid in the calendar
year 2018--18,000.
Another attempt was in the State of Utah. HHS, Health and Human
Services, a Federal agency, has also approved an unprecedented
authority for States to deny coverage for people who otherwise would be
eligible for Medicaid. This authority undermines Medicaid's guarantee
of healthcare coverage to low-income people who meet the eligibility
criteria set by Congress.
Earlier this year, Health and Human Services approved a proposal to
allow the State of Utah to cap enrollment based solely on State funding
decisions. So, in other words, once the number of enrollees reaches the
State's funding cap, other eligible people would be shut out of
coverage. An arbitrary enrollment cap limits enrollment on a first-
come, first-serve basis and would treat similarly situated people very
differently, depending on when they apply for coverage, effectively
holding low-income people's healthcare coverage hostage--hostage to
State lawmakers' annual budget decisions on how many people should get
coverage. So this is another way to limit Medicaid coverage.
[[Page S3348]]
Now, Health and Human Services is reportedly working on a block grant
guidance for States that could give States the latitude to cut coverage
of services or provide payments in ways not allowed under Federal law.
So here are just a couple of examples of what the administration is
doing that I would argue is sabotage: cutting Medicaid by providing
waivers that have not been provided before to the States. I don't think
coverage of Medicaid should be determined by a purely budgetary
decision at the State level. States have to balance their budget. They
have constraints. The Federal Government should ensure that anyone who
is eligible for Medicaid should receive it. There are those who say:
Well, if you go down that path, the Federal Government will not be able
to afford it.
I have heard words used on this floor and other places around the
Capitol that the cost of Medicaid is ``unsustainable.'' That is the
word that is used over and over--unsustainable.
I wonder if the same people, the same Members of Congress, use the
word ``unsustainable'' for corporate tax cuts that went into effect
starting in late 2017, where there was a corporate tax reduction voted
on in the Senate where that reduction went from a 35-percent rate down
to a 21-percent rate. The original idea was to go from 35 to 20, and it
ended up at 21. So that is a 14-point reduction in the corporate tax
rate. We were told, if we did that, if we all agreed to do that--I did
not agree with it--but if we were to agree to do that and the bill went
through and became law, which it did, that somehow wages would be
increased for workers across the board. In fact, the White House, at
that time, promised that wages would go up $4,000 per worker--$4,000. I
haven't had a steady stream of workers coming to my office saying they
got a $4,000 wage increase because of the December 2017 tax bill. In
fact, they are telling me the opposite. Many of them are paying more
than they were before that tax bill.
I make that point and relate it to Medicaid very simply because the
same folks who talked about and have advocated for and even voted
repeatedly to cut Medicaid are the same folks who often supported a
corporate tax cut that cost over a trillion dollars and was not paid
for. Then the same people say: Oh, my goodness. We have a trillion-plus
hole in the budget so we have to go and cut Medicaid or Medicare. So
what results now is a little more than a year later--a year and a half
later, after the tax bill passed, what do we have? We have the
administration coming forward saying: We have to cut Medicaid by a
trillion and a half over the next 10 years and Medicare by over $845
billion over the next 10 years. That is the tradeoff: cut Medicaid and
Medicare, in essence, to pay for a corporate tax cut.
Remember, every point they reduce that corporate tax cut--when they
went from 35 to 34, the cost of that is $100 billion over 10 years.
Then, when it went from 34 to 33, another $100 billion is implicated in
that cut, and you can see the reduction. For every point of the
corporate tax cut, it will cost the Nation, over 10 years, $100
billion.
So when folks start talking about the cost of Medicaid being
unsustainable, I just think that is a camouflage for what they really
want to do, which is to cut Medicaid and reduce those who are eligible.
I am going to try, with everything I have, to prevent them from doing
that because last time I checked, Medicaid was a program about us. It
is an ``us'' program, not a program for someone over there--someone who
is distant from us. Medicaid, as we found out most recently in the
debates about healthcare, is a program about us, about who we are. It
is about babies being born. It is about kids with disabilities. It is
about children who live in families who are very low income. The
families are thereby eligible for Medicaid, and that child not only has
coverage but has the kind of early preventive healthcare we would hope
every child has.
And Medicaid is also about the members of our family who are senior
citizens trying to get skilled care.
So we are going to have a long discussion today, at least for the
better part of an hour, about Medicaid, and I am grateful that
colleagues of mine are willing to come to the floor and talk about this
critically important program and what is at stake for our families.
Mr. BROWN. I want to join my friend Senator Casey today to talk about
the importance of Medicaid. I want to echo his comments and Senator
Wyden's comments, particularly given the attacks from the White House
and State legislatures and, frankly, too many in this body.
I am still incredulous when I think about what happened in this body
and has happened many times. In my State, 900,000 people have insurance
because of the Affordable Care Act. The expansion of Medicaid meant
hundreds of thousands of families can rest easier knowing they will
have health insurance when they need it.
I have sat in this body a number of times and watched my colleagues--
mostly on that said of the aisle, well-dressed, well-paid, health
insurance paid for by taxpayers--who are willing to cast a vote to take
insurance away from hundreds of thousands in their States. Again, these
are elected officials who have taken an oath of office, who have
insurance paid for by taxpayers, and they are willing to take insurance
away from others.
I will illustrate with one story. Fourteen people in Ohio die every
day from an overdose--more than any State in the country. I know it is
a serious problem in Montana and a serious problem all over the country
but more in Ohio than most places. Our State legislature wants to make
it harder for Ohioans to get that care and so does President Trump.
President Trump continues to try to take insurance away.
These aren't people sitting at home. Most of these people under
Medicaid expansion were workers making $10, $12, and $15 an hour,
working every bit as hard as Senators do, but they don't have jobs that
provide insurance so they depended on the expansion of Medicaid. These
are people working hard.
This President wants to take their insurance from them. Senator
McConnell, down the hall, wants to take their insurance from them. They
cast votes. This isn't hyperbole or me making this up.
