[Congressional Record Volume 171, Number 107 (Monday, June 23, 2025)]
[Senate]
[Pages S3488-S3490]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         One Big Beautiful Bill

  Mr. SCHATZ. Mr. President, more than 16 million people are going to 
lose their healthcare, and tens of millions of Americans are going to 
pay more for healthcare every month. Hundreds of rural hospitals are 
going to be forced to close, and we are going to plunge the

[[Page S3489]]

country into trillions of dollars of new debt.
  Now, what is this all for? Is it to improve our schools and roads? Is 
it to make housing and childcare more affordable? Is it because we are 
in the middle of a crisis that just has to be paid for or we are going 
to pay down the national debt? No. It is none of those things. It is 
because they want to cut taxes for the richest people to ever exist. 
And if that means you can't see your doctor or you have to pay hundreds 
of dollars more every month to pay for your healthcare, tough luck.
  Now, here is the thing: Republicans actually know what they are 
walking into because people in their own States are telling them what 
is about to happen.
  ``We can't sustain serving our community the way we are with these 
cuts,'' one hospital leader in Kansas said.
  A health executive in Texas wrote:

       Cutting billions of dollars from [Medicaid] would have 
     widespread and devastating consequences for Texans. Beyond 
     the obvious impacts to people enrolled in the program, the 
     collateral damage of program cuts will be felt across the 
     board. Hospitals will do everything they can to weather the 
     storm, but some may not survive. Others will have to increase 
     their reliance on state or local support or reduce services. 
     Access to care will decrease, especially for high-cost 
     service lines like maternal [health] care and behavioral 
     health. Jobs will be lost. The impact on communities--which 
     rely on their hospitals for employment and growth--will be 
     profound.

  A Utah father who credited Medicaid with saving his own son's life 
said:

       Without Medicaid, these life-saving treatments would have 
     been financially impossible. There is absolutely no way we 
     would have covered the cost on our own. . . . And in this 
     way, our story is not unique. So many families insured by 
     Medicaid could have to make difficult, life-altering 
     decisions if Congress slashes funding.

  A former Republican elected official in Georgia warned:

       Cuts to Medicaid are not only fiscally irresponsible, but 
     they could threaten the livelihoods of our fellow Georgians 
     and the economic opportunities that consistently make our 
     great state a top state for business.

