[Congressional Record Volume 171, Number 29 (Wednesday, February 12, 2025)]
[Senate]
[Pages S933-S935]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  NOMINATION OF ROBERT F. KENNEDY, JR.

  Ms. CORTEZ MASTO. Mr. President, I am joining my Democratic 
colleagues on the Senate floor today because we have pledged to 
Americans that we will always stand up and fight for affordable, 
quality healthcare.
  Right now, Donald Trump and his Republican allies in Congress are 
trying to dismantle healthcare access for Nevadans and Americans across 
the country. As we speak, Republicans are working out a way to pass 
their budget through Congress and slash Medicaid to pay for tax cuts 
for Trump's ultrawealthy friends. Their budget for these billionaire 
tax cuts was just released this morning, and they want to give away 
trillions of dollars to the richest Americans and add about $3 trillion 
to our national debt in exchange for nearly $1 trillion in healthcare 
cuts for working families. You can bet Medicaid will be one of their 
biggest targets.
  It is absolutely outrageous, and it is important that we shine a 
light for the American public so they know what is going on.
  Right now, the Senate is considering the nomination of Robert F. 
Kennedy, Jr., to lead the Department of Health and Human Services--who 
has made it clear that he will be a rubberstamp for Donald Trump even 
if it hurts Nevadans.
  This isn't fearmongering or speaking in hypotheticals. Donald Trump 
has been coming after critical healthcare since his first term in 
office. Every annual budget proposal Trump had in his first term, from 
2017 through 2020, included huge cuts to Medicaid. And when Republicans 
in Congress tried to repeal and replace the Affordable Care Act, 
President Trump was on board with every plan they came up with that 
slashed Medicaid in the process.
  I will tell you what: Democrats stood up to him every time.
  But even after multiple failed attempts, it doesn't seem like 
President Trump has learned that Americans don't want him to roll back 
Medicaid.
  His Project 2025 manifesto calls for the Centers for Medicare and 
Medicaid Services to impose lifetime caps on Medicaid. What does that 
mean? That means a person can only receive Medicaid benefits for a 
limited period of time no matter their income or their healthcare 
needs. That would leave about 92,800 Nevadans who are low-income and 
depend on Medicaid for healthcare at risk of losing their coverage.
  We know RFK, Jr., will just let this happen if he becomes the 
Secretary of Health and Human Services. HHS oversees the Centers for 
Medicare and Medicaid Services, which means Mr. Kennedy would have 
control over what happens with these essential healthcare programs.
  What is ironic is that Mr. Kennedy doesn't seem to even know the 
difference between Medicare and Medicaid. He confused the two multiple 
times during his confirmation hearing before the Senate Finance 
Committee.
  Also during that hearing, he made it very clear to me and he made it 
very clear to the general public who was watching that he would refuse 
to even tell me he wouldn't be a rubberstamp for this administration, 
that he could have an independent thought and fight any harm that would 
occur to Nevadans or across this country; he would stand up with them. 
He made it very

[[Page S934]]

clear that he would not, that he would stand with Donald Trump.
  I cannot support someone who would let Donald Trump give his 
billionaire friends tax cuts at the expense of Nevadans' healthcare.
  I know some of my colleagues on the other side of the aisle have 
argued that their plan to cut Medicaid is about getting rid of waste 
and fraud. Listen, I am all for reducing government waste and fraud and 
streamlining our bureaucracy.
  I will tell you, I served for 8 years as the attorney general in the 
State of Nevada, and during that period of time, the Medicaid Fraud 
Unit was in my office. We prosecuted and we went after individuals, and 
we held people accountable for that waste and fraud in the Medicaid 
Program. So I am all about addressing waste and fraud. In fact, I know 
that my Democratic colleagues and I have offered to work in a 
bipartisan way to cut wasteful spending.

