Congressional Record, Volume 171 Issue 131 (Wednesday, July 30, 2025)

[Congressional Record Volume 171, Number 131 (Wednesday, July 30, 2025)]
[Senate]
[Pages S4869-S4878]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

Medicare and Medicaid

Mr. BLUMENTHAL. Mr. President, today, marks the 60th anniversary of
the day that President Lyndon Baines Johnson signed the Social Security
Amendments of 1965, establishing Medicare and Medicaid--cornerstones of
American healthcare. These programs provide millions, including 1.5
million people in Connecticut, with access to comprehensive and
affordable healthcare.
Nothing is more important than our health. As the saying goes, if you
don't have your health, you don't have anything; and if you don't have
healthcare coverage, which for most Americans guarantees treatment,
diagnoses, effective healthcare, you don't have your health.
I am here--I wish I could say--to celebrate these vital programs,
but, really, I am here to defend them, to defend them against deep and
damaging cuts made by Senate Republicans and the Trump administration.
Their budget decimates Medicaid benefits. It threatens rural and
pediatric hospitals. It increases health insurance premiums for the
majority of Americans. Let me repeat: It increases premiums paid by
everyday Americans--the majority of our fellow citizens.
Health insurers are already proposing a median premium increase of 15
percent in 2026. That will be the largest in 5 years, and that is just
an estimate. You know, if you have had any experience with health
insurers, that if they are estimating 15 percent, it could well, in
fact, likely be higher. These cuts are not about eliminating fraud or
waste in the Federal government; they are about delivering tax breaks
to billionaires on the backs of working Americans.
This bill is an absolute disgrace. The American people should hold
every Member who voted for it accountable when they are next up for
election.
It is the biggest Medicaid cut in our history. Over 900,000 people in
Connecticut rely on Medicaid for their health insurance coverage; 30
percent of them are children.
In fact, in Connecticut, Medicaid covers 41 percent of births and 68
percent of people living in nursing homes. The majority of people in
nursing homes, in other words, depend on Medicaid, and they could well
be thrown out of those nursing homes.
Under this bill, up to 158,000 people in Connecticut will lose
Medicaid, and 53,000 will lose their ACA coverage. Even those who keep
their health coverage will see reduced benefits and strained providers
as the State struggles to make up the difference. People in Connecticut
are lucky because there will be an effort to make up the difference,
but many other States won't have that ability.
Just to be clear, these cuts are going to have an impact on everyone
because the Medicaid Program is a huge source of funding for all
hospitals. All hospitals depend on Medicaid. Even if you are not there
with Medicaid coverage, the quality of care that you will receive will
suffer as a result of these cuts. So even if you have private health
insurance, your nearest hospital could close. You may have to wait
longer for an appointment to see a doctor. Your out-of-pocket costs may
increase. Hospitals will attempt to recoup that lost funding on your
back. They have no choice. They have to stay open, and they have to
cover their costs.
To make matters worse, my Republican colleagues refuse to extend the
ACA enhanced premium tax credits. And 112,000 people in Connecticut
rely on these credits to lower their monthly premiums. They are a
lifesaver. They are a lifeline to health insurance coverage.
Without the extension, 10,000 children are at risk of losing
essential services, and 81 small business owners in the State will see
their premiums skyrocket. Premiums will rise for small businesses as
well as individuals.
These numbers are staggering. They are stunning. But they fail to
capture

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the human costs, the impact on everyday people who look out the window
in the morning as they have their first cup of coffee or see their
children at night for dinner as they come home and wonder what will
happen in the event of a healthcare emergency--not even an emergency.
What will happen in the event of the flu, COVID, or any of the other
kinds of healthcare challenges that may arise?
So the net result here in human terms is couples forgoing children,
grandparents losing independence, people seeing preventable deaths,
skipped checkups, burned out healthcare workers. That is the real cost,
the human cost, the impact on people's state of mind, their level of
anxiety, their ability to focus on work because of physical pain they
may have because of illness but also anxiety about how that illness is
going to be covered by health insurance.
