[Congressional Record Volume 171, Number 85 (Tuesday, May 20, 2025)]
[House]
[Pages H2191-H2197]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
GOP TAX SCAM HURTS EVERYONE
(Under the Speaker's announced policy of January 3, 2025, Ms. Schrier
of Washington was recognized for 60 minutes as the designee of the
minority leader.)
General Leave
Ms. SCHRIER. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days in which to revise and extend their remarks
and include extraneous material into the Record.
The SPEAKER pro tempore (Mr. Hurd of Colorado). Is there objection to
the request of the gentlewoman from Washington?
There was no objection.
Ms. SCHRIER. Mr. Speaker, I am here as one of the co-chairs of the
Congressional Doctors Caucus in the House of Representatives. I am here
to talk straight with you and with the American people and my
constituents about this tax plan that is being worked on by my
Republican colleagues.
It will explode the deficit. It will also hurt every single person in
this country by making the biggest cuts to Medicaid and to food
benefits ever.
I want to make clear, as I talk about this, how reckless it is and
that even people who do not rely on Medicaid themselves will be
impacted by this. I am outraged. We are talking about a cut of $715
billion to Medicaid. That is the largest cut ever. It will kick 13.7
million Americans off of their health insurance.
Let's just be really clear about why they are doing this. This isn't
to balance the budget. It is not to deal with the deficit. In fact,
this bill is exploding the deficit. This is to pay for a gigantic tax
break for the wealthiest people in this country a la Elon Musk.
It is morally bankrupt to think about that, that transfer, about
taking healthcare away from the people in my district and across this
country and transferring it to the wealthiest Americans. It is also
fiscally reckless.
Doing this will essentially collapse our healthcare system in the
United States of America. That is why just last week, we spent 26\1/2\
hours in the Energy and Commerce Committee discussing this very thing,
telling the stories of our constituents, painting a picture of what it
would mean to cut 13.7 million Americans off of their insurance.
It is interesting that this whole discussion didn't start until 2
o'clock in the morning because my Republican colleagues didn't want to
have this discussion during the day when people would actually hear it.
They waited until the dead of night to bring up this topic of taking
healthcare away from our constituents.
Mr. Speaker, in the State of Washington, one in three people rely on
Medicaid. I am going to tell you that most people who do don't even
know it because in Washington State it is called Apple Health. If
people are asked if they are on Medicaid, they will say no. If they are
asked if they are on Apple Health, they will say yes.
This represents the most vulnerable people. These are kids, pregnant
women, people with disabilities, and the elderly in nursing homes.
These are the people who need our help the most.
I think about my patients. I am a pediatrician. I think about the
ones who have Apple Health. If they didn't have it, if they didn't have
access to come see me, their primary care pediatrician, and get
diagnosed early with a mild pneumonia or an ear infection or whatever
the case may be, they would be forced to go to the emergency department
for that care.
It is not like they are not going to get sick. They are going to get
sicker, and they are going to go later when things are more expensive
and more complicated.
Mr. Speaker, do you know what else? Even if you are not on Medicaid,
as I think about my patients with private insurance, they are going to
be waiting in that emergency department line, too. They will have
broken an arm or have some other emergency. They are going to be
waiting in a longer line. We all know that the lines are already long
to be seen in the emergency department.
The care there is the most expensive a person can get. The lines are
the longest lines. Somebody is going to pay for that care. Otherwise,
hospitals go underwater, and they go out of business.
Who is that? That is the people who are not on Medicaid but who are
paying private insurance premiums. Those premiums are going to go up.
It will hurt individuals who buy their own insurance. It will hurt the
businesses and the companies who employ those people. This hurts
everybody.
I want to tell you the story about Ayla. This is Ayla. She is 4 years
old. She was born in 2021 in a rural part of my district after an
uneventful pregnancy. Right after she was delivered, something went
very, very wrong. She was in dire straits. She was clearly sick. She
needed emergency care.
Thank goodness, this rural hospital has a labor and delivery unit.
They were well-equipped to resuscitate a baby, to stabilize her, and
then to Life Flight her to a hospital that could provide the specialty
care that she needed.
Let's think about it for a moment. If Medicaid gets cut and these
rural hospitals see a disproportionate share of patients on Medicaid,
either those hospitals are going to close or they are going to start
cutting back services. Mr. Speaker, I will tell you the first service
to go will be labor and delivery.
What if that had happened after these Medicaid cuts? What if Kittitas
Valley Healthcare didn't have labor and delivery? What if Ayla had been
born then? What if she had not had the specialists there and had not
had the ability to be resuscitated there in the delivery room? She
would not have made it.
That is what we are going to see when they start cutting away at
Medicaid. It will mean the closure of rural hospitals and fewer labor
and delivery units. More people will get sicker. They will get poorer.
Children like Ayla will not make it.
That is what I mean when I say it collapses our whole healthcare
system. Our healthcare system is like a three-legged stool. One of
those legs is Medicaid. If we start taking that away, the whole system
collapses.