Let me tell you a story real quick. One of the best treatment centers
in Ohio is called Talbert House. I was at Talbert House one day in
Cincinnati. I sat with a man and his daughter. He turned to me, put his
hand on his daughter's arm, and said: Without Medicaid, my daughter
would be dead. How dare Members of this body--elected officials who are
supposed to represent the public interest--take away insurance from
people like his daughter. Every day I just can't believe it.
Mr. CASEY. Mr. President, I will at this time yield the floor to my
distinguished colleague from the State of Washington, Senator Murray.
We are honored by her presence here on the floor. I will come back a
little later.
The PRESIDING OFFICER (Mr. Cramer). The Senator from Washington.
Mrs. MURRAY. Mr. President, I want to thank my colleague for starting
this really important discussion that all of us should be very well
aware of, and I appreciate his leadership.
People across this country have been absolutely clear. They want us
to fight for families who are struggling with high healthcare costs and
help to make sure that everyone in our country can get quality
affordable care. But while Democrats have been coming forward with
solutions and calling on Republicans to come to the table to address
the healthcare sabotage they have helped President Trump accomplish,
instead, they have been repeatedly on the other side, refusing to fight
the fire and having only just shown real interest in fanning the
flames.
There are so many glaring examples about how President Trump has
worked to sabotage families' healthcare. We are here today to focus on
just one--the tireless efforts to undermine Medicaid.
It is a program that helps people across the country get affordable,
quality healthcare. State after State has now worked to expand Medicaid
in recent years, and time after time, we have all seen the benefits of
those efforts. Data shows us that Medicaid has helped reduce racial
disparities in healthcare. It has helped us increase
[[Page S3349]]
access to treatment for opioid use disorder. It is a critical need as
our country confronts a nationwide epidemic. It has helped to improve
maternal and infant health, another area where we desperately need to
make progress.
Medicaid expansion has helped tens of millions of people get quality,
affordable healthcare. That is exactly why States that expanded
Medicaid have seen their uninsured rates drop more than those that did
not.
Yet some Republicans have tried every trick in the book to try to
undermine that progress. Back when Republicans were first calling for
their harmful TrumpCare plan, they made clear that they wanted to put
Medicaid on the chopping block in a very big way--not only rolling back
Medicaid expansion but proposing deep cuts for moms and kids and people
with disabilities and seniors who need those long-term services and
support. Even after people across the country spoke up and pushed back
and defeated that backward proposal, Republicans have still tried to
take away care from millions of families across the country who rely on
Medicaid.
President Trump has called for enormous cuts to Medicaid in his
budget proposals. He has pushed for burdensome paperwork requirements
that serve no real purpose except to put up barriers that make it
harder for people to get the care they need and easier for him to take
their care away.
Here in Congress, Republican leadership made clear that their
preferred way to pay for the expensive tax breaks they gave to
corporations and the wealthy was to cut programs like Medicaid that
gave healthcare to those who struggle and are in need.
Even as President Trump and Republicans fight against the wishes of
people across the country for these backward proposals, they are
fighting to dismantle Medicaid in court as well.
If President Trump gets his way in his blatantly partisan lawsuits,
not only will protections for people with preexisting conditions be
struck down, not only will young adults be dropped from parents' plans,
not only will essential health benefits that ensure coverage and that
include prescription drug coverage and maternity care and more go away,
not only will lifetime annual caps on coverage return--even for people
who are insured through their employer, by the way--but if President
Trump has his way in court, Medicaid expansion also will be struck down
and tens of millions of families in this country will have the care
that they rely on today taken away.
That is wrong, and Democrats are not going to stand for it. We are
going to be here to defend patients' care and look to expand coverage
and improve quality for families.
I am really proud that my home State of Washington is leading the
way. In my home State, instead of taking Medicaid away from people, we
are taking on even more challenges through the program. Our State is
showing how Medicaid can help to provide people with long-term care
benefits in their home, and how it can help address employment
challenges and housing needs and other social determinants of health
that improve the health of our entire communities.
In short, we are showing how Medicaid can do more, while many
Republicans here in the Nation's Capital are trying to get it so it
does less.
Enough is enough. It is time for Republicans to stop sabotaging our
families' care, stop trying to take coverage away from families and
make it more expensive and out of reach, stop trying to undermine
Medicaid and the lives of the millions of people who rely on it and
start working with Democrats to fight for patients and for families.
If Republicans want to keep sitting by and cheering on the harmful
healthcare sabotage proposals, they are going to keep seeing families
and patients and Democrats standing up to hold them accountable.
I yield the floor.
The PRESIDING OFFICER. The Senator from Pennsylvania.
Mr. CASEY. Mr. President I want to thank my colleague from the State
of Washington for outlining the challenges presented now to Medicaid in
terms of efforts by Republicans, which I have described with three
words: decimate, slash, and sabotage. I think all three are an accurate
description of what they have tried to do.
But I am also grateful that Senator Murray was highlighting some of
the great benefits of the program in her initial remarks on the floor.
We just had a report yesterday from a great organization called
Protect Our Care. I will not read the entire report, but I was struck
by a few findings that they summarized in that report, quoting from
various studies about the impact of Medicaid. Here are just a few. A
number of these findings relate to Medicaid expansion, which was the
expansion of Medicaid that became law when the Affordable Care Act was
passed back in 2010, but it is only now, years after Medicaid expansion
has gone into effect, that the impact is being felt in a very positive
way.
For just a couple of highlights here on Medicaid expansion, for
example, expansion was associated with lower rates of maternal
mortality. In this case, the research was done by the Georgetown
University Center for Children and Families. The research also found
that States that had expanded Medicaid experienced 1.6 fewer maternal
deaths per 100,000 women than States that refused to expand Medicaid.
As folks might remember, the law allowed States to expand Medicaid,
but a number of States had not taken advantage of that. There is a
clear advantage for States that expanded on this indicator for maternal
mortality.
