[Congressional Record Volume 166, Number 25 (Thursday, February 6, 2020)]
[House]
[Pages H870-H879]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 EXPRESSING DISAPPROVAL OF THE TRUMP ADMINISTRATION'S HARMFUL ACTIONS 
                            TOWARDS MEDICAID


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
include any extraneous material on H. Res. 826, Expressing Disapproval 
of the Trump Administration's Harmful Actions Towards Medicaid.
  The SPEAKER pro tempore (Mr. Blumenauer). Is there objection to the 
request of the gentleman from New Jersey?
  There was no objection.

                              {time}  1430

  Mr. PALLONE. Mr. Speaker, pursuant to House Resolution 833, I call up 
the resolution (H. Res. 826) expressing disapproval of the Trump 
administration's harmful actions towards Medicaid and ask for its 
immediate consideration.
  The Clerk read the title of the resolution.
  The SPEAKER pro tempore. Pursuant to House Resolution 833, the 
resolution is considered read.
  The text of the resolution is as follows:

                              H. Res. 826

       Resolved, That it is the sense of the House of 
     Representatives that--
       (1) the illegal actions taken by the Trump administration 
     to undermine the Medicaid program, including beneficiary 
     protections, are a cruel attack on a program that provides 
     for the health and well-being for some of our most vulnerable 
     citizens;
       (2) the Trump administration should immediately withdraw 
     its illegal block grant guidance and cease its campaign to 
     undermine and weaken Medicaid; and
       (3) the Trump administration should uphold its 
     responsibility to faithfully execute the law, including the 
     Medicaid Act, and cease any and all efforts that threaten the 
     care of the millions of Americans who rely on Medicaid.

  The SPEAKER pro tempore. The resolution shall be debatable for 1 
hour, equally divided and controlled by the chair and ranking minority 
member of the Committee on Energy and Commerce.
  The gentleman from New Jersey (Mr. Pallone) and the gentleman from 
Oregon (Mr. Walden) each will control 30 minutes.
  The Chair recognizes the gentleman from New Jersey.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to speak in support of H. Res. 826 
expressing disapproval of the Trump administration's harmful actions 
toward Medicaid.
  Last Thursday, the Trump administration continued through its 
relentless campaign to sabotage the Affordable Care Act and its 
unprecedented attack on Medicaid. Despite promising as a candidate that 
he would not cut Medicaid, the Trump administration proposed just that 
last week. It has issued guidance that will allow States to block grant 
their Medicaid program. Just another day and another broken promise by 
this President.
  Unfortunately, like a lot of his other broken promises, this proposal 
could have devastating consequences on the health of millions of 
Americans, including those affected by the opioid epidemic.
  One in five Americans have access to healthcare through Medicaid. 
Block grants limit the amount of Federal dollars States receive, 
forcing them to cut benefits, cut payments to doctors, and tighten 
eligibility standards.
  The administration's proposal is also illegal. Converting Medicaid to 
a block grant would require an act of Congress. Our Republican 
colleagues understand this, and that is why they included a Medicaid 
block grant provision in their failed attempt to repeal the ACA.
  Congressional Republicans know that block granting Medicaid is a 
seismic change in the program that requires a change in the law. I 
would hope that they would be concerned by this illegal action and 
would join us in sending a bipartisan message of disapproval to the 
Trump administration.
  I would also like to refute some claims that you are likely to hear 
during this debate, Mr. Speaker. First, this has nothing to do with 
increasing State flexibility. It is about cutting

[[Page H871]]

Medicaid. States already have significant flexibility to design a 
Medicaid program that works best for them.
  You are also likely to hear that the Trump administration proposal 
only applies to the Medicaid expansion population. But, again, that is 
not true.
  As the Kaiser Family Foundation makes clear, States could include 
many low-income parents and pregnant women who currently rely on 
Medicaid. Now, imagine if States would be allowed to cut pregnant women 
off of their health coverage in the midst of a maternal mortality 
crisis, which we now have.
  At the end of this day, this illegal proposal will lead to lower 
quality of care for fewer people. I encourage my colleagues to support 
this resolution and reject the administration's illegal and cruel 
attack on working families, and I reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in opposition to this resolution. We wouldn't be 
having what is going to be a spirited debate today over the facts if 
the Energy and Commerce Committee had bothered to have a hearing on the 
underlying issue.
  I have asked the chairman, my friend, Mr. Pallone, to do exactly 
that. He cited a source, Kaiser Family Foundation, saying pregnant 
women are going to be involved in all of this. The head of CMS and 
their lawyers say: Not true. Not the case at all.
  So here we have a disputed fact on the floor being hammered out here 
without the benefit of due process and regular order. There has been no 
regular order, no hearing, no opportunity to bring in these very 
qualified people, and do what we do best in this Congress, which is 
listen to the experts, take the testimony, make up our minds, and have 
debates.
  No. The administration put out their letter, their guidance, saying 
here is how States can innovate. Our State of Oregon spent a lot on 
innovation in this space. We were both in the State legislature at 
times, and we sought waivers as a State so we could innovate, create 
the Oregon Health Plan, and do all of these things. Forty States have 
waivers. Most of our States have waivers so they can innovate; so they 
can bring better healthcare to the working poor; and find cost savings 
they can plow back into better services and more services, which is 
what this underlying proposal allows.
  Let me talk about a couple of things: One, there is no mandate here. 
This is not, as my friend describes, some evil-empire approach where 
the Trump administration is forcing something on States. That is 
factually not the case. This is States seeking an option to innovate 
and provide better healthcare at lower costs to the people they are 
trying to serve.
  They would have to meet rigorous standards, including all of the 
essential health benefits required under ObamaCare. That is a 
requirement here. They can't walk away from that.
  This applies to able-bodied adults, not to children, not to people 
with disabilities, on down that list of mandatory populations. This 
does not affect the mandatory. This is only the expansion population in 
the States that expanded Medicaid.
  They are going to argue differently because I heard it in the Rules 
Committee. I can tell you directly from CMS, that is not the case. That 
is not their intent. That is not what they have suggested. That is not 
in their proposal.
  If we are going to have this difference of opinion, I go back to the 
underlying issue here. Why in the devil did we not take an hour or two 
to do regular order and have the Subcommittee on Health, chaired by my 
dear friend from California, Ms. Eshoo, who could have done a great job 
having a hearing? She can be rigorous on the administration. We could 
have hashed this out there. But no.
  This isn't even a resolution of disapproval that stops what the 
administration is proposing. This is the partisan equivalent of a press 
release. It is a sense of Congress saying: We don't like this.
  So when we are done with that, then what happens? Nothing. This is a 
partisan, political, pathetic debate that serves no real legislative 
purpose. Done.
  If you want to argue legislation, the grownup work we do so well at 
Energy and Commerce, then let's have a legislative hearing. Let's bring 
in the Kaiser Family Foundation that was just cited and hold them 
accountable under oath to show us where what they claim is fact. We can 
dispute whether something is legal or not. Let's have the lawyers there 
to give us guidance. But that is not what we are doing.
  On Monday afternoon, this language got posted. We went to the Rules 
Committee. We asked for an opportunity to have an alternative, a motion 
to recommit on this issue. We were denied that. We had no opportunity 
to dig into the facts and the figures.
  We do know one thing: Our States are great laboratories for 
innovation. They really are. California has waivers. Oregon has 
waivers. A lot of States have waivers. We had it back in the day when, 
I think, Project Independence was a waiver from Medicaid because we 
thought we could do it better and be a laboratory.
  This administration believes in that. States can, those closest to 
the people can create even better programs to take care of those they 
serve. This is a Federal-State partnership.
  Mr. Speaker, I object to this resolution.
  Mr. Speaker, I rise in opposition to House Resolution 826; a 
resolution hastily put together that opposes the Administration's 
Healthy Opportunity demonstration initiative in Medicaid.
  The Centers for Medicare and Medicaid Services introduced a voluntary 
proposal to allow states to file for an 1115 Waiver called the Healthy 
Adult Opportunity Initiative. This is an option; let me emphasize, an 
option, for states for certain able-bodied adults-only.
  This optional Healthy Adult Opportunity Initiative does not apply to 
children, seniors, or those with disabilities--just able-bodied adults. 
It is a prepackaged set of flexibilities, most of which are already 
used by states in running their programs.
  There are many provisions in this proposal that we can all get 
behind: lowering drug costs, increasing transparency, and greater 
access to health care. These proposals build on bipartisan legislation 
we've worked on in the past.
  Administrator Verma released a 56-page letter for the demonstration 
initiative on January 30th. Industry groups were already voicing 
opposition to the initiative only an hour later--pretty quick to read 
it and write an opposition to it if you ask me. House members were 
faster than that.
  The day before the plan was released, 36 House members sent a letter 
to Secretary Azar and Administrator Verma opposing the initiative. How 
can you oppose something you haven't even seen?
  The resolution says that the goal of the Waiver Opportunity is to 
deprive Medicaid beneficiaries of health services. But on Page 7, CMS 
points out that any state electing to participate in this demonstration 
initiative will be expected, at a minimum, to provide coverage of items 
and services in the categories of the ACA's Essential Health Benefits 
(EHBs), benefits such as (1) ambulatory patient services; (2) emergency 
services; (3) hospitalization; (4) maternity and newborn care; (5) 
mental health and substance use disorder services, including behavioral 
health treatment; (6) prescription drugs; (7) rehabilitative and 
habilitative services and devices; (8) laboratory services; (9) 
preventive and wellness services and chronic disease management; and 
(10) pediatric services, including oral and vision care, which 
generally are not applicable for the populations that would be covered 
under any state that participates in the Waiver Opportunity.
  The resolution also asserts the initiative would roll back access 
standards. But on Page 4, CMS expressly states that those who 
participate in the demonstration will be monitored to ensure health 
outcomes are achieved.
  This resolution is just another case of Democrats putting partisan 
political rhetoric in the way of facts and meaningful health reform.
  The Healthy Adult Opportunity--if states choose to participate in 
it--will not give states the ability to cap beneficiary enrollment or 
cut benefits. CMS is putting an expenditure cap on the waiver should a 
state choose to take this option, but expenditure caps are fairly 
common in health programs.
  For example, the Children's Health Insurance Program (CHIP) and many 
section 1115 Medicaid demonstrations (of which more than 40 states 
currently participate voluntarily) already operate under a funding 
ceiling.
  I want to point out that while total federal funding will be capped, 
the waiver does not change the need for states to submit claims 
reflecting actual expenditures to obtain federal matching funds for the 
Medicaid program and to maintain health outcomes as under current law. 
Again, states will not be allowed to cap