That is what we are talking about: Hospital closures, taking away
services, long waits in emergency departments, and a population that is
sicker and that needs more care. That care becomes more expensive. It
hurts us all.
That is why I am so outraged that this is the mechanism that my
Republican colleagues want to use to pay for a tax plan that will give
gigantic cuts to the wealthiest taxpayers in this country such as Elon
Musk. That is unconscionable. I wanted to start with that.
I am really honored to yield to our Speaker Emerita Nancy Pelosi from
the great State of California.
[[Page H2192]]
Ms. PELOSI. Mr. Speaker, I am pleased to receive time from the
distinguished Congresswoman from Washington State (Ms. Schrier). She is
a pediatrician. We have all learned a lot about how public policy has a
direct impact on the health and well-being of the American people.
When I hear them talk about cutting over $700 billion in Medicaid and
that it is just waste, fraud, and abuse, this beautiful child is not
waste, fraud, and abuse. I will talk about a little child in my remarks
who is not waste, fraud, and abuse.
This Special Order comes together to shine a bright light on the
Republican plan to fund tax breaks for billionaires by making huge cuts
to Medicaid.
That is what it looks like. The fact is they will still with their
tax bill add nearly $4 trillion to the national debt to cover their tax
break for the wealthiest people in our country.
{time} 1940
This is fiscal engineering to reduce the role of government in the
lives of the American people where it is most needed. This is Robin
Hood in reverse, taking resources from where it is most needed, from
people who need it most, and giving it to those who need it less, the
billionaires in America.
This is shameful. It is a fraud, and it is a shame.
When President Johnson signed Medicare and Medicaid into law, he
traveled to Independence, Missouri, to be in the presence of former
President Truman who had worked on this when he was President, but it
came to fruition under President Johnson. President Johnson went there,
and he signed the bill in the presence of Harry Truman. He reminded the
American people of a shared tradition:
``Never to be indifferent toward despair. . . . never to turn away
from helplessness. . . . never to ignore or spurn those who suffer
untended in a land that is bursting with abundance.''
Indeed, Medicaid saves lives and is a pillar of health, security, and
justice for tens of millions of Americans.
People often think of Medicaid as healthcare for poor children, and
that would be justification enough, healthcare for poor children.
However, it also is a middle-income benefit for nursing home residents
and people needing it for long-term care services. They get that
largely through Medicaid. It is also a benefit for people with
disabilities.
The Republicans' devastating budget plan would push about 14 million
Medicaid recipients off lifesaving healthcare and leave countless
vulnerable families exposed to catastrophic medical bills. This is
terrible. This is about health and financial health that is being
devastated.
Working families and children from low-income households would face
ruinous consequences as would rural hospitals--as the distinguished
Congresswoman has mentioned--families seeking opioid addiction
treatment for their loved ones, and middle-class Americans with long-
term care needs.
Mr. Speaker, I ask unanimous consent to insert a statement from the
California Medical Association into the Record.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from California?
There was no objection.
California Medical Association,
May 12, 2025.
CMA statement on House Republicans' proposed cuts to Medicaid
California Medical Association President Shannon Udovic-
Constant, M.D., issued the following statement regarding
House Republicans' proposed cuts to Medicaid:
``The latest federal proposal to gut Medicaid is reckless.
Physicians and hospitals will be pushed to the brink, forced
to close their doors and unable to continue to care for their
patients.
``These would be the largest Medicaid cuts in history and
will leave veterans, seniors, the disabled, children and
working families without health care coverage--making
emergency rooms the only point of care for millions of
people. Communities will be devastated, and lives will be
lost.
``Congress must reject these cuts and instead focus on
strengthening the safety net that protects us all. Otherwise,
at least 13.7 million people will lose health care
coverage.''
Ms. PELOSI. This is what they have said about this.
California Medical Association issued the following statement
regarding House Republicans' proposed cuts in Medicaid:
``The latest Federal proposal to gut Medicaid is reckless. Physicians
and hospitals will be pushed to the brink, forced to close their doors
and unable to continue care for their patients.''
Mr. Speaker, that is because when this funding leaves those rural
hospitals, then not only do the Medicaid patients lose, but all the
patients in that rural area lose.
``These would be the largest Medicaid cuts in history and will leave
veterans, seniors, the disabled, children and working families without
healthcare coverage''--this is as the distinguished physician colleague
has said--``making emergency rooms the only point of care for millions
of people. Communities will be devastated; lives will be lost.
``Congress must reject these cuts and instead focus on strengthening
the safety net that protects us all. Otherwise, at least 13.7 million
people will lose healthcare coverage.''
Republican attacks on healthcare impact real people, including little
children. My guest at the President's State of the Union Address to
Congress was Elena Hung, mother of Xiomara, a courageous Little
Lobbyist, who is 11 years old.
Xiomara has complex medical needs, including chronic lung disease,
chronic kidney disease, and global development delays. She has a
tracheostomy, is ventilator and oxygen dependent, and uses a feeding
tube.