A second finding, in addition to reducing maternal mortality, is that
Medicaid expansion has also been associated with a significant
reduction in infant mortality.
A study published in the American Journal of Public Health in April
of 2018 found that the decline in infant mortality was more than 50
percent greater in States that expanded Medicaid, compared to those
that did not. So there is a second finding on infant mortality.
Beyond improving health surrounding childbirth, Medicaid expansion
improves access to family planning. A University of Michigan study
found that one-third of women enrolled in the State of Michigan's
expanded Medicaid Program reported that their coverage improved access
to birth control and family planning services.
Michelle Moniz, a doctor, the study's lead author, concluded that her
team's findings ``suggest that the expansion provided an important
service for populations with a high unmet need for family planning
care.''
So there are just three examples and three different studies, with
one validating the benefit of Medicaid expansion to reduce maternal
mortality. So fewer pregnant mothers are dying, in the case of one
study, because of Medicaid expansion.
The second study is talking about reducing infant mortality because
of Medicaid expansion, and the third says that, because of Medicaid
expansion, there is improving access to family planning.
So those are just three examples in three different studies about the
benefit of Medicaid expansion.
Unfortunately--and it is important to put this on the record--when
you see the Republican bills to repeal the Affordable Care Act, every
one of them seems to have one thing the common: They don't simply talk
about limiting Medicaid expansion. They don't just talk about cutting
it back. A number of these proposals that we have debated here--and I
guess we only had a vote in the Senate on one--they all have in common
that they want to eliminate Medicaid expansion--not just cut it but
eliminate it.
Somehow, for some reason, and I will never understand this, my
Republican colleagues want to get rid of Medicaid expansion. They seem
to think it was a bad thing, that it was a bad result for the American
people that Medicaid expansion became law and States were able to take
advantage of it, increasing the number of people covered by something
on the order, at last count, of 12 million people.
Why is it a bad thing that 12 million people got healthcare? I will
never be able to understand that, as long as I live. Why is it wrong,
why is it bad that 12 million more people got healthcare through
Medicaid expansion?
Is it also then, by extension, a bad thing to reduce maternal
mortality? Is that a bad thing as well? Is that a bad result? Is it
also a bad result of Medicaid expansion that we were able to
[[Page S3350]]
show in States that expanded Medicaid that infant mortality goes down?
Is that a bad result? Is it a bad result in States that expanded
Medicaid, as opposed to States that did not, that in addition to the
reduction in maternal mortality and infant mortality, that there was
access to family planning? Is that a bad thing as well?
I don't think many Americans would reach that conclusion. They would
argue, I think, just upon the coverage question, that 12 million people
or more getting healthcare is an advancement--that we are all better
off when 12 million get healthcare coverage.
There seems to be a prevailing point of view here among some that if
the guy next to you gets healthcare, somehow that diminishes you. That
is contrary to all the evidence, contrary to all the studies about
coverage. But in the case of Medicaid expansion, it is not simply that
12 million more Americans got coverage, but now there is empirical data
and empirical results that tell us that maternal mortality is likely to
go down and infant mortality is likely to go down. That is a good
result.
That is why, when people talk about cutting Medicaid by a trillion
and a half over the next 10 years, or eliminating Medicaid expansion,
they have some explaining to do.
Now, maybe if they have a study showing that in States that did not
expand Medicaid they have a strategy to get infant mortality numbers
down and maternal mortality numbers down, let's hear the competing
argument. I haven't heard that, though. I am still waiting for it.
Here is another good result of Medicaid expansion. It has also proven
to be a potent tool for reducing--this is according to the Protect Our
Care report from yesterday. Again, I am still quoting from it. Medicaid
expansion has proven to be a potent tool for reducing racial
disparities in healthcare. Black babies are twice as likely, according
to this report, as White babies to be born at low birth weight, and are
1.5 times as likely to be born prematurely.
One study published in the Journal of the American Medical
Association in April 2019 found that when considering low birthweight
babies and preterm birth outcomes overall, Medicaid expansion was
associated with significant improvements in relative disparities for
Black infants compared with White infants in States that expanded
Medicaid versus those that did not--significant improvements in
relative disparities. That is a good result we know about now--not a
theory, a good result from Medicaid expansion.
I will give you another one. This is about opioid use disorder. I
have no doubt that the problems we have had all across the country--the
epidemic of substance use disorder, a subset of that being the problems
with opioid addiction--and all of the horror and misery and
skyrocketing deaths from that scourge, that public health emergency--I
have no doubt that the concern about that is bipartisan. We have done a
lot of bipartisan work here in the Senate to dedicate new dollars--
billions and billions of dollars--to help on that. The only problem is,
we need many billions more just to meet the treatment needs of those
who are already in that awful grip of an opioid addiction.
We have bipartisan concern and bipartisan action. That is good. I
want to acknowledge that. But here is the problem: When it comes to
Medicaid expansion's role, there seems to be a little disconnect
between and among Members of the Senate on that.
Here is what Protect Our Care tells us: Multiple studies suggest that
Medicaid expansion plays a crucial role in improving access to
treatment for opioid use disorder.
A February 2018 Center on Budget and Policy Priorities analysis of
data from the Federal Agency for Healthcare Research and Quality found
that Medicaid expansion dramatically reduced--I will say it again--
dramatically reduced the share of opioid-related hospitalizations in
which patients were uninsured, so making sure that more people in the
grip of that addiction who present themselves for help actually have
insurance coverage.
Here is a quotation from the Center on Budget and Policy Priorities
study: ``The share of hospitalizations in which the patient was
uninsured fell dramatically in states that expanded Medicaid: from 13.4
percent in 2013 (the year before expansion took effect) to just 2.9
percent two years later.'' So it went from roughly 13 percent down to
basically just 3 percent. So that is another result.