[[Page H872]]

enrollment and qualify for the statutory enhanced federal match rate 
for this expansion population.
  Finally, to the extent a State achieves savings and demonstrate no 
declines in access or quality, CMS will share back a portion of the 
federal savings for reinvestment into Medicaid. Perhaps, this sort of 
shared responsibility and incentives could help the people the Medicaid 
program is intended to serve.
  Now, to be clear, I agree this is a major proposal, one that needs to 
be examined carefully. To that end, let's have a committee hearing at 
Energy and Commerce, the Committee with jurisdiction over Medicaid, 
where we can hear from stakeholders as well as the Administration and 
walk through the facts of the Waiver Opportunity. Instead of a hurried 
disapproval resolution that bypassed the Committee process, let's do 
the work at the Committee level to examine this proposal carefully.
  When I was Chairman of the Energy and Commerce Committee, we were 
committed to a process of regular order, allowing for enough time to 
have meaningful debate and examination of the issues that came before 
our committee.
  House Democrats said they are just as committed to regular order, yet 
time and time again, we come to the House floor to debate bills or 
resolution with no committee process and always for partisan political 
theatre.
  Instead of this resolution, we should be voting to end surprise 
billing. We should be debating how to avoid the Part D catastrophic 
cliff Obamacare created. We should be considering bipartisan 
legislation to lower drug prices.
  This is another episode of House Democrats putting politics over 
progress.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Veasey), who is a sponsor of this resolution.
  Mr. VEASEY. Mr. Speaker, I am proud to bring this resolution to the 
floor today which will fight against the Trump administration's harmful 
Medicaid block grants.
  I would like to take a moment to thank the chairman and the committee 
and their staff for working hard to protect healthcare for all 
Americans.
  Today, we are here to shine a light on yet another one of the harmful 
and irresponsible policies designed by the Trump administration.
  These block grants are just the latest in a slew of attempts by his 
administration to gut the Affordable Care Act and the numerous coverage 
expansions that have been offered to millions of Americans of all ages 
and all backgrounds who were unable to gain coverage before, and the 
millions more who could gain coverage if States like mine would be 
smart and expand Medicaid in our own States.
  They have been talking about these block grants in Texas for a while, 
and they are a hee-hee, ha-ha joke. Everybody knows that these are 
harmful. People in the healthcare industry in Texas know that these are 
harmful, and block grants would be harmful for the Nation.
  This resolution on the floor today demonstrates our majority's strong 
opposition to removing the expanded protections that the Affordable 
Care Act provided to primarily childless adults and those parents who 
are living at or below the poverty line.
  Millions of hardworking Americans have finally been able to gain 
affordable health insurance. Now the Trump administration wants to take 
away the progress made by these Americans and undercut their access to 
healthcare.
  They also want to chip away at the access to healthcare for millions 
of Americans who have and will be able to gain coverage through State 
Medicaid expansions.
  That is why I am proud to lead this resolution today because 
affordable and accessible healthcare is a right. It should not be a 
privilege, Mr. Speaker. It should be a right for all.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from Ohio 
(Mr. Latta).
  Mr. LATTA. Mr. Speaker, I thank the Republican leader of the Energy 
and Commerce Committee for yielding.
  I rise in opposition to H. Res. 826. This resolution is solely a 
political talking point. The administration's proposal does not harm 
Medicaid. I applaud the Trump administration for moving in the right 
direction. Block grants give States the flexibility to invest in their 
citizens' best interests, while spending an estimated $1.4 trillion 
over the next 10 years. That is trillion.
  It is plain and simple. Children, seniors, and individuals with 
disabilities will not be negatively affected by this option, and those 
in low-income communities will be greatly benefited.
  Additionally, CHIP and many of the other Medicaid demonstrations are 
currently running under similar structures.
  As earlier stated by the Republican leader, States do know what is 
best for their residents. By giving States the options to voluntarily 
participate in this program and to share in the Federal savings, it is 
a win. This resolution is simply a Democrat health scare tactic, and I 
encourage all of my colleagues to oppose H. Res. 826.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Eshoo), who is the chair of our Health Subcommittee.
  Ms. ESHOO. Mr. Speaker, I thank the chairman of the committee for 
yielding.
  Mr. Speaker, I rise in support of this resolution. I do so for the 
following reasons: We have heard from our friends on the other side of 
the aisle about process issues. They are always appropriate to bring 
up. But that really is an obfuscation of why we are on the floor today 
with this resolution. This is about healthcare. This is about the 
Democrats looking to protect the healthcare that the American people 
have today.
  Now, from the outset of this administration, Medicaid coverage for 
low-income and disabled Americans, medically complex children, and our 
Nation's most vulnerable communities have been under attack.
  After failing to repeal Medicaid coverage for 17 million Americans in 
the last Congress, the Trump administration is now taking a hatchet to 
Medicaid. They are ripping coverage away from families, through onerous 
paperwork--saying: ``Oh, no, that really doesn't matter,'' but it 
does--onerous paperwork requirements, discriminatory policies against 
documented immigrants, and funding cuts through proposed block grants.