These cuts aren't just numbers. They are children, they are families,
they are grandparents, people with disabilities, your neighbors, your
friends, and probably you at some point.
Republicans knew the consequences. There was no mystery here. They
knew the data. They chose cruelty. These cuts are cruel, and they are
stupid. They are dumb because we all know that preventing health
emergencies, providing diagnoses, catching illnesses early, and
providing care and treatment early, in the long run, saves money for
all of us.
It is unforgivable that they decided to turn their backs on millions
of Americans, including their own constituents whose health and well-
being is on the line.
Since this bill passed, of course, some Republicans are trying to
walk back their vote--buyer's remorse. They had mixed feelings at the
time, perhaps. They are supporting tweets like repealing the Medicaid
provider taxes or boosting rural hospital funds because they see that
those rural hospitals in their own States are going to be closing. They
know the impact of Medicaid cuts on hospitals in all areas and people
in every part of their States.
But those efforts are doomed to failure. They fall short. The rural
healthcare fund doesn't come close to offsetting the losses rural
providers will face from the cuts of Medicaid, just to give you one
example. That is why I have joined Senator Wyden and Senator Schumer in
introducing a bill that will repeal the health provisions in the ``Big
Blatant Betrayal.'' It is not a Big Beautiful Bill; it is a ``Big
Blatant Betrayal.'' This measure would extend the ACA premium tax
credits.
Again, Medicaid cuts are reprehensible and reckless. Cutting the ACA
premium tax credits affects hundreds of thousands of people in
Connecticut and millions around the country, everyday middle-class and
working Americans who have to cover healthcare bills.
I am going to keep fighting against any legislative efforts that put
the interests and desires of billionaires over the needs of working and
middle-class Americans.
This ``Big Blatant Betrayal'' is, in fact, simply cruel and stupid,
and I hope my Republicans colleagues will join us in these efforts to
truly walk back and compensate for the disastrous impact, the
devastating affect it will have on families and working people all
across this great country.
I am honored to yield to our distinguished leader.
The PRESIDING OFFICER. The Democratic leader.
Mr. SCHUMER. Mr. President, I thank my great friend from Connecticut
who cares about these issues so much and is one of our most effective
advocates in the whole country for things like this. I thank him and
thank all of my colleagues who have come to the floor--Senator
Whitehouse, Senator Markey, and so many others who are just eloquent
spokespeople for helping people with healthcare.
Today, Democrats are holding the floor on the 60th anniversary of
Medicare and Medicaid being signed into law to talk about the
Republican all-out assault on our healthcare system.
Look, the American people are just fed up--fed up, up to here--with
the soaring costs of healthcare. They are fed up with Donald Trump and
Republicans cutting their healthcare to help the billionaire class.
But, unfortunately, Donald Trump and Republicans seem to live in a
bubble because while they brag about how big and beautiful their bill
is, the American people feel the opposite.
The more Americans learn about the Republican bill, the more they are
realizing that Donald Trump and Republicans sold them a raw deal--a raw
deal.
The Republicans' ``Big Ugly Betrayal'' is one of the most devastating
bills for American healthcare that we have ever seen. The largest cut
to Medicaid in American history, $1 trillion in healthcare cuts, 15
million people at risk of losing their healthcare coverage--why? To pay
for tax breaks for billionaires; telling a mom whose daughter has
cancer that she can no longer afford treatment, and the child may die
because some billionaire needs more money? I don't have anything
against the billionaires. God bless them. They made a lot of money.
They don't need a tax break at the expense of middle-class, working-
class American families, poor American families who desperately need
healthcare.
What is big or beautiful about what they are doing? Nothing. It is
even nervy to call it big and beautiful.
They listened to Donald Trump who just makes it up as he goes along,
and they say: Yes, whatever he says, no matter how bad it is for the
American people.