I have to ask the question again. Why is it a bad thing that roughly
12 million people got health insurance through Medicaid expansion? Why
is it a bad thing that Medicaid expansion now has a demonstrated track
record on reducing infant mortality and maternal mortality and helping
begin to bridge a racial disparity between a child who happens to be an
African American child versus a child who is not? Why is that a bad
thing?
Why would you propose, with that track record--and I am only
mentioning a few--why would you propose eliminating the program? That
seems to be the prevailing point of view in virtually every healthcare
bill that is offered on this side of the aisle--to take Medicaid
expansion and eliminate it over time. Why would you do that?
I could understand better the argument where they said: Well, look,
we have a new idea. We have an idea that will reduce infant mortality,
maternal mortality, bridge some of those racial gaps, and cover 12
million people with a new program, a new approach. I would listen a
little then and maybe consider their ideas. But when you call for the
elimination over and over again of a program with that track record in
just a couple of years--and this isn't longitudinal data over decades;
we know right away the benefits of more people getting coverage, more
children getting treatment, and people in the grip of an opioid
addiction having insurance and therefore having coverage.
In Pennsylvania, there are tens of thousands of people--not
thousands, tens of thousands--who are getting treatment for an opioid
or substance use disorder condition solely because they happen to live
in a State that expanded Medicaid. If they lived in a State that didn't
expand it, they would be pretty much on their own when it comes to
getting treatment or services for that kind of an addiction.
I really have trouble understanding what my colleagues have
presented. If you want to introduce a bill to change healthcare, I
think it is incumbent upon you to have an alternative, have a better
way of covering as many people, have coverage that is affordable, and
have a strategy that will accomplish what we have already accomplished
through the Affordable Care Act. That number is even bigger. It is the
Medicaid expansion number plus folks who get their coverage through the
exchanges. That number is above 20 million.
So if you have a better proposal, you ought to present it. But they
haven't. That is unfortunate because now we are facing the prospect of
not just proposals that could pass and be signed into law by this
President that would destroy the opportunity for 20 million people to
have healthcare, but a big share of that would be cutting Medicaid
expansion.
The other part that is a direct threat to Medicaid itself is the
lawsuit making its way through a Federal court. I have heard a number
of my colleagues say: Oh, no, we want to preserve protections for
preexisting conditions. We want to preserve most of Medicaid. We want
to cut the costs, and we want to preserve it.
Well, if you have those goals, if you say you are really for having
all those consumer protections from the Affordable Care Act, and if you
really care about seniors getting into nursing homes because of
Medicaid and you care and you want to preserve that, and you care about
kids with disabilities who have their healthcare through Medicaid and
you want to preserve their healthcare, and you want to preserve
healthcare for kids from low-income families through Medicaid--if you
believe all that, you have to oppose the lawsuit. You can't make the
argument that you care about those Americans and you care about
healthcare and protections and all of that and then say you support the
lawsuit. You have to come out against the lawsuit.
Make a statement--you should if you are serious about it, if you are
honest about it--or maybe file something with the Federal court, maybe
a formal filing to say: Here is why I oppose the
[[Page S3351]]
lawsuit. File a brief. Do something. But at least tell the American
people the truth. If you are going to be for preserving these kinds of
protections, you can't be for the lawsuit. In fact, you would have to
be unalterably opposed to the lawsuit if you really care about those
kinds of major healthcare issues, including Medicaid.
If you were really concerned about Medicaid and you wanted to
preserve most of it and you had ideas about how to change it for the
better, you can't support the sabotage by the administration because
the effect in a number of these States with these waivers is that
people lose their Medicaid coverage--as I said, we now know that in
2018, 18,000 people in Arkansas lost coverage. That will be replicated
in other States. Tennessee now is one of the States considering a
block-grant proposal. Utah--I mentioned what they are doing--tying
Medicaid to the State budget, instead of covering folks who are
eligible as opposed to tying coverage and care to how much money is in
the State budget.
I think that if you are going to make an argument in favor of
Medicaid, you have to oppose the lawsuit and you have to stop the
sabotage.
The third thing you can do to be honest about what you say you
believe in--and constructive here--is to say we shouldn't cut Medicaid
by $1.5 trillion over the next 10 years, as the administration
proposed. Just say you are against what the administration proposed and
you don't think we should cut it by $1.5 trillion. And you should add
your opposition to the cuts to Medicare. The administration proposal is
to cut Medicare by $845 billion over 10 years. You should oppose that
as well.
If you do that--if you oppose the sabotage, oppose the lawsuit, and
oppose the budget cuts--then we can have a conversation about lowering
the cost of healthcare, lowering the cost of prescription drugs, and
preserving Medicaid as much as humanly possible even when costs go up.
It is pretty apparent to me that a lot of Americans rely upon Medicaid.
How about if you represent a State, for example, that has a
substantial rural population? I represent the State of Pennsylvania,
which has 67 counties, but 48 of them are considered rural. We have a
lot of rural communities, a lot of counties where there may not be
agriculture in every corner, but there are a lot of small towns and a
lot of rural communities, and they tend to be one and the same. These
are communities that are faced with several levels of challenges. They
often have job loss because a substantial employer has left. They often
have infrastructure problems because they have a lot of bridges that
are structurally deficient. They have all kinds of other economic
challenges that sometimes relate to the markets and agriculture and so
many other problems. Many of these communities also have a so-called
digital divide--they are living in a county where 40, 50, 60 percent of
the people who live in that county don't have access to broadband,
high-speed internet.
In addition to all those problems in some rural areas, they also have
a problem with healthcare access. The good news here is that there are
a lot of kids in rural areas who get their healthcare through--guess
what--Medicaid. Big numbers. In some places, the numbers of children
covered by Medicaid and the Children's Health Insurance Program are
much higher than in urban areas.
In a rural area, if you start cutting Medicaid and eliminating
Medicaid expansion, as many around here want to do, you are not only
going to hurt a child in an urban community or in a small town, but you
are also going to hurt a child in a rural community very badly.