Access to quality, affordable healthcare ensured that Xiomara
received the care she needed during an extended hospitalization and can
now live at home with her family.
Medicaid has helped Xiomara receive the therapies she needs to catch
up with her developmental milestones, including physical therapy,
occupational therapy, feeding therapy, and speech therapy.
However, these very lifelines, including Medicaid and more, are what
Republicans are working to destroy to fund tax cuts for billionaires.
Democrats are standing strong against the administration's many
attacks against families' healthcare. This is just one of them.
With this Special Order hour, we are calling out Republicans to
either vote to protect their constituents' healthcare, or to vote to
take it away. That is the choice.
In stark contrast to the President and Republicans in Congress,
Democrats will always fight to lower healthcare costs. We are unified
and ready to use every tool to stop this GOP scheme. We will always
work to strengthen pillars of health and financial security in America.
That includes the Social Security, Medicare, and Medicaid. We will
always fight for Medicaid.
I just want to go back to that one thing. They are still adding
nearly $4 trillion to the national budget to give tax breaks to their
wealthy billionaire friends. When the Republicans passed that bill and
the President signed it into law, 83 percent of the benefits went to
the top 1 percent, adding $2 trillion to the national debt. They are
doubling down on that, adding almost $4 trillion to the national debt
and saying: We have got to give all this money to billionaires and call
children waste, fraud, and abuse in our Medicaid system.
It is really sinful, it is really sad, and it is something that I
hope the Republicans will reject.
I hope their constituents will call them, because these Medicaid
people are in Republican districts. One of our colleagues in California
has, out of all of our constituents, he has nearly 500,000 people on
Medicaid. Yes, he voted with Republicans on this.
Mr. Speaker, you can be sure he will be hearing from his constituents
because people know.
I will close by saying that Lincoln said:
``Public sentiment is everything. With it, you can accomplish almost
anything. Without it, practically nothing.''
However, for public sentiment to prevail, people have to know, and we
are making sure that our constituents know and they are being informed
as to our knowledge of what Republicans are doing. It is Republican
reverse Robin Hood.
Mr. Speaker, I am grateful for the opportunity to share the story of
this beautiful little girl.
[[Page H2193]]
Ms. SCHRIER. Mr. Speaker, I thank Emerita Speaker Pelosi for her
moral clarity and her fiscal pragmatism in painting a clear picture of
what is going on right now.
Mr. Speaker, I yield to the gentlewoman from Vermont (Ms. Balint).
Ms. BALINT. Mr. Speaker, I thank Representative Schrier, and I am
happy to be here.
Just this morning, President Trump said that the Republicans aren't
cutting anything meaningful in their budget. What a thing to say. What
a shocking thing to say when these cuts will hurt so many Americans. I
am having a really hard time understanding how taking away healthcare
from nearly 14 million Americans isn't meaningful.
It is not meaningful that rural hospitals across Vermont and across
this country are going to be at risk of closing?
Just today I met with Vermonters from a little town called Coventry,
and they are deeply concerned that they are going to lose access to
labor and delivery healthcare at their local hospital.
Republicans are so out of touch with the reality of American families
right now, and it is shocking to call these cuts not meaningful when
their bill will hurt working families.
It takes away food and healthcare from millions and millions of
people, their own voters, but yet they are not meaningful cuts.
These cuts are certainly meaningful for all the kids and veterans who
will go hungry because of this cruel and what I think is a very cynical
bill.
Why are my Republican colleagues making the cuts?
That is what we all want to know.
It is to give the very wealthy another big tax cut and deliver tax
breaks to billionaires and corporations, people who absolutely don't
need any more assistance.
It is taking that money from people who desperately need help and
giving away to the people who don't.
{time} 1950
People who are just struggling to get by are having precious
resources taken away from them.
Right now, across this country, Americans are trying to figure out
the math. Are they going to be able to afford groceries for their kids?
They are trying to decide whether they can afford to go to the doctor.
While that is happening, in real time, my colleagues are spending
time demanding more work requirements for Medicaid recipients when we
know that almost half of adults on Medicaid are already working. They
act like they are not working. They are working, and 27 percent of
those working-age adults on Medicaid are disabled. They are doing the
best they can here.
It couldn't be more obvious that they are just looking to remove more
people from the Medicaid rolls in order to have more money to give tax
breaks to billionaires and corporations. It is sick.
These are real people who we are talking about tonight in every
congressional district who cannot handle these cuts. It is as simple as
that.
The reality is that Americans can't pay for their rent right now.
They can't pay for their groceries. They are too high. Prescription
drug prices are too high. Costs for consumers and small businesses are
just going to go up because of the asinine tariff regime that we have
been dealt.
Of course, Americans feel like it is rigged against them because it
is. That is why we have to be here fighting for them. That is why we
have to be here, raising the alarm about what is happening in this bill
with Medicaid.
What Americans want is fairness. What they need is fairness. We owe
them that. They want and need affordable healthcare, and we owe them
that. They want and need a fair shot, a better life for their kids, and
we owe them that.