The American people don't want their healthcare cut to help out the
ultrarich. It is a nasty proposition from our Republican colleagues.
If I may add an aside--I want to be clear. It is not just healthcare
that is in danger. It is not just healthcare.
Today, we got a rather stunning admission from the administration on
Social Security, another part of the safety net that deserves some
mention now before I give up the floor.
Today, Secretary Bessent admitted in a podcast that the so-called
Trump accounts that the Republicans snuck into the ``Big Ugly Bill''
are, in Secretary Bessent's eyes, a ``backdoor for privatizing Social
Security.'' Let me repeat that. These are Bessent's words. What they
put and snuck into the reconciliation bill that they call BBB, and we
call the ``Big Ugly Betrayal,'' is a ``backdoor for privatizing Social
Security.''
America, do you hear that? From one end of the country to the other,
probably the most popular Federal program ever passed, and they want to
privatize it. Do you know what ``privatize'' means? It means you are in
trouble, Mr. or Mrs. Senior Citizen, because when they privatize it and
the big boys get ahold of it, it is going to be much less money for
you, if any at all.
But now we have it. Bessent actually slipped and told the truth:
Donald Trump and his government want to privatize Social Security.
Another great lie from Donald Trump--he just lies at will--he
promised that Social Security, under his watch, ``would not be
touched,'' while, at the same time, his administration has strangled
the program behind the scenes, laying off staff, shutting down offices,
making it harder to claim benefits. And now they are openly talking
about privatizing it.
Rarely is the end game for Republicans so obvious. They are ramming
historic cuts down Americans' throats to help their billionaire
buddies.
So in light of the attacks, as we mark the anniversary of Medicare
and Social Security--it was a proud, proud day 60 years ago, when
America finally understood that we were a wealthy country, and we had
to use some of it to give people healthcare, the most important thing
in their lives. If you ask the average American: What do you want most?
I want to live long and healthy.
And the reason we are living longer and healthier, with all the
troubles in the system, is because we have Medicare and Medicaid. And
this is the anniversary.
This morning, I was proud to introduce legislation to reverse the
disastrous healthcare cuts in the ``Big Ugly Betrayal.'' The bill is
simple: It repeals the entire healthcare subtitle of the Republicans'
bill and permanently extends the ACA premium tax credits that
Republicans let expire.
Extending these tax credits should be a no-brainer. It will save
Americans on the ACA hundreds--if not thousands--of dollars a year on
their health insurance. Anyone who objects to this wants Americans to
pay more for healthcare, plain and simple.

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The Senate should take up our legislation as soon as possible because
the worst of the Republican cuts are already starting to take effect.
It is not going to happen. Republican colleagues who thought: Oh, we
can delay it so no one will know until after the 2026 elections. Bunk.
It is starting already. Healthcare premiums are going to start spiking
very soon.
Hospitals and clinics are at great risk of closing now, not after
2026. Some have already shut their doors in Maine, Nebraska, and other
States. People in rural communities are worried sick that they will
have to travel even farther to get healthcare.
In many rural counties, including some of mine in New York, the local
hospital is the biggest employer. Those jobs will go by the wayside.
Again, this is not what the American people want. People want
healthcare that is easy to access, easy to navigate, easy to afford.
Seniors, kids, people with disabilities, people who rely on Medicare
and Medicaid don't want to see their coverage ripped away. Republicans
should be working with Democrats to strengthen these programs, not
slash and burn them to the ground.
Don't go home and tell people lies, that your healthcare won't be
affected by this bill. Of course it will. Even the Republican gurus
say: Oh, talk about other things; don't talk about healthcare--because
they know how bad it is.
It isn't too late. It is not too late for Republicans to reverse
course. Democrats, meanwhile, will never, never, never--Senator
Whitehouse, Senator Markey, Senator Hickenlooper, and all of my other
Democratic colleagues will never stop fighting to fix our broken
healthcare system.