  Instead, however, Trump and Republican leadership want to gut 
Medicaid, which millions of Americans depend on to access healthcare. 
It is just wrong. But let me talk about why. Let me tell you a little 
bit about the history of this.
  Medicaid was created in 1965 as a way for the Federal and State 
governments to provide healthcare coverage to low-income people who 
need it. That includes children, pregnant women, seniors, people with 
disabilities, and adults across the United States. It helps veterans, 
new moms and their babies, rural hospitals, primary care providers, 
mental health care workers, and more.
  As of June 2024, 788,481 Nevadans were enrolled in Medicaid and its 
initiatives, like the Children's Health Insurance Program, or CHIP. 
Nearly 800,000 people in Nevada--and that is just Nevada--depend on 
Medicaid to keep themselves and their families healthy. This includes 
one in six adults, three out of eight children, four in seven nursing 
home residents, and one-third of people with disabilities. Forty-three 
percent of our births are covered by Medicaid.
  But here is the deal: Sixty-six percent of adults in Nevada who 
benefit from Medicaid work for a living.
  I cannot say enough about this program and its impact in my State and 
how important it is. People over the age of 65 and disabled rely on 
Medicaid for their long-term care, and people with disabilities rely on 
Medicaid for their long-term care.
  Let me say that there are seniors who helped build this country and 
make America what it is today. They worked hard, they raised their 
families, and they contributed to our economy. Some are veterans of our 
Armed Forces. Now in their senior years, they have chronic illnesses, 
and they aren't able to move around the house like they used to. They 
cannot take care of themselves alone. That is what Medicaid is for.
  In Nevada, 17,600 Medicaid enrollees used home- and community-based 
services and long-term services to support themselves. That means 
nursing facility care, adult daycare programs, home health aide 
services, personal care services, transportation, and supported 
employment.
  It is a common misconception that Medicare and private insurance 
covers long-term nursing facility care or home care. They just don't. 
That is Medicaid. That is what Donald Trump and Republican leadership 
and RFK, Jr., want to cut to thank our seniors for everything they have 
done for our country. They want to roll back the healthcare benefits 
that are giving them the dignity they deserve in their retirement.
  But that is not all. Medicaid also supports low-income children and 
working families, including pregnant women and children with 
disabilities. Nearly 40 percent of all children in Nevada are covered 
by Medicaid and CHIP. This is a crucial program for Nevada's kids in 
making sure that they get their annual checkups, vaccines, hospital 
emergency care, dental and vision care, and the medications they need. 
All of this--all of this--is key to ensuring that our kids grow and 
that they develop at a healthy rate.
  Medicaid also covers more than 40 percent of all births in Nevada. In 
2023, that was 13,206 babies and their mothers who had access to 
essential healthcare that they wouldn't have been able to afford 
otherwise. These are the children, babies, mothers who are now being 
targeted by Donald Trump so he can pay for tax cuts for the ultrarich.
  Another key component of Medicaid coverage includes people with 
mental health challenges and substance use disorders. Nevada Medicaid 
provides screening and early intervention, outpatient and community 
services, crisis and emergency response, and residential and inpatient 
treatment to children and adults.
  I know we have a mental health crisis and a drug epidemic in this 
country. I see it. I hear about it from Nevadans every single day. I 
think both Democrats and Republicans agree that we are just not 
dedicating enough resources towards Americans' mental health.
  When there is a shooting at a school or place of worship or a music 
festival, the first thing I hear is that we need to invest more in 
mental health. And families in both red and blue States are being torn 
apart by fentanyl and other dangerous drugs.
  So why do my Republican colleagues want to do Donald Trump's bidding 
and slash Medicaid, making this crisis even worse? They are working 
right now to pass a budget through Congress that guts these critical 
programs. And they want to confirm Mr. Kennedy, who we know is going to 
go along with every one of Trump's plans.
  If they succeed, what is going to happen to Nevada's working 
families, our seniors, our veterans, and our children? What will happen 
to them if Medicaid is slashed? Well, let me just tell you what is 
going to happen.
  In Nevada, we rely on Federal funding for the vast majority of our 
Medicaid Program. Without it, policymakers in my State will be forced 
to cut coverage and leave hundreds of thousands of Nevadans uninsured, 
without access to affordable, quality healthcare. I said it before. 
Nearly 800,000 Nevadans who have Medicaid now will be in danger of 
being kicked off their health insurance, and 17,600 seniors and 
disabled people in Nevada will be at risk of losing their coverage, 
leaving even more families with nowhere to turn to take care of their 
elderly loved ones.
  When Nevadans lose their coverage, the already-expensive cost of 
healthcare shoots up. Nevada Health Link has a list of costs for people 
without health insurance. Let me tell you what that looks like now if 
they were no longer to have the benefit of Medicaid.
  Mammograms will cost $212 now. Brain MRIs have a copay of $20 to $100 
with insurance, but it will become $1,000 to $5,000 without insurance. 
A visit to the emergency room will cost Nevadans who are insured a $50 
to a $150 copay, but Nevadans who don't have insurance could pay as 
much as $3,000. A baby's visit to the doctor for a wellness checkup 
costs $10 to $30 if they have insurance, but without insurance, it 
costs about $95 per visit.
  These are the kinds of costs the average Nevada family cannot afford 
to pay, but Donald Trump is threatening to make this a reality.
  If Donald Trump cuts health insurance in Nevada, even more healthcare 
providers may be forced to close up shop because their patients can't 
pay for their care.
  Let me just stress this even more: Nevada's rural hospitals rely 
heavily on Medicaid. If Medicaid is cut, these hospitals that are 
already understaffed and overwhelmed would have to reduce their 
services, if not shut down entirely.
  Now, that is not unique to Nevada. Every rural community that relies 
on Medicaid is going to have the same problem. If you know our rural 
communities, you know that very rarely is there access to healthcare in 
a rural community, and when those providers are there, that is the 
place for our rural Americans to go. Sometimes they have to drive, in 
my State, 2 to 3 to 4 hours just to get access to healthcare. If we 
take away those areas and the locations for healthcare in our rural 
communities, that will devastate rural Americans.
  The reality is, in Nevada, we just don't have enough providers in our 
Medicaid Program. It is one thing to have a clinic open that door; it 
is another to have a hospital be able to open those doors to 
communities. But if you