                              {time}  1445

  Block grants are not exactly tidy. It is not the way they are being 
represented. They use the word ``flexible.''
  Whom is it flexible for? It is flexible for the States that can't 
stand it and allow them to cut, and they are the States that have some 
of the poorest people in them.
  The administration's actions have already taken a terrible toll. They 
are directly responsible for 818,000 fewer children being enrolled in 
Medicaid and the Children's Health Insurance Program and 750,000 fewer 
adults being enrolled in Medicaid since 2017.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Mr. PALLONE. Mr. Speaker, I yield the gentlewoman from California an 
additional 30 seconds.
  Ms. ESHOO. Mr. Speaker, I would like to hear the Republicans today 
stand up on the floor and say: We object to the administration being in 
the court to eviscerate, remove, undo, and get rid of the entirety of 
the Affordable Care Act, and I don't think this can stand.
  Mr. Speaker, I urge my colleagues to support it. I think a vote 
against this resolution is a vote to throw millions of Americans with 
preexisting conditions overboard.
  Mr. WALDEN. Mr. Speaker, I have to just respond in that none of that 
is what is in this resolution because this resolution has no force of 
law. This resolution is not healthcare policy; it is a press statement. 
It does nothing to deal with any of the issues my dear friend has just 
raised, other than make a statement.
  Do you want to legislate? Then legislate. Let's go have a hearing. 
Let's go have a markup. Let's go work on these issues together.
  Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. 
Burgess). The good doctor is the former chairman of the Health 
Subcommittee.
  Mr. BURGESS. Mr. Speaker, I did want to speak in opposition to H. 
Res. 826. It is indeed a political exercise, and I am disappointed that 
the Democrats have decided to discuss the Healthy Adult Opportunity 
demonstration in this manner.
  If we are to have legitimate debate on this optional policy, then we 
should do so in a hearing. We should do so in

[[Page H873]]

a hearing in our committee. That is why the Energy and Commerce 
Committee Republican Leader Walden and I sent a letter to Chairman 
Pallone to request such a hearing. We should be asking the questions of 
the agencies and the States that are deciding as to whether or not they 
want to utilize this option, a new section 1115 waiver for a very 
specific population.
  This optional demonstration changes nothing for children, seniors, or 
individuals with disabilities.
  The comments about the State of Texas are absolutely erroneous. Texas 
did not expand Medicaid. This only applies to the Healthy Adult 
expansion population, not to the traditional mandatory populations.
  All essential health benefits requirements would remain in place, and 
States do not have to take the option. States can maintain the status 
quo and continue to operate their Medicaid programs as they were before 
this opportunity was presented to them.
  Again, this is an option. Give States flexibility. States are great 
laboratories of innovation. We should let them innovate.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Illinois (Mr. Rush), who chairs our Energy Subcommittee.
  Mr. RUSH. Mr. Speaker, I thank the chairman of the full Committee on 
Energy and Commerce for yielding me this time.
  Mr. Speaker, I rise in support of H. Res. 826. Over the last 3 years, 
the Trump administration has deliberately and repeatedly sabotaged the 
Affordable Care Act. This has led to higher healthcare costs for low- 
and middle-income Americans. This has also led to an increase in the 
number of uninsured Americans, including those in my home State of 
Illinois.
  As such, Mr. Speaker, it is not surprising to me that the 
administration is, once again, attacking vulnerable Americans' 
healthcare.
  We have not forgotten that our colleagues across the aisle tried and 
failed to force through the Medicaid block grant in the year 2017. It 
failed, Mr. Speaker, because the American people saw the plan for what 
it was: a way to weaken the Medicaid program.
  Under this latest proposal, just like TrumpCare, much of the 
financial burden would shift to States. States, Mr. Speaker, would be 
forced to reduce benefits, kick vulnerable Americans off Medicaid, and 
siphon funds from other priorities, including schools, roads, and first 
responders.
  Mr. Speaker, healthcare is a human right, and we cannot and we will 
not stand idly by if this right is taken away from the most vulnerable 
among us.
  As such, Mr. Speaker, I am proud to vote in favor of this resolution 
to express my disapproval of the Trump administration's Medicaid block 
grant plan.
  Mr. WALDEN. Mr. Speaker, once again, I just point out the State 
Governor would have to seek a waiver and get approval to maintain all 
the essential benefits of the Affordable Care Act in everything they 
do. This only applies in States that took the expansion, not others. 
States are the great laboratories that innovate and deliver healthcare 
better for the working poor.
  Mr. Speaker, I yield 2 minutes to the gentlewoman from Washington 
(Mrs. Rodgers).
  Mrs. RODGERS of Washington. Mr. Speaker, I thank the gentleman and 
our leader for yielding.
  Mr. Speaker, I stand in opposition to H. Res. 826.
  It really is a partisan resolution. It has zero reforms. It is being 
rushed through to attack the administration's Healthy Adult Opportunity 
program to modernize Medicaid.
  The majority is ignoring that Medicaid's status quo is leaving people 
like pregnant women, the elderly, and people with disabilities behind 
today. Instead of working in a bipartisan fashion to actually 
improve Medicaid, they are more interested in scoring political points.