This bill that cuts Medicaid is a statement of values. It shows
exactly what and who the Republicans are caring about. It is not you
and your family. It is not me and mine. It is about propping up
billionaires and kicking the rest of us in the teeth while they do it.
What kind of leaders take away healthcare and food from working
people so that the wealthy can get even more money? What kind of
leaders? Not strong leaders, not leaders of conscience.
It is shameful.
Ms. SCHRIER. Mr. Speaker, I thank Representative Balint for that
clarity. I appreciate drawing that distinction that Speaker Emerita
Pelosi referred to as reverse Robin Hood. That is exactly what is going
on here.
Who are you standing up for? We saw with the Republican 2017 tax cut
that the vast majority of that benefit went to the wealthiest, and it
did not trickle down to people. People are already having trouble
affording rent, home prices, food, and other goods.
Putting this kind of financial pressure not just on Medicaid
recipients but on everybody else, because insurance rates and medical
costs are going to go higher, only makes that squeeze worse.
Mr. Speaker, I yield to the gentlewoman from Hawaii (Ms. Tokuda).
Ms. TOKUDA. Mr. Speaker, I rise today with a warning--no, a plea.
Rural America is already in crisis. People there die younger. Mothers
face greater risks when giving birth. Hospitals teeter on the edge of
collapse.
Medicaid is the thin lifeline holding together that fragile system.
Cut it and people will die.
At Adventist Health Castle in Kailua, 75 percent of patients rely on
Medicaid and Medicare. They have already weathered the storm of COVID.
With new GOP-led cuts to provider fees, they may be forced to shut down
essential services--obstetrics, pediatrics, and emergency services,
care that literally keeps babies and people alive.
This is not just about one hospital in Hawaii. This is a national
crisis. Rural Americans face significantly worse health outcomes and
health disparities. In too many rural counties, life expectancy is a
decade shorter than that of their urban neighbors.
Maternal mortality in rural areas is nearly double that of urban
areas, and more than 200 rural hospitals have closed their doors since
2005. Over 450 more are currently at risk of shutting their doors.
This isn't hypothetical. It is happening right now. Let's be clear:
When these providers and hospitals close their doors, everyone in those
communities, including, by the way, some Members of Congress and their
families, will lose their healthcare. It won't bring me or anyone
impacted any comfort or peace to say, ``I told you so.''
Suma Metla, a pediatric physical therapist and mom, treats kids with
complex needs. Forty percent of her patients are on Medicaid. She told
me plainly, as she sat in my office today with her 1-year-old, Kashi:
If these cuts pass, we will not survive past this year.
Already, speech therapists and other specialists are shutting their
doors in Hawaii and across the country. Her own practice is buried in a
2-week backlog. One of two hospitals that offer similar care, and we
only have two throughout the State, has a 100-child waiting list right
now.
Suma has traveled to Lanai to treat children no one else could reach.
She tried to keep care going through telehealth, but when Congress let
those tools expire, families were left stranded.
Let's talk about the preschool teacher in my district whose son was
born weighing less than 2 pounds--5 months in the NICU, emergency
surgery, feeding tubes, with a hospital bill 50 times more than she
will make in a single year covered by Medicaid.
That little boy is now 3 years old, full of life, laughter, and love
and obsessed with music and trucks. He is alive only because Medicaid
was there.
We cannot forget what is at stake. These are not just numbers on a
page. They are real lives, real children, real families, and real
communities, people like you and me.
Slashing Medicaid won't balance a budget. It will close hospital
doors. It will rip care from those who need it most. It will end lives.
We must not let this happen. Find the courage. Have a conscience.
Vote ``no.''
Ms. SCHRIER. Mr. Speaker, I thank Representative Tokuda for bringing
up that particular issue of children in the neonatal intensive care
unit, where I have worked.
I think about this frequently. When over 40 percent of births in this
country are covered by Medicaid, I think about what it would mean for a
family
[[Page H2194]]
to be bankrupt for the rest of their lives if they had a premature baby
or a baby with special needs. I also think about what would happen if
those babies didn't get the right care.
Sometimes this is not a matter of life and death but a matter of
life, death, and lifelong disabilities. That is what good NICU care
will mean, and it makes a difference for these babies who are relying
on Medicaid.
Mr. Speaker, I yield to the gentleman from California (Mr.
DeSaulnier).
Mr. DeSAULNIER. Mr. Speaker, I am reminded of the first oath the
gentlewoman took before she got here: First, do no harm.
I wish my Republican colleagues would take that oath because the harm
that this proposal does to the least amongst us in this country is
unfathomable, cruel, and madness from a financial perspective.
When everyone is cut off from Medicaid, where will they go? They will
go to public hospitals that are already underfunded and trying to serve
the least among us.
After all the stories you have heard, I want to put in some numbers.
Think of multiplying these numbers to the stories you have heard,
particularly for people who are the least among us as Americans.