It gets worse from there. If you cut Medicaid, rural hospitals that
are already on the brink of failure or bankruptcy or at least downturn
in their ability to balance their budgets--a lot of those rural
hospitals will fail. We know that. The data is pretty clear on that.
If all of your focus is on a rural area and you think rural children
should have the chance for good-quality healthcare, and if you think
rural hospitals--sometimes the biggest employers in a community--should
remain open, you should really care about Medicaid. You should really
be worried about proposals to cut it by $1.5 trillion over a decade, as
the administration proposes. You should be very concerned about
proposals to eliminate Medicaid expansion because guess what is another
challenge in a lot of these communities--the opioid substance use
disorder crisis.
My colleagues are here, and I want to make sure they have an
opportunity to weigh in as well. We are privileged to be joined by two
colleagues.
I yield the floor to my colleague from the State of Oregon, the
senior Senator from the State of Oregon.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Mr. President, before Senator Casey leaves the floor, I
just want to make a couple of remarks, as the senior Democrat on the
Finance Committee, a ranking member. I particularly want to praise
Senator Casey for being our go-to person on the whole issue of
Medicaid.
Ever since we began to see the substantial cuts in 2017, as Senator
Casey knows, he has been the person we have said is our go-to leader
for the most vulnerable Americans who count on Medicaid being there for
them.
I want to tell a short story about one of Senator Casey's many
contributions to those who find Medicaid to be just a healthcare
lifeline. When the Trump administration began its attack on Medicaid
benefits, I had been the director of the Gray Panthers at home before I
got involved in public service, and a lot of folks came to me. They
said: Ron, that probably isn't a big deal for seniors because Medicare
covers most of those nursing home bills. And I had to say: Gosh, that
is really not the case. Medicare really covers only a small fraction of
nursing home bills. It covers the bills that are essentially for
hospital-like services, and most of nursing home care in America really
ends up getting picked up by Medicaid. Something like two out of every
three beds in long-term care facilities, which are custodial
facilities, end up being funded by Medicaid.
Senator Casey basically took it upon himself, as part of this effort,
to lead the Democrats on the Finance Committee and to lead the
Democrats in our caucus to go out and talk about what this really means
to the most vulnerable people in America. As my colleagues know,
probably 4 or 5 months into this debate with this relentless attack on
Medicaid coming week after week after week, most Americans began to
understand a little bit about what was on the line for millions of
senior citizens.
I thank my colleague because he really began the effort to make the
point that growing older in America is really an expensive proposition.
Even when you save and you scrimp, you don't go on a vacation, you
don't buy the boat, and you don't do the extra, growing older is really
an expensive proposition. So if you have a widower on the corner in
your neighborhood, and he always mowed his lawn, and he always helped
with the sports teams and the like, and now he is getting kind of frail
and may need some nursing home care, now we still have a safety net, an
essential safety net for those people.
I am going to talk a little bit about some of the challenges of
Medicaid. But I would like particularly to begin my remarks--Senator
Cardin has been an advocate in the Finance Committee, as well, on
Medicaid--by pointing out that Senator Casey, really, at the very
outset of this discussion, began the effort to make the case that a lot
of people weren't aware of, and that is that Medicaid is a safety net
for millions of older people.
Here is the story of Medicaid in 2019. For the vulnerable in America,
our people want to make sure that there is more access to Medicaid.
Unfortunately, on the other side of the aisle, Republicans are taking
that very access away. Just for a few minutes, I am going to draw out
this contrast because there is quite a difference of opinion between
how the majority party in the Trump White House are working against the
interests of vulnerable folks across the country.
As I mentioned, 2016 saw the beginning of this all-out attack by
Republicans on Medicaid--hundreds of billions of dollars in cuts,
proposed caps, block grants, basically an unravelling of the program as
we know it today.
Essentially, from Portland, OR, to Portland, ME, people said: No way.
We
[[Page S3352]]
are not going to support this kind of attack on Medicaid. So in some
States, like Utah, they chose the ballot box to actually expand
Medicaid under the Affordable Care Act. The voters chose more access to
Medicaid, not less. But Republican lawmakers in Utah had decided to
deny them their choice. Just think about that one.
I sure hear a lot of talk on the other side of the aisle about
States' rights and empowering people at home. This is an example of
where voters chose more access to Medicaid, not less. The Republican
lawmakers said: Hey, we know better than that. We are not going to give
folks that choice. So Utah lawmakers took a hatchet to the plan that
voters approved on election day and started carving it out. The only
expansion they would allow is a lot smaller than what voters wanted--
spending more money to cover fewer people.
Then lawmakers in Utah followed a path cleared in other Republican-
controlled States, and that was to punish those who were enrolled in
Medicaid with essentially bureaucratic water torture, with such a
barrage of paperwork that it was almost impossible to penetrate what
was really necessary to get through the program. This has been seen in
Arkansas, Kentucky, and elsewhere.
All of this, of course, is not couched in the bureaucratic maze of
redtape it actually is. The discussion is always: Well, this is just
about work. That is just not true. It is about getting people kicked
off their healthcare.
When you talk about Medicaid patients, you are talking about people
who are working and people who want to work. What we are up against are
a host of Republican schemes that are basically putting stacks of
paperwork between those who need healthcare and their doctors.
These are busy working people with kids to raise, older parents to
care for, and bills to pay. Yet lawmakers are trying to force them to
fill out stacks and stacks of paperwork just to make sure that somebody
can actually find their way through the maze and see a doctor.
If you look at what happened in Arkansas in 2018, you get a sense of
how destructive these bureaucratic schemes are to people's healthcare.
There were 18,000 people who lost their Medicaid coverage--18,000
people. Trump officials swore up and down that those paperwork
requirements wouldn't hurt anybody, but as we saw when the Secretary of
Health and Human Services came before the Finance Committee earlier
this year, they shrugged when you asked why so many people lost their
coverage in Arkansas after the paperwork requirements were put in
place.