  There are currently over 700,000 individuals across this country on 
waiting lists, people with disabilities on waiting lists, to get care 
within Medicaid. I would urge you to check your States, Mr. Speaker. 
Two-thirds of the 700,000 who are waiting for care and services that 
they need currently today on Medicaid are living with a disability.
  I listened to one family's story. Their daughter had a rare 
neurological condition. She was put on a Medicaid waiting list for 10 
years to be approved for services--10 years.
  This is happening in my home State of Washington, too. There are 
almost 14,000 individuals with disabilities today waiting for care and 
services.
  The most appalling figure is that at least 21,900 people across the 
country have died waiting for Medicaid services that they need.
  The status quo is unacceptable. It needs to be fixed. We need a 
solution, not a partisan resolution that maintains the status quo.
  It is time to modernize Medicaid. Let's work together. Let's get 
solutions. The Healthy Adult Opportunity program will improve the 
Medicaid program's integrity by giving States the option to innovate 
and provide coverage by enrolling in the program. This will give States 
the flexibility to control costs and share the program's savings within 
Medicaid. States like Washington could put those savings directly back 
into the Medicaid program so that they can shorten their waiting list 
and save lives.
  Let's have a hearing. Let's get this done. Let's work in a bipartisan 
way.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Pennsylvania (Mr. Michael F. Doyle), who chairs our Communications and 
Technology Subcommittee.
  Mr. MICHAEL F. DOYLE of Pennsylvania. Mr. Speaker, I have a strange 
feeling of deja vu today because, once again, Democrats are down on the 
floor, speaking out against another attempt by the Trump administration 
to take away people's healthcare.
  This should go without saying, but let me say clearly: Block grants 
do not strengthen the Medicaid program, and they do not protect 
Americans.
  It makes sense that when the economy is bad, more people might need 
Medicaid, and when the economy is good, Medicaid payments shrink. This 
is common sense and good public policy. Medicaid should be there when 
people need it the most, yet the Trump administration wants to undo 
that. Instead, the amount of money that a State would receive would be 
flat, and States would have to adjust their coverages accordingly.
  That means one of two things: either fewer people can be covered or 
fewer services can be covered. In fact, this policy encourages States 
to cut coverage and divert Medicaid money to other parts of their 
budgets.
  We should be trying to improve people's healthcare and investing more 
so that American families don't have to.
  Republicans have been trying to cut Medicaid for 30 years. This is 
just the latest attempt. They most recently failed to cut Medicaid 
coverage when they were in the majority and tried to repeal the 
Affordable Care Act because the American people were overwhelmingly 
opposed to their plan. Now the Trump administration is trying to go it 
alone.
  But the American people will see through what you are doing, and they 
will see the Republicans in Congress, once again, turning a blind eye 
while this President and his administration try to take healthcare away 
from millions of Americans.
  Mr. Speaker, I urge my colleagues to support this resolution to 
condemn this outrageous and unwise proposal.
  The SPEAKER pro tempore. Members are requested to address their 
remarks to the Chair.
  Mr. WALDEN. Mr. Speaker, could I inquire as to how much time each 
side has remaining.
  The SPEAKER pro tempore. The gentleman from Oregon has 18\1/4\ 
minutes remaining. The gentleman from New Jersey has 19 minutes 
remaining.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from 
Michigan (Mr. Mitchell).
  Mr. MITCHELL. I am not sure, Mr. Speaker, if you are aware or my 
colleagues are aware that we are now over 15 resolutions expressing 
disapproval with some policy of the administration, more than one per 
month. It appears maybe we have a monthly checklist that we must do 
some resolution disapproving of the administration's action on a 
monthly basis.
  There is a point in time in this body we actually legislated. Imagine 
that. We considered an issue. We would have hearings. We would get 
experts in. We would have a bill. We would have regular order. We would 
amend the bill. And we would debate the policies.

[[Page H874]]

  This is not legislation. H. Res. 826 has less impact and less 
importance than the tissue in the Cloakroom has on this body. I repeat 
that: less impact because, frankly, it is more useful.
  This is not. This is a media opportunity. This is a press release. At 
some time, the media will have people gathered together to bemoan the 
policy of the Trump administration.
  By the way, this is simply a guide to the States if they want to 
pursue waivers. States are choosing what is best for their citizens to 
serve them. As has been noted, there have been over 43 waivers approved 
by multiple States.
  So let me just say, I watched with great interest last evening the 
debate over expressing one's opinion and First Amendment rights in this 
body. With great interest, I watched them. So let me at this point in 
time express my opinion and exercise my First Amendment rights by 
simply saying----
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Illinois (Ms. Schakowsky), who chairs our Consumer Protection and 
Commerce Subcommittee in Congress.
  Ms. SCHAKOWSKY. Mr. Speaker, I rise to condemn the Trump 
administration's cuts to Medicaid as yet another broken promise from 
this President.
  On May 7, 2015, then-candidate Trump tweeted: ``I was the first and 
only potential GOP candidate to state there will be no cuts to Social 
Security, Medicare, and Medicaid.'' He even said that these programs 
were a part of what makes America great.
  The President was right. Medicaid is a pillar of our society. Mr. 
Speaker, 3.26 million people in my home State of Illinois receive their 
healthcare through Medicaid. Since Illinois expanded Medicaid in 2013, 
our uninsured rate has been cut nearly in half. One study found that 
expanded Medicaid coverage reduced mortality in Illinois by 6 percent.
  Mr. Speaker, 40 percent of kids in my State can see a doctor when 
they are sick and get vaccinations and screenings that they need only 
because of Medicaid, and over 275,000 Illinois seniors and almost 
400,000 people with disabilities rely on Medicaid. In fact, Medicaid 
pays for over half of all long-term services and supports across the 
United States.

                              {time}  1500

  Despite all this, the administration is gutting Medicaid funding and 
allowing States to cut benefits.
  Mr. Speaker, I urge my colleagues to join me in voicing our 
opposition to the Trump administration by voting ``yes'' on this 
resolution. Medicaid matters, and we will protect your care.
  The SPEAKER pro tempore. Members are reminded to address their 
remarks to the Chair.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  I just point out that, again, this is a State option. Nobody is 
mandating anything on any State. States can come to the Federal 
Government, as they willfully do, and say: We have a better idea to 
take care of the working poor. We think we can achieve some savings 
that we understand. If we do, we will be plowed back into more benefits 
and services in some large measure to improve and expand Medicaid in 
our State.
  Mr. Speaker, our States have done that. As you know, others are. This 
is an option. It is not a mandate.
  Finally, the resolution on the floor today has no legal effect on any 
of this. It is a press release called a resolution. It never even goes 
to the Senate. It will never go to the President. It will never become 
a law. It is just a press statement.
  Mr. Speaker, so for all the comments about stopping this and stopping 
that, you do that with legislation. That is why we have said you ought 
to have a hearing in the committee of jurisdiction. If you want to mark 
up a bill, let's go do that. Let's have witnesses. Let's do what we do 
best around here. But we are not doing this.
  Mr. Speaker, I yield 2 minutes to the gentleman from Georgia (Mr. 
Carter), Congress' pharmacist.
  Mr. CARTER of Georgia. Mr. Speaker, I rise today to speak against H. 
Res. 826, a resolution that was hastily put together that opposes the 
administration's Healthy Adult Opportunity demonstration initiative in 
Medicaid.
  The use of waivers to grant States more flexibility in managing their 
healthcare systems is foundational to health reforms from both parties 
throughout the years. In fact, most Medicaid programs across the 
country today are currently operating under some form of waiver.
  In the latest waiver proposal, the Trump administration would allow 
States more flexibility to manage their Medicaid expansion population 
by choosing to accept their Federal funds in a per person or lump sum 
basis. States would be able to take that Federal money and more 
efficiently treat these patients and then share in the savings.
  The Medicaid program was built to be a safety net for our children 
and the poor, not to be our Nation's largest insurer. This waiver would 
not affect how Medicaid cares for children, seniors, or those with 
disabilities.
  The Healthy Adult Opportunity waivers are designed only to help 
States manage the rapidly ballooning costs from able-bodied adults who 
are now on Medicaid after ObamaCare.
  Medicaid benefits and patient access to care will not be cut in this 
proposal. Any State pursuing a Healthy Adult Opportunity waiver will 
still be held responsible for the accessibility of services to 
beneficiaries.
  As much as my friends across the aisle seek to demonize this proposal 
and use every scare tactic in the book, this is sound policy to help 
the growing number of States struggling to manage the costs of their 
growing Medicaid programs.
  Mr. Speaker, I commend President Trump, Secretary Azar, and 
Administrator Verma for their work, and I urge my colleagues to vote 
against this resolution.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Florida (Ms. Castor).
  Ms. CASTOR of Florida. Mr. Speaker, I thank Chairman Pallone for 
yielding the time.
  Affordable healthcare is fundamental to the well-being of American 
families, but the Trump administration doesn't believe that. Now, they 
are proposing again to shrink, block, or eliminate health services 
under Medicaid.
  For over 50 years, Medicaid has provided a coverage guarantee. It is 
guaranteed that if you fall on hard times or if you have a disability 
or you are a senior in skilled nursing, care will be there if you need 
it. But this proposal out of the administration will severely chip away 
at that coverage guarantee.
  It is particularly harmful to my home State of Florida, and it will 
complicate our ability to expand Medicaid health services to families 
who need it.
  Don't just take it from me. Patient advocates, doctors, and hospitals 
overwhelmingly oppose block grant waivers because they will weaken 
access to care. Groups like AARP, the American Cancer Society Action 
Network, the American Academy of Pediatrics, the Federation of American 
Hospitals, the Children's Hospital Association, and many others have 
spoken out against block grants and waivers.
  Unfortunately, this is part of the administration's broader 
antihealthcare agenda. They have tried to weaken affordable care 
through budgets; we have rejected it. Through legislation, we have 
defeated it. Now, they are in the courts to take away that coverage for 
preexisting conditions.
  The Trump antihealthcare agenda is cruel. It is wrong. And I urge my 
colleagues to reject it today by passing this resolution.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from 
Kentucky (Mr. Guthrie).
  Mr. GUTHRIE. Mr. Speaker, I rise today in opposition to H. Res. 826, 
a rushed resolution to dismantle the Trump administration's Healthy 
Adult Opportunity Medicaid initiative.
  The Affordable Care Act expansion of Medicaid is simply 
unsustainable. It is bankrupting my home State of Kentucky.
  In the 114th Congress, I served as the chair of the House Committee 
on Energy and Commerce's Medicaid Task Force. We explored ways that 
would make Medicaid sustainable so that it can be fully utilized by 
vulnerable populations for generations to come.
  The Trump administration has proposed a commonsense option that will 
not affect funding for children, pregnant women, the elderly, or people 
with disabilities but, rather, give States flexibility for their 
Medicaid programs.