  So the stakes are clear: It is people's health. It is people's hard-
earned money. It is people's lives. And whether you are in a red or a 
blue State, you will absolutely feel the weight of this terrible piece 
of legislation.
  More than a quarter of nursing homes may close. Hundreds of rural 
hospitals will shutter. And for what? To pay down the debt because we 
are a nation at war, because we want to invest in infrastructure or 
schools or healthcare? No. The reason they are making these cuts to 
food assistance, the reason they are making these cuts to rural 
hospitals, the reason they are making these cuts so that people are 
going to have to pay several hundred dollars more per month for their 
own healthcare is to create enough revenue for the biggest tax cut, the 
biggest wealth transfer from working people to wealthy people in the 
history of the United States of America.
  Even if you are not on Medicaid yourself, you likely know someone who 
is--a friend, a neighbor, a relative, a coworker. And, more than that, 
kicking tons of people in your community off of healthcare will drive 
up costs for everybody else and make high-quality care hard to find. 
You are going to pay more for less care--all for the biggest tax cut in 
American history for the people who need it the least.
  I have no problem with the people who need it the least. But the 
truth is, they need it the least. If you are financially successful and 
you make $4 million a year, God bless. That is the American dream. It 
does not mean you need a tax cut, and it does not mean you need a tax 
cut paid for by reducing services, especially in rural communities.
  The good news is this: We actually don't have to do this. There is no 
rush to do this. There is no clamoring among constituents in red or 
blue States to do this. This is an add-on.
  What they want to do is extend the original tax cuts. I opposed those 
tax cuts, but I can understand that Republicans, as an article of 
faith, want to extend the tax cuts that their President enacted two 
terms ago--fair enough--good, solid, old-fashioned policy 
disagreements.
  But then they just larded it up with stuff--giveaways to special 
interests, and cuts and cuts and cuts to things that people care 
about--left, right, and center.
  We don't actually have to do it this way. You are going to pay more 
for less care, all so that billionaires have a little more money 
sitting in their accounts.
  It is going to require four Republicans saying: Enough is enough.
  I have heard a number of my Republican colleagues talk about how 
essential Medicaid is to their rural communities.
  And it is not just the people who are on Medicaid. Obviously, those 
are the people you have to be primarily concerned with. But a lot of us 
go home and visit both urban and rural hospitals, and they all say the 
same thing, which is that, if you blow out 30 percent of your revenue, 
you can't function as an institution.
  So it is not just a question of whether you personally are on 
Medicaid or you personally care about Medicaid. It is about: Does your 
rural hospital even survive after this bill is enacted?
  Nobody wants this, and there is still time to kill this bill.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.
  Mr. WELCH. Mr. President, there is time to kill this bill, and I hope 
we do.
  You know, as my colleague from Hawaii just said, what is happening in 
this bill is the infliction of bipartisan suffering, whether it is in 
the State of Vermont or the State of West Virginia or the State of 
Tennessee. Folks who are depending on Medicaid are going to lose it.
  Let me just give a couple of examples.
  When I was in the House, my good friend David McKinley, a Republican, 
invited me to West Virginia, and we went to the Harrison coal mine. I 
was very deeply moved because the only people I know who work as hard 
as coal miners are dairy farmers. So we have a lot in common--hard-
working folks in Vermont, hard-working folks in West Virginia.
  But what this bill is going to do is threaten the access to 
healthcare that those West Virginia folks need, just like those folks 
in Vermont need, just like those folks in Tennessee need. It is not 
about whether you are a Republican or a Democrat. It is not about 
whether you are from a red or blue State. It is actually about real 
people who work in coal mines, who work on dairy farms, who work in 
factories, and seniors who need the help of nursing homes.
  Two out of three nursing home beds are paid for by Medicaid. Parents 
of disabled children so depend on healthcare, especially through 
Medicaid. And that is true in West Virginia. It is true in Nebraska. It 
is true in Tennessee. It is just as it is in Vermont.
  Let me just give a few numbers. In Vermont, 32,000 people--32,000 
people--are going to lose healthcare if this bill is passed. In West 
Virginia, 76,000 people will lose their healthcare coverage. In 
Tennessee, it is going to be 290,000 people who are going to lose their 
healthcare.
  It is not just those individuals who are going to lose healthcare. 
This budget reconciliation bill, the Big Beautiful Bill--the big bad 
betrayal--there are real consequences to this that are going to be 
devastating to rural America. And we have a lot in common in Vermont 
with so many other parts of rural America, like West Virginia and like 
Tennessee.
  Rural hospitals will close, and people will be forced to travel for 
their care so far that they oftentimes won't be able to get it. And the 
sad reality is, if you take away people's healthcare, they are going to 
get sick and stay sick. You take away people's healthcare, and people 
are--people are--going to die.
  You know, the American Hospital Association showed that this bill 
will likely close 338 hospitals in rural communities across the entire 
country, in your State and in mine. In Vermont, the fear is that 3 out 
of 14 hospitals are at risk of closure with the passage of this bill. 
In West Virginia, seven hospitals are at the risk of closure. In 
Tennessee, nine hospitals will be immediately at the risk of closure.
  Do you know what happens too? It is like we don't even debate this; 
we don't even discuss it, when this reality is about to strike a 
hammerblow to folks in rural America. If people lose their

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healthcare, it doesn't mean they don't need healthcare. It just means 
they can't pay for healthcare.
  So folks in Vermont who were depending on Medicaid are going to show 
up at our rural hospitals. Our hospitals are under a legal requirement 
to provide care.
  By the way, they would provide care even without a legal requirement 
because that is what we do in rural America: We help folks who need 
help.
  But those hospitals already on a thin margin are not going to be able 
to afford it. That is what threatens to have them go out of business.
  And then, we know the spiral. This bill, in Vermont, is going to 
result in over $200 million in uncompensated care in the next 10 years. 
In West Virginia, it is $1.4 billion. In Tennessee, it is over $3.5 
billion.
  These rural hospitals provide critical care to people in need. We 
have to protect the people first. If we take away their hospitals, they 
have no protection. We have to protect the struggles that communities 
in rural America have to keep a strong community sense against the 
enormous pressures that they face.
  There is a cruelty in this bill. There is an irresponsibility in the 
Senate if we don't acknowledge explicitly what the impact of this bill 
will be on the people we represent, on the hospitals that are dependent 
on us, and on the future of community strength in all of our rural 
communities. Let's kill this bill.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. MORENO. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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