There are 78.5 million people enrolled in Medicaid and the Children's
Health Insurance Program across America. This is 10 percent higher than
in February 2020, pre-COVID.
One in three people with disabilities, 15 million, have Medicaid.
Comparatively, 19 percent of adults without disabilities have Medicaid.
These are the people who Republicans and Democrats in the past have
tried to protect. Now, we are being cruel and dismissive of their
needs.
One in five Medicaid enrollees has a disability. Two-thirds of
Medicaid enrollees do not receive SSI benefits.
{time} 2000
Mr. Speaker, 10.3 million people would lose Medicaid coverage in the
next 10 years if the budget reconciliation bill of the Republicans
passes because of its punitive work requirements. Most of these people
are already working.
In 2022, Medicaid covered two-thirds of all home-care spending. 4.5
million people receive Medicaid-covered home-care services each year in
America.
Medicaid cuts as proposed under the Republican budget threaten
optional benefits the most, including long-term services and supports
that help the disabled and the elderly in home- and community-based
services that help protect these Americans who need our help. They live
with disabilities in their own communities and get the support, love,
and affection of those communities and their families.
In California alone, almost 15 million Californians are on Medicaid.
1,906,300 Californians on Medicaid have a disability. Of those, 992,000
people are working, aged 19 to 65. A million people in California with
disabilities who get Medicaid are working, and now they are going to be
forced to go through a bureaucracy that supposedly the majority wants
to make more efficient. That is not efficiency. That is cruelty to the
least amongst us.
Mr. Speaker, 68 percent of California adults on Medicaid have a job.
In just my district, which is the fifth wealthiest district in the
House, 131,634 people are on Medicaid and are at risk of losing care
under the Republican budget. 45,916 of those are children, 19,000 are
seniors, 10,000 are people with disabilities, 48,300 adults are on
Medicaid due to ACA expansion.
Mr. Speaker, this is madness. I thank my colleague for bringing this
to the floor, and I thank her for her spirit and her personal testimony
to what this will mean to millions of Americans who are the least
amongst us.
Ms. SCHRIER. Mr. Speaker, I thank the gentleman for his comments and
putting this in a very personal way.
I am wondering for people out there watching if they are thinking,
gosh, I wonder is this really true? Are hospitals really going to
close? Are we really going to lose labor and delivery and have to drive
hours to get to the nearest hospital to deliver a baby?
In my district, the hospital that I talked about earlier is between
two mountain passes. If it is snowing, there is really nowhere to go
except by Life Flight, and that is not hyperbole. I have sat with the
heads of school-based health clinics and community health centers, with
heads of hospitals, with nursing homes--and, by the way, we have been
referring to rural hospitals, but there are urban hospitals and
suburban hospitals that are also highly dependent or have a very high
percentage of Medicaid-dependent patients.
We are already seeing cuts in hundreds of employees in the Seattle
area because of these impending cuts to Medicaid. I want to just be
crystal clear; this is absolutely true. We are hearing this across the
board that when Medicaid gets cut, we all lose.
We lose our local labor and delivery service. We lose our local
emergency room. We lose the ability to be seen quickly in the event of
an emergency because somebody who could have been taken care of by a
primary care physician a couple of days earlier with an uncomplicated
illness is now in the emergency room ahead of you in line, making you
wait when you are having a heart attack. That is completely preventable
by using the leanest, most efficient healthcare service and insurance
that we have called Medicaid.
I want to tell another story. This is the story of Miguel. Now, we
talked about Ayla before, a little 4-year-old girl. Miguel is at the
other end of life. He is a senior. He is a constituent who is dependent
on Medicaid. He is actually a 76-year-old widower who lives in
Wenatchee, the apple capital of the world.
Now, after Miguel's wife passed away, he relied solely on his Social
Security check to cover his living expenses. He is a retired orchard
worker, and he worked hard to earn that Social Security. He spent
decades doing physically demanding labor without access to a pension
later, and private insurance was never affordable.
He still depends on Medicaid to stay in his modest home, receiving
regular in-home nursing visits and help with daily tasks, like bathing,
cooking, and managing his medications. Medicaid's coverage for home-
based care is, by the way, far more affordable than nursing home-based
care. He gets that home-based care, transportation, and care
coordination through Medicaid. Without that, he would have no way to
attend his checkups, manage his diabetes, and function through the
limitations that he suffered because of a stroke.
Miguel fears losing access to the services that allow him to live at
home with dignity, with independence, in familiar surroundings, and he
deserves that. Frankly, that is the most cost-effective way to help
Miguel.
For seniors like Miguel, Medicaid is not optional. It is their
lifeline. It is how they keep dignity. It is how they stay at home.
Unfortunately, Miguel's fears are not unfounded. The rural hospital
that he depends on treats patients who are more likely to be on
Medicaid or Medicare. In other words, they have a disproportionate
share, and if these patients, these Medicare patients, lose their
health insurance because of this bill, the cost of their care gets
absorbed by the hospital.
