[Congressional Record Volume 171, Number 113 (Monday, June 30, 2025)]
[Senate]
[Pages S4075-S4076]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                 H.R. 1

  Mr. GRASSLEY. Mr. President, contrary to misinformation campaigns 
seeking to stop commonsense Medicaid reforms from getting to the 
President's desk, the One Big Beautiful Bill does not take away 
Medicaid from those who need it. In fact, the bill will strengthen the 
Medicaid program, so that it can continue to serve the vulnerable 
populations it was designed to serve.
  Before I discuss the program integrity measures in this bill, I want 
to give some context on Medicaid spending. Under this bill, Medicaid 
will spend over $7.4 trillion over 10 years. We are only slowing the 
growth of Medicaid spending as Medicaid spending will still go up at 
about 2 to 3 percent annually, compared to 4.5 to 5 percent annually, 
if we don't pass this bill.
  A sizable majority of Americans support efforts to stop wasteful 
spending that drains resources for people who truly need this safety 
net and puts an unfair burden on taxpayers. Between 2015 and 2024, the 
total amount of improper Federal Medicaid payments was over $560 
billion. Some independent estimates put it closer to $1.1 trillion. We 
must do something about it. I am also the author of major updates to 
the False Claims Act, a major tool to save taxpayers money.
  Since my reforms were enacted, the Federal Government has recovered 
more than $78 billion lost to fraud--much of it in government 
healthcare programs--and saved billions more by deterring would-be 
fraudsters. We are doing more in this bill, because taxpayers and those 
who rely on Medicaid deserve better. That is why we are putting an end 
to the billions of dollars of waste, fraud, and abuse in healthcare 
programs.
  Let me list off a few provisions that establish some program 
integrity:

       Reducing duplicate enrollment under the Medicaid program.
       Ensuring deceased individuals and health care providers 
     don't remain enrolled.
       Payment reduction for erroneous excess provider payments 
     under Medicaid.
       We're also going to require states to check if an 
     individual is eligible to be on Medicaid twice a year, 
     instead of once a year.

  These provisions alone save over $94 billion, according to the 
nonpartisan Congressional Budget Office, CBO. We establish robust 
verification for individuals receiving premium tax credits through the 
Federal marketplace.
  We also ensure that if someone gets more subsidization than they are 
allowed based on their income, the excessive subsidy amount is 
returned.
  Last year, I pointed out to the Treasury Inspector General that 
excessive payments were not being recouped. Through my oversight, I 
discovered over 40 percent of excessive Federal marketplace subsidy 
payments totaled over $10 billion dating back to 2016. These excess 
payments were not recouped because of current safe harbor rules. This 
excessive waste will end in this bill and save over $60 billion, 
according to CBO.
  We also delay costly regulations that establish one-size-fits-all 
rules, including for nursing homes and State Medicaid programs. I am a 
strong proponent of nursing home oversight and ensuring our most 
vulnerable senior citizens and those with disabilities have access to 
high-quality care. We

[[Page S4076]]

should be addressing the workforce challenges nursing homes face by 
partnering with nursing homes, not mandating from Washington, DC. 
Delaying the nursing home staffing mandate rule and so-called 
``streamlining eligibility rule'' saves over $187 billion according to 
CBO.
  We also ensure Medicaid, Medicare, and Federal marketplace resources 
are going to Americans, instead of illegal aliens. Taxpayers expect us 
to prioritize vulnerable Americans and seniors in these programs. We 
prohibit Federal financial support under Medicaid for individuals who 
don't have verified citizenship, nationality, or satisfactory 
immigration status. These provisions save over $163 billion according 
to CBO.
  When my colleagues on the other side of the aisle fearmonger and 
misinform what is in the bill, they must be willing to defend billions 
in healthcare waste, fraud, and abuse spending that total over $500 
billion, as standalone provisions. As I have illustrated, we establish 
some commonsense program integrity measures and stop wasteful spending.
  We delay costly regulations that hurt patients and providers, 
especially those living in rural America. We stop Medicaid and Medicare 
resources from going to illegal aliens. Most importantly, we preserve 
the Medicaid program for those who most need it.

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