[[Page H875]]

  I will continue to work with my colleagues on the House Committee on 
Energy and Commerce to make Medicaid sustainable and accessible to 
those who need it.
  Mr. Speaker, I urge my colleagues to oppose H. Res. 826.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Matsui).
  Ms. MATSUI. Mr. Speaker, I rise today on behalf of the millions of 
Americans who rely on Medicaid for access to mental health services. 
Individuals with mental illnesses and addictions were among the largest 
beneficiaries of the Medicaid expansion.
  The mentally ill, along with disabled, low-income families, and older 
adults, will undoubtedly suffer if their coverage is reduced or taken 
away entirely under the Trump administration's new guidance to cut 
Medicaid funding. Block grants will shift costs to States, forcing them 
to make tough decisions about what services to cut, picking the well-
being and care needs of one patient population over another.
  Not only is this plan unethical, it is illegal. And the American 
people understand block grants would hurt some of the most vulnerable 
amongst us. We cannot allow this administration to recklessly cause 
such hardship.
  Mr. Speaker, I urge my colleagues to join me in expressing their 
disapproval of the Trump block grant plan by voting to support H. Res. 
826.
  Mr. WALDEN. Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Massachusetts (Mr. Kennedy).
  Mr. KENNEDY. Mr. Speaker, Medicaid saves lives. It helps save 
patients from poverty and provides families with access to critical 
care. It is the largest payer of mental healthcare in the country and 
the longest payer of long-term care in the country.
  It covers half of all births and strengthens special education 
opportunities in our schools. It covers working families. It covers 
babies. It covers the elderly, the sick, the addicted, and those in 
need.
  In short, it covers those that this administration has relentlessly 
targeted from its very first day, from a healthcare repeal effort that 
would have denied care to millions of Americans; to a lawsuit that 
could still steal healthcare from millions more; then a relentless 
effort to impose onerous bureaucratic red tape known as work 
requirements on people struggling to make ends meet; and now this, an 
illegal and immoral block grant that will end in countless lives lost 
to preventable deaths.
  We can afford trillions of dollars in tax cuts to make the rich 
richer. We can afford $60 billion for a wall that falls in the wind and 
fails in the rain. But taking care of our neighbors, that is a cost we 
can't bear, a challenge too great for this country to shoulder.
  For an administration that seeks to make America great, our President 
far too frequently doubts the capabilities and grit of our fellow 
neighbors. But as this administration stands proudly behind this 
illegal policy, I have no doubt that it will be rejected by this 
Chamber, in our courts, and by the American people yet again.
  Mr. WALDEN. Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
California (Mr. Cardenas).
  Mr. CARDENAS. Mr. Speaker, I rise today to express my strong 
opposition to President Trump's constant efforts to gut Medicaid.
  Let's be clear. This is another attempt by President Trump to take 
healthcare away from millions of Americans. This block grant proposal 
is the latest step in Trump's ongoing efforts to end the Affordable 
Care Act. Trump is, tragically, trying to affect the most vulnerable in 
our country: children, people with disabilities, low-income families, 
and seniors.
  According to a recent study, this proposal could lead to cuts of $37 
billion, perhaps as much as $49 billion a year of healthcare benefits 
to our American citizens.
  Just 2 days ago, President Trump spoke right here in this Chamber, 
saying that he is out to protect healthcare for the American people. 
But once again, we see he is trying to hurt Americans when all he is 
trying to do is talk one way and take actions like this against the 
American people and their healthcare.
  I know what it is like to not have healthcare, when I was a little 
boy, when an aspirin, a prayer, and the emergency room were your only 
options.
  Americans should not have to suffer through that. There is no need 
for it. But this President wants people to suffer.
  Many of my constituents rely on Medicaid for their health coverage. 
People shouldn't be forced to choose between buying medicine for their 
children or putting food on their tables.
  Mr. Speaker, I am proud to join my colleagues in Congress, such as 
Congressman Veasey, in supporting H. Res. 826. We will not stay silent 
as this administration continues its efforts to gut and take healthcare 
away from millions of Americans across our great Nation.
  The SPEAKER pro tempore. Members are reminded to refrain from 
engaging in personalities toward the President.
  Mr. WALDEN. Mr. Speaker, I was going to raise that point.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
California (Mr. Ruiz), a member of our committee.
  Mr. RUIZ. Mr. Speaker, block-granting Medicaid will increase out-of-
pocket costs, limit patient care, and take away health coverage for 
millions of Americans across this country.
  Block-granting Medicaid is just another way of cutting Medicaid. To 
reduce costs, States will cut eligibility, cut payments to doctors and 
hospitals that care for the poor, and cut coverage for seniors and 
medicines.
  These cuts will raise out-of-pocket costs for Americans, result in 
fewer hospitals and providers for Medicaid recipients, and increase 
barriers to care for low-income, rural, and vulnerable patients.