For hospitals in rural areas that are already struggling, barely
keeping their heads above water, this could be the death blow. This
will force them to first cut services. I talked about labor and
delivery. I could also talk about mental health services and opioid
treatment. Those are often the first to go. This would leave Miguel
without access to care.
I am not trying to fearmonger or deceive Americans, but this is
scary. It is real. I am simply saying what our community health
centers, and our hospitals, and our nursing homes, and our school-based
health clinics are telling me, that the Republicans' budget will take
healthcare away, and health insurance away from 13.7 million Americans
all while, therefore, increasing costs for everyone, decreasing access
to care, and leaving us all sicker and poorer.
Now, we haven't even talked really about the impact on nursing homes
and on our seniors. Speaker Emerita Pelosi touched on this, but I also
want to be very clear that three out of five middle-class, working-
class Americans in nursing homes depend on Medicaid to pay those bills.
We already say in Washington we don't have enough nursing homes. In
fact, people who should be in nursing homes are now filling hospital
beds because there is nowhere else to go. Just
[[Page H2195]]
imagine if more nursing homes close what that will do to hospitals,
what that will do to those patients.
Then think about this: I am in the sandwich generation. If I had a
parent who relied on Medicaid to be in a nursing home and could not
otherwise afford that, I would need to leave my job to take care of my
parents. That is not what they would want for themselves or for me or
for my family. This is what millions of families out there will go
through if these Medicaid cuts happen.
Ms. PELOSI. Will the gentlewoman yield?
Ms. SCHRIER. I yield to the gentlewoman from California.
Ms. PELOSI. Just briefly, I want to make this further point. Ms.
Schrier has been so eloquent, and all of us associate ourselves with
her remarks and the professional knowledge that she brings, the
intellectual resource she is on all of this.
I just want to add one thing. At the same time as the Republican
reverse Robin Hood plan is going, taking it from those who need it
most, giving it to those who have the most, they are also taking nearly
$300 billion from SNAP.
{time} 2010
SNAP is for food. Food is medicine. You are going to make people even
more sick if those children don't have food.
There was one time when Medicaid first began that one of the people
who was starting community health centers around the country insisted--
insisted--with the Federal Government that food be counted as medicine
because it is about health. Children who do not have access to food are
the ones who suffer the most.
I see that our colleagues have arrived.
Let me just add one thing. People ask me: What is your why? Why did
you ever decide to leave home and come to Congress? I have five
children. The idea that one in five children in America lives in
poverty and goes to sleep hungry at night in the greatest country that
ever existed in the history of the world, I just couldn't handle that.
That is what took me from kitchen to Congress and housewife to House
Speaker, to feed the children.
When Matthew says: ``When I was hungry, you fed me,'' in the Gospel
of Matthew, what do we do with that? Just tear it up. This is immoral.
It is sinful for us to be taking food out of the mouths of babies to
give tax cuts to rich people.
Yet, do you know what? It isn't about that. Republicans are giving
those tax cuts anyway. The majority is fiscally engineering the
shrinking of the compact that we have with the American people and that
developed countries have with their constituents.
We are behind the rest of them in many of these regards when we have
to take food out of the mouths of babies to say that we are going to
give a tax cut to the wealthiest, but we just really are taking food
out of the mouths of babies because we don't want to feed them. That is
what this is about, $1 trillion: $700 billion or more for Medicaid and
$300 billion for SNAP. It is reverse Robin Hood a la Republicans.
Ms. SCHRIER. Mr. Speaker, I so very much appreciate those comments
and Speaker Emerita Pelosi's dedication to children in every way.
Just to put an even finer point on that, food is medicine, cutting
SNAP benefits not only takes food away from hungry people, but it also
undermines our economy because those dollars are spent at our local
grocery store.
I also have to just mention that food banks, which are the next line
of support, are also under threat because DOGE and Elon Musk and Donald
Trump have cut the food going to those food banks, leaving shelves
bearer and leaving food banks having to ration foods. They also
canceled the program where local farmers can provide their food to the
local food banks, which is the healthiest and local and fresh food.
All of this just adds up, once again, to hurting people in need in
order to fund a tax cut for the billionaires in this country.
Mr. Speaker, I now yield to my colleague from Minnesota (Ms.
Morrison) to give her perspective about Medicaid.
Ms. MORRISON. Mr. Speaker, I thank Representative Schrier for
yielding me time.
Mr. Speaker, I rise today alongside my colleagues in the Democratic
Doctors Caucus and as the first and only pro-choice OB/GYN here in
Congress to speak out against the Republicans' disastrous budget
proposal and to fight for our women, children, and families.
For more than 20 years, I have had the honor and privilege of taking
care of OB/GYN. One of the great joys of my job is caring for my
patients during their pregnancies and helping them grow their families.
I carry my patients and their stories with me, and they inform my work
here in Congress.
I think about them and all of the challenges that new parents face
during pregnancy and then after they head home with their new baby:
recovering from the delivery, adjusting to life with a little one,
accessing the care they and their family need, balancing caregiving and
work, making ends meet, and the cost of raising children in the United
States. It is a lot.