A Federal judge even weighed in, blocking all of this paperwork,
while the Trump administration continued to push the States to take
them up. The schemes spread to States across the country, and it was
not just paperwork.
With the Trump administration's blessing, Tennessee is the first
State trying to turn its Medicaid Program into a block grant. This
basically takes a sledgehammer to Medicaid as we know it now. Medicaid
block grants mean putting nursing home care--which I just outlined
earlier in discussing Senator Casey's important role here--at risk for
millions of seniors. You risk children and people with disabilities
having to be cut off from their healthcare. But block-granting Medicaid
is one of the top goals for Republicans in the Trump administration.
Finally, Trump administration budget slashers are trying a new,
additional scheme that is going to hurt so many people across the
country. In this particular area, they basically are trying to bring
some mathematical sleight of hand so they can change key economic
measures in ways that boot vulnerable people off Medicaid and off food
stamps.
What they are doing here--again, this is all shrouded in language
that just sounds eminently reasonable--is basically talking about where
the poverty line ought to be, and then they want to find an artificial
way to push the poverty line down without doing anything to lift people
out of economic hardship. So you are talking about parents who work
long, hard hours and still struggle to make ends meet, people who are
trying to find affordable housing, who have practically given up the
idea of being able to save for retirement, and who are still trying to
pay college tuition. What does the Trump administration say? These
people just have life too easy.
The impact of this change would be enormous. Three hundred thousand
children could lose comprehensive health coverage, and a quarter
million adults could lose their coverage.
Colleagues, this is the Medicaid agenda for Senate Republicans and
the Trump administration: Let's go out there and look under every
possible rock to find a scheme to restrict access to Medicaid. That is
the agenda. Find a way to cut the funding, to deny expansion after the
voters approved it.
We now have two members of the Finance Committee with a long, long
history of advocating for vulnerable people facing health challenges,
so I am going to close and just say this: Ever since I was director of
the senior citizens--the Gray Panthers--I always said that the single
most important issue in America is healthcare. Whether it is North
Dakota or Michigan or Maryland, if you and your loved ones don't have
your health, everything else pretty much goes by the board. Somehow
that message has not gotten through to the majority here in the Senate
because under this majority and under the Trump administration's
healthcare agenda, they are buying into a completely different set of
principles. They are willing to set millions of Americans back with
respect to their healthcare needs. On this side of the aisle, we are
going to keep fighting to protect Medicaid.
As I indicated, our next two speakers have a long track record of
advocating for the vulnerable. I am just going to make a unanimous
consent request. Senator Cardin has been very patient with respect to
waiting to speak.
I yield the floor.
The PRESIDING OFFICER. The Senator from Maryland.
Mr. CARDIN. Mr. President, I thank Senator Wyden for his
extraordinary leadership on the Senate Finance Committee as our ranking
Democratic member, who recognizes the importance of healthcare. To
Senator Casey, who has been our companion in regard to Medicaid, in
regard to children, and in regard to the basic importance of healthcare
as a matter of right, to Senator Stabenow, who has really led our
efforts on behavioral health, incredible efforts that have been made to
provide community services, particularly to those who are most
vulnerable, we recognize the importance of moving forward and advancing
healthcare for all Americans. That is why we are taking this time to
express our real concern about President Trump's proposal, his budget
proposals, which would cut Medicaid by $1.5 trillion, the effort to
repeal the Medicaid expansion that we saw under the Affordable Care
Act, the thought of turning Medicaid at the Federal level into a block
grant, capping our participation and putting the burdens on our States.
It is a direct attack on vulnerable Americans, jeopardizing their
access to healthcare. There are 70 million Americans that depend on
Medicaid. There are 1.2 million Americans who are veterans and who are
women, children, and seniors.
In Maryland, almost half of our Medicaid population are children. For
seniors, one out of every five Medicare-eligible beneficiaries also
needs Medicaid. They are dual eligible. And 60 percent of the adult
Medicaid enrollees are workers, and 70 percent are from communities of
color.
Medicaid expansion has made a big difference in access to healthcare.
It has reduced health inequalities. The uninsured rate in the State of
Maryland has dropped from 10.2 percent to 6.6 percent. That is
important not just for the individuals who now have health coverage. It
stops the cost shifting and the distortions in our healthcare system
with people who do not have health insurance.
If we were to eliminate Medicaid expansion, 289,000 Marylanders would
lose their coverage--the essential health coverage that it provides for
our children in the early periodic screening and diagnostic treatment
so that we can help children live healthier lives through correction of
healthcare problems and prevention of more serious healthcare issues.
As Senator Wyden pointed out, in long-term care, three out of five of
our
[[Page S3353]]
residents in nursing-type, long-term care facilities are Medicaid
payments. It would be devastating with that type of cut on their long-
term care needs.
We made major advancements in Medicaid on covering behavioral health
and addiction. One out of every three individuals who are part of
Medicaid expansion have a behavioral health issue. The opioid crisis is
well known to all of us. We know that part of the solution is getting
people help and treatment through Medicaid expansion and the Medicaid
Program providing that safety net to millions of Americans.
The expansion of dental services is something I have been engaged in
ever since the tragedy in 2007 in my State, when a youngster died from
lack of access to dental care, Deamonte Driver. Medicaid is a lifeline
for dental services.
So in the United States of America, the wealthiest Nation in the
world, healthcare should be a right, not a privilege. We made progress
in the Affordable Care Act. Let us build on that success but not move
in the wrong direction. Rather than cutting Medicaid, we should be
looking at ways to work together to improve coverage and affordability.
Rather than eliminating the Medicaid expansion, we should be looking at
additional ways to cover those who have no health coverage or
inadequate health coverage. Rather than limiting the Federal program as
part of Medicaid for our States, we should be looking at ways to
strengthen the Federal-State partnership so that we work together so
that every American has access to affordable, quality care.
I urge my colleagues that that should be our goal. Let's work
together. Again, I thank Senator Casey for bringing us here today under
this issue.