                              {time}  1515

  It will harm people in underserved areas with physician shortages, 
like Desert Hot Springs, Eastern Coachella Valley, and Hemet in my 
district, people in rural areas, low-income seniors, children, people 
with disabilities, our neighbors and families.
  Put simply, Medicaid block grants hurt the very people Medicaid is 
here to help. That is why I urge this body to vote for H. Res. 826 and 
make a strong statement to protect healthcare for millions of 
Americans.
  Mr. WALDEN. Mr. Speaker, I yield myself as much time as I may 
consume.
  May I say, the proposal before us today has no force of law. There is 
a lot of heated rhetoric, yes. There is a lot of fire and brimstone, 
yes. There are even words that probably could have been taken down. But 
the resolution before us is nothing more than a partisan political 
press release.
  So for all of the comments, you could legislate, but you are not. You 
could actually have the force of law.
  Now, let's get to the underlying issue. All these attacks on the 
President say the President is doing this, the President is doing this, 
that, and the other thing, when, in fact, that is not what is happening 
here. The President is giving States the opportunity to do a better job 
of providing healthcare to their citizens.
  Nothing in this waiver process that exists today in statute or exists 
tomorrow under this proposal that the administration has put forward is 
allowed to adversely affect people on disabilities or pregnant women or 
children. This goes to the expanded adult population, where they can 
then innovate.
  Our State, Mr. Speaker, as you know, is seeking a waiver to be able 
to expand substance abuse disorder treatment. That would be allowed 
under this. States like California could come to the administration 
under this authority and say we would like to expand our Medicaid 
program to include more services for people who need mental health, so 
mental health and substance abuse disorders.
  Mr. Speaker, earlier in the debate, my colleague from Washington 
State talked about the backlog for people on disabilities who can't get 
access to Medicaid. So what is wrong with a State saying: We can do it 
better; we can do it more efficiently; we can save money; and we can 
plow the savings back into expanded coverage?

[[Page H876]]

  By the way, Mr. Speaker, Oregon has been a leader in this sort of 
effort with our CCOs, our Coordinated Care Organizations, where they 
have done precisely this. They do wraparound services. They take the 
most vulnerable and people in need in our communities and say: Let's 
all get together and take care of this patient. In doing so, the 
savings, in large measure, go back into expanded services.
  So, for all the doomsday talk I hear on the floor, Mr. Speaker, let's 
get to the facts of the matter. The facts of the matter are nobody is 
being forced to do a block grant; nobody is being forced to do cap and 
a gap.
  What we are saying is: States, let's be thoughtful about this. Come 
to Washington. Here are some things we know work elsewhere, and you can 
do it in your State and save money and probably provide more benefits 
and maybe save a little for the taxpayers and improve the quality of 
the healthcare for the people you are overseeing.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Michigan (Mrs. Dingell), also a member of our committee.
  Mrs. DINGELL. Mr. Speaker, I thank my chairman for all the hard work 
he has been doing.
  I rise in strong support of H. Res. 826 and in opposition to the 
Trump administration's recent proposed cuts to Medicaid.
  Medicaid provides important lifesaving care for our Nation's 
children, seniors, and disabled, including in my home State of 
Michigan. That is why political leaders, under the leadership of 
Governor Rick Snyder, a Republican, worked across the aisle to expand 
Medicaid in Michigan in 2014.
  This expansion, Healthy Michigan, currently covers over 650,000 
Michiganders, providing them access to both quality and affordable 
healthcare and protection from crippling medical bills.
  It has also supported rural hospitals both in Michigan and across the 
country. Without Healthy Michigan, hospitals across the State that 
serve some of our most vulnerable residents would face closures and 
terrible increased financial pressures.
  Finally, Medicaid is the single largest payor of long-term care in 
this country and allows our seniors the opportunity to live with 
dignity as they age.
  The Trump administration's recent actions puts this all at risk. Both 
the 2017 healthcare proposal and the CMS proposal would block grant 
Medicaid, drastically cutting the resources it provides for lifesaving 
medical care.
  We know what this means: increased healthcare costs for my 
constituents and a loss of coverage for seniors, the disabled, and our 
children, who are the overwhelming majority of Medicaid recipients.
  This resolution sends a strong message: We will make good on our 
commitment to provide quality and affordable healthcare to every 
American, and I urge my colleagues to support it.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, Michigan doesn't have to apply for another waiver. 
Nobody is going to force anything like we just heard on Michigan. That 
is not the proposal from the administration, and nothing in this 
resolution stops anything anyway.
  In fact, I would argue, Michigan probably came to an administration 
to get exactly an 1115 waiver to do everything my friend and colleague 
just said they are doing in Michigan, just like Oregon had to come back 
and get waivers to do what we are doing.
  All this administration is doing is saying: Let's make that waiver 
process a little easier, but you have to make sure you are continuing 
to provide the best care possible to the people you serve.
  And once again, despite what we have heard on the floor today, 
nothing in their proposal would apply to the categories we have been 
discussing: the mandatory, the legacy population. That is not what is 
there.
  That is why, Mr. Speaker, it would have been so much better to have a 
real hearing in the Energy and Commerce Committee where we could have 
had a real discussion with real experts there to get us all on the same 
basis of fact. It is unfortunate we don't have that.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from 
North Carolina (Mr. Butterfield), who is the vice chair of our Health 
Subcommittee.
  Mr. BUTTERFIELD. Mr. Speaker, for the life of me--for the life of 
me--I just cannot understand why 14 States have flatly refused to 
expand their Medicaid program to provide healthcare to their low-
income, healthy, childless adults, a demographic that was omitted from 
Medicaid in 1965 when it was enacted into law.
  North Carolina, my home State, would greatly benefit from Medicaid 
expansion. Other congressional districts would benefit.
  And to my Republican friends: The fact is that your low-income 
constituents would greatly benefit. Talk to your doctors. Talk to your 
hospitals. Talk to your providers. The coverage low-income individuals 
would receive will not only benefit them, but the entire economy of 
your State.
  Let's cooperate on this one. Let the States know that Medicaid 
expansion will benefit them, and it will not break their budget. We, 
the Federal Government, will pay 90 percent of the costs in perpetuity.
  For the President to direct the block granting of Medicaid to the 
State will be absolutely beyond his executive authority.
  I repeat: To direct block granting to the State will absolutely be 
beyond his executive authority.
  To cap and slash these benefits is unlawful, and it is cruel. It will 
require authorization from this Congress.
  I urge my colleagues to vote ``aye'' on this resolution, H. Res. 826.
  The SPEAKER pro tempore. The Chair would remind Members to address 
their remarks to the Chair.
  Mr. WALDEN. Mr. Speaker, my friend from North Carolina, I would just 
say, through the Chair, that Oregon is an expansion State. So you are 
right. We have seen the benefits of this in my State. We have seen the 
benefit of flexibility. We have sought waivers and gotten them to do 
exactly the sorts of things you are saying.
  And, ironically, under the proposal of the administration, North 
Carolina could use this authority to expand its Medicaid population. 
That is allowed under the proposal from the administration out to the 
States. They can actually use these tools and do exactly what the 
gentleman is saying: expand the population in North Carolina.
  So there are good thing things in here.
  Mr. Speaker, I am not going to get into the legal debate. I am not a 
lawyer. I am not burdened with a law degree. But I would argue that, if 
we had this discussion in our committee we love so much, maybe we would 
have a better outcome here.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from New 
Jersey (Mr. Pascrell).
  Mr. PASCRELL. Mr. Speaker, I have a great deal of respect for both 
you and the chairman, but there is a parting of the ways here. I want 
to urge my colleagues to stand against the administration's vicious 
assault on Medicaid. That is how I perceive it.
  The expansion of Medicaid by the ACA is one of the great success 
stories of government in action in the last 50 years. Despite the 
decade-long obstructionism, Medicaid expansion has saved 19,000 older, 
low-income adult lives--and I know they don't challenge those numbers--
and 825 lives just in our State of New Jersey.
  But many Republicans have rejected the attempts to destroy--they 
tried to destroy the ACA at the ballot box and at the courthouse. But 
like Captain Ahab after his white whale, they remain singularly 
dedicated to stealing healthcare away from as many Americans as 
possible.
  This administration knows their policy is pure poison. They gave it 
an innocuous name and, as we heard on Tuesday, are lying about the 
details to fool people.
  Americans will not be fooled by this Orwellian scheme. This policy 
would rip away healthcare for some of the most vulnerable of our 
neighbors. They want to obliterate the ACA no matter what the 
consequences.