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don't have the providers, that is essentially shutting down healthcare 
for individuals and people across this country.
  I will say my State is working to build out networks and encourage 
providers to come to Nevada, but we can't do it without critical 
funding from Medicaid. If Donald Trump cuts Medicaid, one of the first 
things my State will have to do is cut payment rates for healthcare 
providers, which will make our shortage of providers even worse, and it 
will disincentivize providers coming to live and work in Nevada. The 
ripple effect it will have on my State's economy will be disastrous. We 
just can't let this happen. This is going to affect Americans in every 
State across the country.
  We have to come together as a Congress and protect our working 
families from Donald Trump's billionaire tax cuts, and that includes 
voting no on RFK, Jr., whom Trump handpicked to lead HHS because he 
knew Mr. Kennedy wouldn't do a thing to stop him.
  With RFK running our Department of Health and Human Services, it is 
not just Medicaid that is in danger; Trump also wants to dismantle the 
Affordable Care Act. As we all may remember, he has concepts of a plan 
to do just that, but let's talk about what that means.
  Before the ACA, if you were an adult with no dependents, even if you 
were low-income, you had no access to Medicaid. Unless your employer 
provided health insurance, you had none. Now, thanks to the ACA, more 
people than ever before can get the healthcare they need. Over the last 
11 years, that has amounted to 20 million low-income adults enrolling 
in affordable, quality healthcare coverage through Medicaid. This has 
been a huge gift to our economy.
  Think of it this way: If you were an adult who had a chronic illness 
that kept you from working, you didn't used to have access to health 
insurance, but because of the ACA, you can now get the care and 
treatment you need and get back into the workforce.
  The ACA has helped Medicaid support our workers to boost our 
healthcare workforce, and it has made us a stronger and healthier 
nation. But, once again, Donald Trump wants to roll this expansion of 
Medicaid back and strip healthcare from thousands of Nevadans so he can 
pay for tax cuts for his elite, billionaire friends.
  Well, I don't know about my colleagues on the other side of the 
aisle, but I have no interest in cutting taxes for the ultrawealthy 
when we should be cutting taxes for working families. Here is how we 
can do that: Part of the Affordable Care Act provided tax credits for 
low-income Nevadans to make their healthcare premiums cheaper and help 
them afford their insurance. When we passed the bipartisan American 
Rescue Plan and the Inflation Reduction Act, we made those tax credits 
available to even more people, especially to those who had been 
impacted by the COVID-19 pandemic. But now those tax credits for hard-
working families are set to expire at the end of this year.
  This would be devastating to Nevada families and small businesses, as 
11,000 Nevadans would lose their healthcare coverage. Nevadans who have 
benefited from these tax credits would see their healthcare premiums go 
up by $2,000 a year, on average, and 250,606 small businesses and self-
employed workers in Nevada who qualified for these tax credits will see 
their premiums increase.
  I will tell you what: My Republican colleagues in the majority now 
have a decision to make. Instead of letting these tax credits for 
working families and small businesses expire and throwing thousands of 
lives into chaos, they could renew them. It should be simple. Let's 
come together and prioritize hard-working families and small businesses 
over billionaires. That is what we were elected to do, and it is what 
the American people expect of us.
  We cannot give our country over to the elite--to the wealthiest 
people like Robert F. Kennedy, Jr.--who will do whatever President 
Trump wants him to do to our healthcare system.
  My Democratic colleagues and I stand here today and every day ready 
to continue pushing back against Donald Trump's attacks on Americans' 
healthcare. Trump can say whatever he wants about not touching Medicaid 
and making America healthy, but the truth is that he will do whatever 
it takes to lift up his elite, billionaire friends and then tell you it 
is for your own good. Robert F. Kennedy, Jr., will be just a 
rubberstamp for that agenda. Because of that, I will be voting no on 
his confirmation.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Ricketts). The Democratic leader.

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