I yield the floor.
The PRESIDING OFFICER. The Senator from Michigan.
Ms. STABENOW. Mr. President, I was looking to my colleagues because I
think we all understand and are trying to accommodate each other's
schedules and have the opportunity to speak on the floor. So I
appreciate the opportunity to say a few words. I first thank Senator
Casey for organizing this very important discussion on the floor, and
Senator Cardin and Senator Wyden for their passion, and I want to join
them in speaking out about protecting Medicaid.
We are talking about people, the majority in nursing homes. We have
three out of five seniors in Michigan who have nursing home care and
get that through Medicaid, which is critically important, as well as
children and families. So I want to lend my support to them, and then I
wish to expand the talk about another very important piece of
healthcare and how we bring down costs for people.
I have always believed that healthcare is a basic human right and
everyone should be able to afford the medicines they need. We have
seniors in nursing homes that are there. We talked about Medicaid. In
fact, they are more likely than not going to be involved in needing
prescription drugs, some kind of medicines, and I am deeply concerned
that people are not able to get their medications at a price they can
afford to get what they need. Unfortunately, that is certainly
happening in Michigan right now.
As we know, over the past decade or so, the costs of medications have
really skyrocketed. It is actually shocking to see the numbers going
up. Between 2008 and 2016, prices on the most popular brand-name drugs
have gone up over 208 percent. I know that in Michigan most people's
salaries haven't gone up 208 percent. And if someone is living on a
pension or Social Security, that certainly hasn't gone up 208 percent.
So these are huge increases. And according to AARP, the average price
of brand-name drugs that seniors often take rose at four times the rate
of inflation just in 2017--four times the rate of inflation. So even if
you are getting a small little increase, an inflationary increase in
your salary or in a pension, your medicines could have gone up four
times higher.
I hear from seniors all over Michigan about what a struggle this is.
I know we all hear this. Some people are forced to cut back on other
necessities, like groceries or paying their bills. Others cut their
pills in half or skip doses. You know, this has gone on and on for too
long. Some folks stop filling their prescriptions altogether, risking
their health.
Suzanne lives in Howell, MI. She takes several medications, including
insulin, and she shared her story with me. Unfortunately, for Suzanne,
the price for insulin has gone from $21 a month to $278 a month to $410
a month--the same medicine. The same medicine was $21 a month and now
is up to $410 a month.
Suzanne isn't alone. In fact, insulin prices overall have tripled in
the past 15 years, and let me just add that insulin was discovered over
100 years ago by two Canadian doctors who felt they should not be
reimbursed for their patent because this discovery was so important for
changing people's lives and the quality of their lives. They actually
gave the patent to the University of Toronto for three Canadian dollars
over 100 years ago, and yet we are now seeing the price triple just in
the past 15 years.
This places a real burden on people with diabetes and their families.
Suzanne said this:
I don't even take the amount that I'm supposed to take. . .
. We can't put money into our retirement. My husband has to
work past [retirement age] because we can't afford to live.
She added:
This is a life or death drug. I have to have this drug to
live.
Suzanne doesn't take insulin because she wants to. She takes insulin
because she will die without it. Nobody should be forced to risk their
health or their life by cutting back on the medications they need to
survive.
Unfortunately, the pricing of prescription drugs in this country is
the ultimate example of a rigged system. In 2018, there were 1,451
lobbyists for the pharmaceutical and health product industry. That is
almost 15 lobbyists for every Member of the Senate. Their job is to
stop competition and keep prices high. Our job is to unrig that system
and bring prices down. The No. 1 way we can bring prices down is to let
Medicare negotiate.
Currently, Medicare is prohibited, as we know, from harnessing the
bargaining power of 43 million seniors in America to bring down
prescription drug costs. Why aren't we harnessing the market price
through negotiation? That doesn't make any sense.
When Medicare part D became law in 2003, that language was put in
there to stop negotiation. It didn't make sense in 2003, and it doesn't
make sense today.
We know negotiation can work because it works for the VA, or the
Veterans' Administration. The Veterans' Administration negotiates
prices, and they save about 40 percent compared to Medicare. In fact,
according to a recent AARP analysis, Medicare could have saved $14.4
billion on just 50 drugs--$14.4 billion on just 50 drugs--if they had
had the same prices as the VA, and this was in 2016--$14.4 billion.
In 2016, Medicare Part D plans spent $3 billion on a hepatitis C
treatment, HARVONI. Under VA pricing, that cost would have been $1.7
billion. These are differences that are related to real money coming
out of people's pockets when they are trying to just put food on the
table and live their lives and be able to survive in many cases.
Medicare Part D plans spent $1.8 billion on REVLIMID, which treats
multiple myeloma, a type of blood cancer. Under VA pricing, Medicare
Part D and American taxpayers could have saved more than half a billion
dollars. Given the potential for such huge savings, it is no surprise
that the American people support allowing Medicare to negotiate drug
prices.
I hear it everywhere I go: Why can't Medicare just negotiate and get
a better deal--commonsense?
One recent poll showed that 92 percent of voters support allowing
Medicare to negotiate with drug companies. Only Republicans in Congress
and pharma lobbyists are stopping negotiation from moving forward. We
need to change the system and put people before profits. We need to put
people before profits.
The best way to do that is to allow Medicare to negotiate with the
drug companies. That could make a big difference for people like Jack,
who lives in Constantine. Jack was diagnosed with stage IV prostate
cancer late last year. His oncologist wanted him to start taking a drug
called Zytiga. It
[[Page S3354]]
was going to cost an astonishing $15,000 for the first month.
A generic medication had become available, but after Medicare and
supplemental insurance, Jack still would have to pay $3,400 the first
month and more than $400 each month after that.
In his letter to me, Jack wrote this:
I just retired in June, moving back to Michigan to be
closer to my family, and this cost . . . is an extreme
hardship.