[[Page H877]]

  Mr. Speaker, I support this resolution to send a loud message: Those 
on the other side cannot be allowed to steal your healthcare. We will 
do everything in our power to stop their schemes.
  Now, the ``Joker'' movie may not prevail at Sunday's Oscars. We must 
think about any other jokers that go through any of their basements, 
including the White House, after today's vote. What will they be 
sulking about? This is important legislation.
  Mr. WALDEN. Mr. Speaker, may I inquire as to the amount of time each 
side has.
  The SPEAKER pro tempore. The gentleman from Oregon has 8 minutes 
remaining. The gentleman from New Jersey has 3\3/4\ minutes remaining.
  Mr. PALLONE. Mr. Speaker, I don't have any more speakers other than 
myself at this time, so I am prepared to close.
  Mr. WALDEN. Mr. Speaker, I don't believe we have any more, but I 
still have 8 minutes, so I am going to share a few comments.
  Mr. Speaker, I want to say a couple of things.
  When I chaired the Energy and Commerce Committee, we did try to do 
some reforms on healthcare, certainly, and there was a big 
disagreement, but we also extended funding for community health 
centers, the biggest increase they had ever gotten, 2 years fully 
funded.
  The chairman and I both are supportive of a 5-year extension of fully 
funding community health centers going forward. In my State, I think we 
had 63 different places people got healthcare in my district, and 122--
well, a lot of people in Oregon go through community health centers.

  As chairman, I led the effort in this Congress the last session to 
fully fund a 10-year expansion of the Children's Health Insurance 
Program. That is the biggest expansion, I think, in modern legislative 
history, probably.
  Many Democrats voted against it when I tried to get it extended for 4 
years, and then a lot of Democrats voted against it when it was 6, and 
then eventually we got to 10--unprecedented. We got that into law. We 
eventually came together and we got that into law.
  We have done a lot of work on special diabetes program funding and a 
special program for those with diabetes in our Native American 
community.
  One thing after another, in the last Congress, we accomplished in a 
bipartisan way.
  The work we did on opioids together as a Congress, you were a very 
important part of that, Mr. Chairman, on a proposal that we passed in 
the House. Unfortunately, we fell a little short in the Senate to get 
better communication among providers.
  We put real money behind that, billions of dollars into our States 
and communities; and that help is starting to show up with expanded 
access--I think it is a 38 percent increase in access--to the kind of 
services, health services, people dealing with addiction need.
  And, as a result of our work, I would say, in public education and 
other work, we saw, finally, a topping off in the overdose deaths.
  Now, there is more work to do there.

                              {time}  1530

  This proposal, the underlying proposal the administration has put 
forward, I would argue, builds on the notion of local, State, Federal 
partnership to serve the same people. We would give States more 
authority to manage their Medicaid programs more efficiently and 
effectively. Savings would be put back into the Medicaid program in 
large measure.
  Now, my friend from New Jersey, not the chairman, but the predecessor 
speaker here, talked about ripping away healthcare. Ironically, it is 
the socialist left that wants to take away all Americans' healthcare 
and have the Federal Government run it. That would be Medicare, 
Medicaid, Medicare Advantage, veterans' healthcare in there, Medicare 
for all proposals that would, I think, bankrupt the Federal Government.
  But it would rip away all the health insurance products out there and 
make them illegal. So if you liked your health insurance, you could say 
good-bye to it. And some of these same people that can't count votes in 
Iowa want to run your insurance in America, and I don't think that is 
really a good thing.
  So we stand here today opposing this resolution. We stand here today 
saying, the resolution does nothing anyway, other than make a 
statement. Do you want to legislate?
  We can be partners, as we were on community health centers, as we 
were on opioids, as we were on children's health insurance, as we were 
on a lot of things; but let's go back to work where it belongs, in the 
committee.
  Mr. Speaker, I would just ask my colleagues, vote against this 
resolution. Then let's get back to work on the real policy in the place 
where policy is done best. And with all due respect to those on the 
Ways and Means Committee, that would be the Energy and Commerce 
Committee. That is one thing we agree on in a bipartisan way.
  We can do our work there. We can get this right. Mr. Speaker, I ask 
for a ``no'' vote, and I yield back the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume 
to close.
  I would urge my colleagues on both sides of the aisle to support this 
resolution. And in doing so, I would like to point to some of the 
whereas clauses of the actual resolution.
  It points out that the President has waged an unrelenting war on 
Medicaid. It says that, under President Trump's watch, the number of 
uninsured children has increased, reversing years of decline, largely 
as a result of substantial losses in Medicaid coverage for children.
  Over a million children have lost Medicaid and CHIP coverage, and 
over 750,000 adults have lost Medicaid coverage.
  And I know that my colleague, the ranking member, who I respect, made 
reference to pregnant women and said that they would not be included 
under this block grant.
  In contrast to that, I want to read something from--the American 
College of Obstetricians and Gynecologists was sent a letter, and they 
say, under Federal law, States must cover pregnant women earning up to 
138 percent of the Federal poverty level in their Medicare programs.
  Almost all States cover pregnant women beyond the Federal minimum. 
Any pregnant women covered beyond this minimum are, therefore, an 
optional population, and could be included in a State's block grant 
demonstration program. So, the fact of the matter is that pregnant 
women and postpartum women would be included in this.
  Also, it says in the whereas clauses, not only the guidance that we 
are trying to reverse here today that allows States to cap their 
Medicaid funding through a block grant, but the President has also 
proposed regulations to roll back access standards put in place to 
ensure beneficiaries receive the care they need.
  He also issued guidance to allow State Medicaid programs to restrict 
access to prescription drugs by adopting closed formularies. He 
proposed massive annual compounding cuts in Federal funding to the 
program, in direct contradiction to an explicit campaign promise.
  Last year, the President's budget cut Medicaid by $1 trillion. We are 
going to get the President's budget next week. I would not be shocked 
if he didn't cut it again by $1 trillion.
  We have been seeing this war by President Trump on Medicaid in every 
way, and that is why we are here today, to say this war against 
Medicaid has to stop.
  If the GOP claim that they support Medicaid, which oftentimes they 
don't, then they should be voting for this resolution.
  So I urge all my colleagues to support this resolution, and I yield 
back the balance of my time.
  Ms. SCHAKOWSKY. Mr. Speaker, I rise to condemn the Trump 
Administration's cuts to Medicaid as yet another broken promise from 
this President.
  On May 7, 2015, then-Candidate Trump tweeted: ``I was the first & 
only potential GOP candidate to state there will be no cuts to Social 
Security, Medicare & Medicaid.''
  He even said that these programs were a part of what makes America 
great.
  Well, Mr. President--you were right: Medicaid is a pillar of our 
society.
  3.26 million people in my home state of Illinois receive their health 
care through Medicaid.