I yield the floor.
The PRESIDING OFFICER. The Senator from Massachusetts.
Mr. MARKEY. Mr. President, I thank Senator Schumer for his historic
leadership on this issue. He has framed it perfectly for this Chamber
and for the American people to understand what is at stake in our
country in the year 2025.
A little more than 100 years ago, life expectancy in the United
States of America was 48 years of age--48. We had gone from the Garden
of Eden to a little more than 100 years ago, and life expectancy was
still 48 years of age.
Then what happened? Well, then, because of the progressive movement,
programs started to be put on the books--vaccines, public health
interventions, NIH research on diseases, but big programs got put on
the books as well.
In 1935, Social Security passed. It is an income supplement for old
people in our country. When it passed, life expectancy was 61 years of
age in the United States--1935. Who voted no? Republicans, in 1935. Why
did they vote no? For billionaires and millionaires of that era that
didn't want to help with the healthcare for everyone in our country.
In 1965, we voted in the Senate for passage of Medicare and Medicaid.
What was the life expectancy then? Seventy years of age. Who were the
``no'' votes? Republicans here, voting against Medicare and Medicaid.
Today, life expectancy is 78 years of age; 30 years of bonus life for
the average American in a little over 100 years because of all of these
programs.
Now, what have the Republicans done? The Republicans have decided--
because of their ancient animosity toward Medicare and Medicaid and the
Affordable Care Act and NIH funding for research for cancer and
Alzheimer's and Parkinson's--to slash all of those programs. They
finally have a chance, with Donald Trump, to listen to the billionaires
of the thirties and the sixties and fulfill their dream where we cut
the programs for ordinary families in our country. And they just did it
a month ago.
Those cuts go right to the heart of what it is that makes the
Democratic Party fundamentally different from the Republican Party, and
that is our interest in and our passion for the healthcare of every
American. The Republicans have opposed these programs throughout their
entire history.
Donald Trump is right at the front of the line, always questioning
whether or not we should be supporting Medicare, Medicaid; whether or
not we should be supporting the community health centers, supporting
rural hospitals. Donald Trump has always been at the front of the line
saying: Absolutely not. And the Republicans are following him all the
way.
And even when some Republicans say that they have some questions
about it, like in ``The Godfather,'' part 1, they got an offer they
couldn't refuse; and the ones that refused it, they can't even run for
office next year because Trump has already taken them out. And what was
it over? Medicaid. It was over Medicare. It was over the Affordable
Care Act and making sure all of those healthcare programs are there for
everyone in our society.
So, today, we celebrate the 60th anniversary of the passage of
Medicare and Medicaid that Lyndon Johnson brought to the American
people.
I will give you a few numbers. Right now in our country, 72 million
Americans benefit from Medicaid--72 million. Eighteen million people
with disabilities in our country are on Medicaid. They need the
program. They have disabilities. And 37 million children in the United
States are on Medicaid. That is 50 percent of the kids in the United
States. Fourteen million kids with special needs are on Medicaid in our
country, right now.
And the Republicans, on the floor of the Senate, slashed all those
programs. Kids with special needs, adults with disabilities, 37 million
kids--they just slashed it. And by the way, it is just a promise to
billionaires and millionaires who want their money back.
Ralph Waldo Emerson said that health is the first wealth. So that is
what Medicare and Medicaid, what Social Security, what the Affordable
Care Act, what NIH funding for research for cancer and diabetes and
Alzheimer's--that is what it is. It is providing the first wealth--
health--to everyone.
What the Republicans are doing--they have already done it--is they
are looting the money for all those programs--all of them--to give it
over to the billionaires, and it will lead to a complete and total
devastation of the healthcare system in our country that we have built
over the last two generations.
Millions of people have relied on Medicare and Medicaid to access the
healthcare that they need. Yet, sadly, my Republican colleagues and
Donald Trump have marked this milestone of the 60th anniversary by
signing into law unprecedented cuts in Medicare and Medicaid.