I think about all of the babies I have delivered whose moms got their
healthcare through Medicaid and how critical that was to help them get
off to the best possible start.
It is because of those patients and patients all across the country
that I stand here today both incredulous and outraged that the
Republican majority in Congress is shoving a budget through that will
gut Medicaid, the very health insurance program that covers 40 percent
of all births and insures almost half of all children in our country.
As an OB/GYN, as a mother, as a Member of Congress, and as an American,
this is unconscionable to me. We already have a maternal health crisis
in our country.
Let's look at the facts about that maternal healthcare crisis that we
face now and remember that this is before we gut Medicaid. In more than
half of our country, women do not have a place to go to get obstetric
care. Among our peer nations, the United States has the highest rate of
both maternal and infant deaths.
In 2022, there were more than double and sometimes triple the rate of
maternal deaths in the United States compared to most other high-income
countries, and unacceptable disparities exist. Black, American-Indian,
and Alaska-Native women are three to four times more likely to die from
a pregnancy-related cause compared to White women. Most of these
deaths, more than 80 percent, are preventable.
What is the Republican majority doing to address this unacceptable
crisis? Instead of working to find ways to improve women's health and
to help moms and babies, they are shoving a budget through that will
devastate our Nation's maternal healthcare and decimate many of our
hospitals and clinics. It will unequivocally make our Nation's maternal
health crisis worse.
Why in the world are they doing this? Why are they choosing to harm
women and children? They are doing it to pay for tax cuts for the
ultrawealthiest among us. That is literally why. To make the math work
to cut taxes for billionaires, they are choosing to sell out the health
of women, moms, new babies, and the future of our country to pay for
tax cuts for billionaires, choosing to take healthcare away from moms
and their babies.
Let's be clear. This won't just be devastating to the moms and new
babies who get their healthcare coverage through Medicaid. It will be
devastating for maternal healthcare across the country. All of this is
coming from the party that calls itself pro-life and profamily. It is
hard to imagine a more antifamily policy.
Instead of wasting time musing around ridiculous ways to persuade
women to have more children, like giving medals for having six or more
babies, I would remind my Republican colleagues that they could start
with something real, meaningful, and impactful right now by not gutting
the health insurance program that covers almost half of all births and
half of all children in our country. The Republican majority needs to
make their profamily rhetoric match their policy, put America's moms
and babies first, and stop these proposed cuts to Medicaid.
Ms. SCHRIER. Mr. Speaker, I thank Representative Dr. Morrison for her
perspective, from the perspective of an OB/GYN who has taken care of
pregnant women and new babies and really
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paints a very clear picture about maternal mortality in this country
and what cuts to Medicaid mean for that.
It is interesting. All of us in the Doctors Caucus have been talking
for years--in fact, for the whole time I have been in Congress--trying
and trying to improve Medicaid reimbursement, to make it so that
Medicaid reimbursement can match Medicare reimbursement so that more
children can have a medical home. It is about expanding Medicaid care
for pregnant women until 1 year postpartum to make sure that they are
healthy and plan their pregnancies and that we can cut down this
outrageous incidence of maternal mortality in this country.
Now we are just fighting to keep Medicaid. That is the situation we
are in now because Republicans want to gut Medicaid and take health
insurance away from 13.7 million Americans to pay for a tax cut for the
wealthiest Americans. That is just plain wrong.
I will talk for a moment about another constituent of mine who paints
just a different angle on what it looks like to cut Medicaid. I will
tell you that our phones are ringing off the hook. People understand
what is going on. They are worried for their health, for the health of
their families, and for the health of their parents. They get what will
happen to their local rural hospital if these go into effect.
I will tell you about Kathleen, who graciously shared a story about
her own mother. Kathleen's mother lived to be 92 years old. She was a
widow for 42 of those years and helped care for five of her
grandchildren.
{time} 2020
Kathleen's mom lived through the deprivations of the Great Depression
and World War II and was never one to complain. She lived simply.
In the last decades of her life, she had a number of serious, complex
medical conditions that presented real challenges for her medical team
and specialists and, of course, for her. Medicaid supplemented her
traditional Medicare plan in the last years of her life and allowed her
to get the medical care that she needed. She was treated with care and
respect.
When Kathleen's mom injured herself in a fall, Medicaid covered the
rehabilitation facility and, later, in-home physical therapy and
occupational therapy so she could be in her own home.
Later, she had a life-threatening event and was hospitalized.
Eventually, she was well enough to move to an outpatient rehabilitation
facility, followed by in-home care. Again, Medicaid was there for her.
The care was safe, reliable, and appropriate, and it gave tremendous
relief to her and her family.
In the last months of her life, Medicaid provided hospice care. The
nurses, home health aide, OT, PT, and case manager were her guardian
angels. They treated her with compassion and dignity.
Isn't this the type of treatment and care, the care made possible by
Medicaid, that all of us deserve, that all of us want, and that we want
for our friends, family, and ourselves?