He added:
Getting pharmaceutical companies to reduce their price so
an average retiree can afford to use them would be a great
place to start. I hope and pray you and your colleagues on
both sides of the aisle would be able to get something done
so people who need the medication that they need to thrive
and survive are able to get it.
Jack is right. He and Suzanne and other people like them across
Michigan and across the country deserve better than what is happening
right now. I could go on, and I will not, through price after price
after price. The reality is prices are too high. We pay the highest
prices in the world. Every other country gets involved in negotiating
prices on behalf of their citizens.
The drug companies told me at a hearing that they make a profit in
every other country but they make more here. They charge more here.
Why? Because they can.
So it is time for us to work together to allow Medicare to negotiate
drug prices and put people before profits.
I yield the floor.
The PRESIDING OFFICER. The Senator from West Virginia.
Mrs. CAPITO. Mr. President, I stood before this body on December 11,
exactly 6 months ago, to discuss what I called then ``an escalating
crisis on our southwest border.'' Well, 6 months later, I don't think
this is a subject for debate anymore. Not only is this a crisis, but it
is one that has escalated and continues to do so. Congress must take
action or I feel it will come to deeply regret our inaction.
When I called it a crisis in December, 50,000 migrants had been
apprehended crossing our southwest border during the previous month of
November. It is now June, 6 months later, and we are looking at the
numbers for May that approach over 133,000 apprehensions--the highest
1-month total in 13 years.
In 6 short months, the numbers of encounters on the border have
increased by more than 156 percent. Over the past 12 months, the number
has increased by more than 229 percent. Those are staggering figures.
To put this in context for my fellow West Virginians, in the month of
May alone, the Border Patrol apprehended a population that is larger
than our capital city, Charleston; Huntington, WV, our neighbor; and
Morgantown, WV, combined--three of our largest cities in 1 month.
As I said standing at this desk in December, the flow of people
across the border is not only larger but is also changing. Twenty years
ago, the vast majority of those crossing our border illegally were
adult men from Mexico. In fact, in fiscal year 2000, 98 percent of
those people caught at our border were Mexicans. Under U.S. law,
migrants from Mexico can be immediately returned to Mexico by the
Border Patrol, but today we are seeing families and not just adults.
Last month, of the over 133,000 people, nearly 64 percent of those
who crossed our borders did that as a family unit, and the vast
majority of them are from other places than Mexico. They are
Guatemalan, Salvadoran, and Honduran. Of the more than 84,000 members
of family units apprehended by Border Patrol last month, only 547, less
than 1 percent, were from Mexico.
So unlike folks from Mexico, these folks who are coming cannot be
sent home immediately under U.S. law. They remain in our country often
for months or years as their cases work their way through the system.
To summarize, today we have significantly more people crossing our
southern border, and because of who they are, whom they are traveling
with, and where they are traveling from, each of these individuals
causes us to have a more significant strain on our system. Our system
makes it advantageous for migrants from places other than Mexico to
cross the border with children. So more people than ever are making
absolutely sure they are accompanied by a child on their long and often
very dangerous journey from those places through Mexico.
All of these factors I have discussed have completely overwhelmed our
system. Everybody in this Chamber ought to believe that and know it is
true. Conditions at Border Patrol stations that were never intended to
be used as migrant shelters are stunning. These facilities are bursting
at the seams, and our Border Patrol agents are spending more time
caring for these migrants than they are patrolling our border, which is
their core function. At any given time these days, somewhere close to
20,000 individuals are being housed in Customs and Border Protection
facilities not at all conducive to extended stays. In other words,
these facilities were not meant for long stays.
People are upset. It is unsettling seeing pictures of people sleeping
on concrete floors under Mylar blankets. I have been to these
facilities and, yes, it is heartbreaking to see, but when drug lords
are dropping off busloads of migrants in secluded parts of our
southwest border, where there is virtually no infrastructure, there is
not much to be done to improve the situation, unless we provide the
resources to deal with this crisis.
So what is happening? In the last 5\1/2\ months, more than 22,000
family units that crossed our border illegally have been released into
the United States--often without any place to go--and told to come back
when their case comes up, which could be years. I am encouraged by the
President, and I am very supportive of the President's plan and his
administration's, where they successfully negotiated an agreement with
Mexico that will lead to more migrants waiting outside the United
States while their asylum claims are being processed. I believe the
agreement will improve the situation on the southern border when it is
fully implemented.
While we have to work to improve the situation going forward, we have
to address the problem we have right here today. I am the chairman of
the Appropriations Subcommittee on Homeland Security. I must repeat to
this body what I repeated here before, 6 months ago. We do not have a
choice. We do not have a choice, but we must get this emergency
supplemental done. It is the only choice we have from a humanitarian
perspective. It is the only choice we have from a border security
perspective.
If we fail, the Department of Homeland Security will be faced with
even more difficult choices. It will either have to stop their efforts
to improve these horrible conditions on our border or it will have to
raid other agencies that are vital to our national security.
I don't want to see that happen. There was a very robust debate a few
months ago about the crisis on our border. Was it real or was it
manufactured? I stood here 6 months ago and said it is real and, quite
frankly, I don't hear that topic up for debate much anymore. I think we
all know it is real. It is tragic, but we can do something about it.
The New York Times, no less, is now deciding the situation is ``a
nightmare'' and is imploring Congress to stop ignoring this crisis.
It was 103 degrees this past weekend at one of our entry points at
McAllen, TX, which is the epicenter of this crisis. We know it is only
June, and it is only going to get hotter. I hate to see what the
situation will look like this summer if we fail to act.
I will end with this. The men and women of the Department of Homeland
Security who work our border and are trying to process this influx of
people are doing incredibly tremendous work. It is stressful, it is
hard, and in many cases it is not the mission they signed up for when
they joined the Department of Homeland Security, but they have stepped
up to address a national need, and it is past time that we stepped up
for them and for these children and these families in need.
Thank you.
The PRESIDING OFFICER. The Senator from Ohio.