By the way, I didn't get to know any of my grandparents. It was a
foreign concept to my brothers and I. These programs hadn't kicked in
yet to extend their life expectancy. The whole concept of a grandparent
is completely alien to me. Not today, thank goodness, for young people
in our country, but not after the Republicans have just passed the laws
that are going to gut the programs that have allowed Grandma or Grandpa
to live longer--much longer. They are gutting those programs. They
don't really care about Grandma and Grandpa. They don't care if they
are kicked out of nursing homes, even if they have Alzheimer's. They
don't care. If you kick them in the heart, you are going to break your
toe.
And that is who the Republicans have been all the way back to Social
Security, since 1935. That is who they are as a party. They don't care.
And life expectancy is going to start to go down and down and down and
down in our Nation, which is their plan. They never liked the whole
idea of funding these programs in the first place.
By the way, here are the numbers; it is unbelievable: $900 billion
cut out of Medicaid. That is 10 million people who are going to be cut
off the program. And they are going to gut the healthcare, ultimately,
if you take all of the programs combined, of 72 million people. Two
million of them are in Massachusetts, but it is huge. And they are
known in different States in different ways. It is MassHealth. It is
Healthy Louisiana. It is MaineCare, TennCare, KanCare. But one in five
Americans rely upon Medicaid for the funding for their healthcare. And
without Medicaid, it is just not there.
And Trump and Republicans are also stealing from a program that pays
for half of all nursing care in our country. And by the way, 70 percent
of the people in nursing homes, right: Alzheimer's, Parkinson's. We
call them Grandma and Grandpa. These guys just assaulted that program,
the Medicaid Program. And it is just absolutely unconscionable what
they are doing.

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So this bill is also going to add $3.4 trillion to the Federal
deficit because they gave more in the tax breaks to the billionaires
than they actually cut in these programs. That is how greedy the
billionaires in our country are right now who are the supporters of
Donald Trump.
And I have just heard from so many of my constituents who are
terrified at what the implications are for the healthcare of their
family, of their loved ones, of their children. It is just absolutely
unbelievable.
A constituent shared that her best friend with a permanent disability
counts on Medicaid support to ensure that she has a wheelchair for
mobility and can receive assistance to continue independent living.
Republicans have cut that program. They have cut that Medicaid Program.
They are going to take away oxygen tanks from nursing home residents,
wheelchairs from kids across the country, just to give tax breaks to
the megawealthy.
Again, the Republican Party harbors an ancient animosity toward all
of these programs going back to 1935. This was their moment. The
``Billionaire Boys Club'' comes together: Give us back all our money
that has been used to extend the life expectancy by 30 years for all
those people who don't deserve it--meaning all of the regular families
in our country. It is just a direct assault upon them.
And it is not just the people who are on Medicaid who will suffer
from these cuts. Hospitals, healthcare centers, nursing homes, they are
all going to be forced to close across our country. The funding that
keeps them open is Medicaid; it is Medicare. That is what pays for the
bills for each and every one of those institutions.
It is going to be harder for families to find a pediatrician, harder
for people to get mental health care, harder for seniors to get care as
they age. Providers will lose their jobs. Families will lose access to
care. And as millions more Americans lose their health insurance, skip
appointments, ration medications, the billionaires who can afford
concierge medicine will get another handout from the Federal taxpayers.
The rich will get richer, and the sick will get sicker in our country,
and it is going to increase the Federal deficit by $3.4 trillion.
It is almost unbelievable how irresponsible Trump and his billionaire
buddies are, and the Republicans all went all in--all went all in. But
it makes sense because that is who their party is. Their party is the
party of the rich, and they have never supported the programs that help
regular people get access to healthcare. So it is their roots. It is
the Republican Party.
And Medicare, by the way, is going to be cut by $500 billion over the
next 10 years. That is Grandma and Grandpa. They are on Medicare. They
cut it by $500 billion just a month ago. And again, it is going to add
trillions to the deficit.