For so many seniors in this country, this type of care is made
possible thanks to Medicaid. It is unfathomable that my Republican
colleagues want to deny our seniors the type of comprehensive,
compassionate, and thoughtful care that Kathleen's mother received.
That brings us full circle to how these cuts to Medicaid, Apple
Health in Washington State--something a lot of people out there think
is that they are not relying on Medicaid, so maybe it doesn't affect
them.
The message I really want to deliver, Mr. Speaker--and I am actually
going to look at the camera to speak directly to the American people--
is that cuts to Medicaid, or to Apple Health, impact every single
person in this country.
They impact you if you are the son, daughter, or spouse of a senior
who needs to be in a nursing home because nursing homes will close, and
you will have to leave your job to take care of your ailing parent or
spouse.
They impact everybody who lives in a rural community or in an urban
community where there are a lot of patients who rely on Medicaid
insurance, because when Medicaid doesn't pay the bills for those
people, the hospital gives away that care for free. Then, they either
cut services or close--or, more likely, a combination of them--and your
insurance premiums go up because somebody has to pay. Who is going to
make up the difference? Private insurance. That means your insurance
rates go up, and they are already high.
Everybody hurts from this, even if you are not paying for your own
health insurance. I bet, at some point, you are going to the emergency
room, and those patients who don't have Medicaid are now getting
sicker, waiting longer, and getting their care late in an emergency
department.
If you think the waits are bad now because hospital beds and ER beds
are full of patients in mental health crises or with fentanyl overdoses
or with nursing home patients who don't have a nursing home to go to,
if you think the waits are bad now, just wait till 13.7 million
Americans lose their health insurance.
We are all impacted. If you live in a rural area and have private
insurance, you are doing fine, but if the labor and delivery department
closes at that rural hospital and maybe you have a high-risk pregnancy
and need obstetrics care and might have a complication with that
delivery, you might have to go live in a more urban area for the month
before that delivery just to make sure that you are safe and that your
baby is safe.
This is something that none of us should have to worry about in the
United States of America. This is a prosperous country. We have
excellent healthcare here, and to think that my Republican colleagues
want to cut Medicaid, a lifeline for the patients who depend on it and
for our entire healthcare system, that they want to cut what the people
most in need depend on--again, we are talking about the elderly, people
with disabilities, pregnant women, children. To think that they would
cut care for them in order to pay for gigantic tax cuts for
billionaires--it is a backward transfer of money. It is Robin Hood in
reverse. It is just plain wrong. I have explained now that, in addition
to being morally bankrupt, it is also fiscally reckless.
It is irresponsible, and I just don't understand how this is the plan
that my colleagues came up with. Their constituents are going to hurt
every bit as much as mine and, statistically, with more rural areas and
already more vulnerable rural hospitals, chances are their constituents
are going to hurt even more.
I sure hope that people out there are paying attention. Call the
people who represent you. Tell them what your fears are. I know people
are calling me, and I am standing up here to appeal to my Republican
colleagues and let the American people know what is going on right now,
why they should be concerned.
This is a democracy. Call the people who represent you. Tell them
what you think. Tell them what it would mean for you, for your family,
for your neighbor.
Again, when it is one out of three in Washington State, what would it
mean if these largest-ever cuts to Medicaid transpired?
Here is what is going to happen tonight. At 1 o'clock in the morning,
the Rules Committee is going to meet. They are going to craft the rules
for Trump's so-called big, beautiful bill, which would be a travesty
for the people I represent. They are going to do this at 1 o'clock in
the morning when everybody else is asleep, not watching, not paying
attention, not watching the nightly news. This is not prime time
because, I think, they are embarrassed about what they are doing, but
they are going to do it anyway. They are going to do it for the people
who were in the front row at President Trump's inauguration. That is
who they are going to do it for.
This is not helping their constituents. It is not helping my
constituents. America, it is not helping you.
It is morally bankrupt. It is fiscally irresponsible. It is just
plain cruel. That is why I, along with the rest of the Doctors Caucus,
have spent this evening talking about what this means for our patients
and for our healthcare system.
We understand it on a visceral level because we have lived in and
worked in this healthcare system. We have worked in crowded emergency
departments, seeing people who, if they had health insurance, wouldn't
need to be
[[Page H2197]]
in the emergency department. We have taken care of patients who didn't
have insurance like Medicaid, so they delayed care or they didn't pick
up a medication because it was too expensive and they didn't have
coverage.
We have seen these things. Dr. Morrison and I have both seen
complicated pregnancies and neonatal resuscitations. These are patients
who rely on Medicaid. We are here as doctors who swore an oath to our
patients to protect them, to stand up for them. This is us standing up
for our patients, to plead with my Republican colleagues not to cut
Medicaid.
Mr. Speaker, I will let them know and will let my constituents and
the American people know that I will continue to fight every minute to
make sure that these cuts don't happen and that we keep this oath to
our patients.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. Members are reminded to direct their remarks
to the Chair and not to a perceived viewing audience.
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