[[Page H878]]

  Since Illinois expanded Medicaid in 2013, our uninsured rate has been 
nearly cut in half.
  One study found that expanding Medicaid coverage reduced mortality by 
6 percent.
  40 percent of kids in my state can see a doctor when they are sick 
and get the vaccinations and screenings they need to stay healthy only 
because of Medicaid.
  Over 275,000 of Illinois' seniors and almost 400,000 people with 
disabilities rely on Medicaid to live independently, including nursing 
home care and services that help them live at home.
  In fact, Medicaid pays for over half of all longterm services and 
supports a cross the United States.
  Despite all this, the Administration is gutting Medicaid funding and 
allowing states to cut benefits that people need to survive.
  Why?
  Maybe because they need to pay for the GOP Tax Scam, which created a 
$1.5 trillion deficit in tax breaks for millionaires and billionaires.
  And because they want to continue their legacy of punishing low-
income people and the most vulnerable among us.
  Medicaid is critical to the health and financial security of people 
across the United States.
  I urge my colleagues to join me in voting YES on this resolution so 
that we can send a clear message: Medicaid matters, and we will Protect 
Your Care.
  Mr. COHEN. Mr. Speaker, I adamantly oppose Tennessee's proposal to 
block grant its version of Medicaid, TennCare, and the Administration's 
proposal for all states to have the opportunity to restrict Medicaid 
funding. This proposal would harm Americans most in need across the 
country. We should not be encouraging states to limit resources and cap 
budgets. In Tennessee, one in ten people have no health insurance. When 
this is the case, we should be expanding options for affordable health 
care options. Instead, this Administration has relentlessly attacked 
Medicaid and the people who depend on its support to stay healthy. The 
fact is, the majority of non-disabled, non-elderly adults on Medicaid 
are working hard and rely on Medicaid to help get the basic health care 
that they need. I am proud to support H. Res. 826 and will continue to 
fight for access to health care for all Americans. I urge my colleagues 
to do the same.
  Ms. JACKSON LEE. Mr. Speaker, I rise to join my Colleagues in support 
of House Resolution 826, ``Expressing disapproval of the Trump 
administration's harmful actions towards Medicaid.''
  Great Presidents are made by landmark policy initiatives and programs 
that bring a positive impact for the lives of the American people or 
the world.
  Trump has promised to introduce new proposals to protect those with 
pre-existing conditions if the Affordable Care Act (ACA) bill is 
replaced, but so far none of his administration's alternatives have 
come close to providing the level of healthcare currently available.
  The landmark bill, seen as one of the key pieces of legislation 
signed by President Obama barred insurers from denying coverage, or 
charging more, to those with a pre-existing condition.
  Trump said during his State of the Union Address that he would 
protect the rights of the insured with pre-existing conditions is not 
true and the dishonesty of his statement is revealed by his 
administration joining a lawsuit to take away this important 
protection.
  Through his actions Trump is doing all that he can to end the 
protections for those with pre-existing conditions.
  Trump's Justice Department joined a lawsuit that would end the 
protections for pre-existing conditions.
  In July of this year, Medicare and Medicaid will reach 55 years of 
service to Americans from all walks of life.
  On July 30, 1965, President Lyndon B. Johnson, another great 
president, signed Medicare and Medicaid into law as part of the Social 
Security Act.
  This landmark legislation that truly represents Americans at our best 
became a reality due to the tireless efforts of great leaders like 
Teddy Roosevelt, Harry Truman, and Lyndon B. Johnson.
  The signing of the law that established Medicare forged a promise 
with American seniors that we must not allow Donald J. Trump to take 
from them.
  America's word matters and our promise to our seniors cannot be 
allowed to be broken.
  Both Medicare and Medicaid promise our nation's elderly and poor that 
they could enjoy their lives with peace of mind and the security of 
reliable, affordable, and high-quality healthcare.
  Medicaid created a crucial partnership between the Government and the 
governed to provide a basic health care safety net for some of the most 
vulnerable Americans: children of adults with low incomes, persons with 
disabilities and the poor.
  Mr. Speaker, over half a century later, the legacy of these programs 
has proven how powerful government action can be to the life and 
wellbeing of our nation's most vulnerable.
  Today, the Trump administration is trying to go back on this promise.
  On January 30, the Centers for Medicare & Medicaid Services (CMS) 
released its long-rumored guidance on Medicaid block grants.
  This notice to state Medicaid directors invites states to restructure 
their Medicaid programs in a radical manner previously rejected by 
Congress, by capping federal funding at an artificially low level. 
Millions of Americans will be denied health care because of this 
draconian directive. Also persons who are disabled, children, and 
seniors will be most impacted. We should vote no on cutting medicaid 
and making Americans sicker.
  Medicaid's financing is already based on federal matching of state 
Medicaid costs.
  The current program reimburses states as they spend money to pay for 
Medicaid services, with the federal government paying for a portion of 
state costs ranging from 50 percent to 90 percent, depending on the 
nature of the cost and the state.
  State fiscal flexibility is therefore built into Medicaid: States can 
spend what is needed on Medicaid knowing that their match rate is fixed 
in statute.
  Today, 70 million Americans rely on Medicaid for health care, ranging 
from preventive services, hospital visits, lab tests, to critical 
medical supplies, and prescription drugs.
  Before the Medicaid, funding poor families with children, pregnant 
women, and low-income working Americans were not able to afford even 
the most basic medical care they needed to remain healthy and 
productive.
  The most likely group to be block granted under HAO in the next 
several months is therefore the Medicaid expansion population, composed 
of adults who are under 138 percent of the federal poverty level and do 
not otherwise qualify for Medicaid as disabled, as a very low-income 
parent, or as a pregnant woman.
  However, according to the guidance that CMS released, other groups of 
Medicaid beneficiaries are also vulnerable to a federal approval of a 
similar block grant if they are in any way optional for states to 
cover.
  The HAO guidance is a quid pro quo that proffers to states accept 
financial risk in return for new flexibility.
  But ``flexibility'' in this case is simply another route to cuts to 
Medicaid that are not allowed under the Medicaid statute.
  As detailed below, HAO allows states to make otherwise disallowed 
cuts to Medicaid eligibility, benefits, and provider payment rates.
  The underlying reason for changing eligibility is to reduce the 
numbers of those covered.
  In my home state of Texas and in communities across the U.S. Medicare 
and Medicaid are vital programs that have significantly changed the 
lives and improved health outcomes of many Americans over the past 
century and represent the best American values where we believe Health 
is a Human right not a commodity. Medicaid is also really needed when 
communities face natural disasters like hurricane Harvey in Texas.
  Unfortunately, Texas has the highest percentage of uninsured (27.6 
percent) in the nation, 4 percent more than Louisiana the next state on 
the list and has opted out of participating in Medicaid expansion.
  The State of Texas' refusal to participate in the Medicaid expansion 
created by the Affordable Care act has already put the poor residents 
in my state in jeopardy, with this proposed change many more will be at 
risk of losing health insurance.
  In the 18th Congressional District there are 195,400 persons with 
Medicaid.
  Mr. Speaker, my constituents in the 18th Congressional District of 
Texas favor access to universal health care, because they understand 
the insecurity and feeling of helplessness of being uninsured or 
underinsured.
  I join my colleagues in support of H. Res. 826 because it sends a 
clear message to this Administration and the American people that the 
House of Representatives--the People's House will not tolerate harmful 
changes to critical health care programs like Medicaid by this 
Administration.
  The SPEAKER pro tempore (Mr. Courtney). All time for debate has 
expired.
  Pursuant to House Resolution 833, the previous question is ordered on 
the resolution.
  The question is on the resolution.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. WALDEN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

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