So let me just say it again. The ``Big Ugly Bill'' is going to
trigger $500 billion in cuts to Medicare, the program that over 67
million Americans are dependent upon. And most of them are called
Grandma and Grandpa. Their programs get slashed, the programs that have
kept them alive for preceding generations. My grandparents didn't stay
alive. That is what they are doing: They are lowering the life
expectancy of Grandma and Grandpa in this country. And those cuts start
right away with the $45 billion cut next year.
So it goes without saying that Medicare is popular, Medicare is
successful, Medicare is absolutely necessary. So this is an incredible
moment in our history. People deserve more than being afraid to take an
ambulance because they are worried how much it will cost. They deserve
more than rationing their medication because they just can't afford the
next dose. Americans deserve more.
Healthcare should be affordable to all, and everyone should be able
to get the healthcare that they need.
And here are the numbers. According to Yale University--Yale
University--51,000 people a year are going to die because they won't
have access to the preventive care that is in all of these programs.
That is a half a million people every decade are going to die early
because they don't get access to the healthcare they need.
That is all on the Republican Party, and, by the way, they never
cared anyway. They never cared about those families. They never cared
about those people. They never care about the impact on the rest of the
family when people die a premature death. It is 500,000 people,
according to Yale University, that will die because of these cuts.

So this is an incredible moment in time. Every American deserves the
basic dignity of access to high-quality healthcare, and we are not
going to allow this fundamental assault on Medicare and Medicaid to
stand. We got knocked down a month ago, but we are not knocked out. We
are going to get up, we are going to fight, and we are going to win in
the same way the preceding generations got up and fought and won
against the Republican assault on the healthcare of families in our
country.
The fight is on, and it is for the well-being and health of every
family in our country.
I thank you, Mr. President. Again, it is so great to be here with
Senator Schumer and Senator Blumenthal and my great friend, the leader
from the great State of Rhode Island, my friend Senator Whitehouse.
Mr. President, with that, I yield the floor.
The PRESIDING OFFICER. The Senator from Rhode Island.
Mr. WHITEHOUSE. Mr. President, today is kind of an exceptional day.
It is the 60th anniversary of the Medicare and Medicaid Act, which
created two of the most successful programs for families really that
the world has ever seen.
It should be a moment for celebration. Unfortunately, a bad turn has
been taken, and there are now attacks on Medicaid and Medicare
happening right in this building.
The ``Beautiful for Billionaires Bill'' that the Republicans forced
through on a purely partisan basis cuts Medicaid explicitly--$1
trillion cut to Medicaid. So folks who are on Medicaid are going to see
a real danger in their lives as a result of those cuts.
You may say: Well, I am not on Medicaid. I have private insurance. I
have Medicare. I am going to be fine.
Not so. When the cuts are that big, they knock essential revenue away
from hospitals, away from your family doctor, away from health centers,
away from nursing homes. And I don't know about all the other States,
but in Rhode Island, all those institutions are struggling. These are
not easy times for people who are providing healthcare in our
healthcare system. When you knock $1 trillion out of their pockets--
because that is where this goes. Medicaid money doesn't go to
individuals, into their pockets, it goes to their providers. If you
take away that revenue from the providers, you put them at risk.
You don't have to be on Medicaid to be harmed if your nursing home
closes down because it has gone broke because Medicaid funding is no
longer available.
So the Medicaid cuts are right in our face, and the damage they are
going to do to healthcare institutions is obvious.
What is a little bit trickier and what I am calling out here on the
floor today is the sneak attack on Medicare. I could run a tape here of
all the Republicans who said: Oh, we are not going to cut Medicare. Oh,
Medicare is different. Oh, we are going to protect Medicare.
We heard the President say it.
It was all hogwash. It was all complete hogwash. The sneak attack is
underway, and I am going to tell you how it works. It works because the
``Beautiful for Billionaires Bill'' added $3.4 trillion or more to the
debt. The Republicans had to lift the debt limit by $5 trillion, so it
is a big number added to the debt. When that much added debt gets
dumped onto our fiscal picture, it triggers another law. It triggers a
law called the Statutory Pay-As-You-Go Act. Our technical term for it
around here is that it triggers ``sequestration.''
When you create that much added debt, when you run up deficits that
badly--as the Republicans have done to fund their billionaire tax
cuts--here is what happens to Medicare. This is from the Congressional
Budget Office. It triggers a $45 billion cut to Medicare in 2026, and
it will increase each year to about $75 billion as an annual cut to
Medicare in 2034. Between 2026, next

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year, and 2034, this trigger will produce $535 billion in cuts to
Medicare.
They don't want you to know that. They don't want to tell you that.
They would like it to just happen automatically so they don't have
fingerprints on it, but their fingerprints are all over it.
So what we should be doing is passing my bill to put Medicare and
Social Security on permanently sound footing as far as the actuarial
eye can see by simply lifting the cap on how much of your income is
subject to Social Security and Medicare contributions. Easy to do. Very
simple. Very fair. It makes Social Security and Medicare solvent
essentially indefinitely if my bill passes.
That is what I would like to be talking about. Instead, we have a
direct attack on Medicaid; a rebound attack from those cuts on the
major institutions of our American healthcare system, like our family
doctors and our doctors and our nursing homes; and a sneak attack--a
sneak attack--through the pay-as-you-go provisions on Medicare to the
tune of over half a trillion dollars.
Mr. President, this is not a good day. I regret that we are at this
sorry pass.
I yield the floor.
The PRESIDING OFFICER. The Senator from Hawaii.
Ms. HIRONO. Mr. President, I rise today to celebrate Medicare and
Medicaid, two programs that have enabled millions--millions--of
Americans to get the healthcare they need.
Sixty years ago today, President Johnson signed into law a bill
creating these two critical programs. At the bill signing, President
Johnson said:

This great nation cannot afford to allow its citizens to
suffer needlessly from the lack of proper medical care.

Together, Medicare and Medicaid have helped generations--60 years,
generations--of Americans stay healthy, get to work, pay their bills,
and care for their families. Today, nearly 40 percent of Americans rely
on Medicare and Medicaid.
Over the years, Democrats have fought to expand and strengthen
Medicaid even further, including in the 2010 Affordable Care Act. But
while the Democrats have worked to strengthen and expand Medicaid,
Republicans have waged war on Medicaid and the Americans who depend on
it.
Just this month, they passed a nearly thousand-page bill. They have
the audacity to call it a Big Beautiful Bill. I call it the ``Thousand
Pages of Pain Bill'' that will devastate communities across our country
by stripping healthcare access--including Medicaid access--from some 15
million Americans, including more than 40,000 people in Hawaii.
There are a lot of States that have more people on Medicaid than are
on Social Security, so this is a critically important program to our
communities.
Frankly, Medicaid coverage literally keeps people alive. Without this
coverage, millions of Americans won't be able to get the care they
need--annual wellness visits, prescription medication, long-term care,
and the list goes on.
Inevitably, more people will end up in emergency rooms as a last
resort because if you don't have healthcare, you are not going to go to
the doctor for wellness checks and et cetera--preventive care out the
window. So you wait until you are very sick, you end up in emergency
rooms, and then you overwhelm the hospitals--hospitals that are already
facing higher costs and tight margins, especially in rural communities.
The Republicans' big--we call it the ``Big Bad Bill''--their ``Big
Bad Bill'' also implemented new work reporting requirements for
Medicaid. See, this comes from the attitude that people who are on
Medicaid somehow don't deserve it, and so we are going to place all
kinds of requirements because we think that people are just taking
advantage of these programs--not that they need it, not that they use
it so they can actually go to work.
These reporting requirements are so burdensome that it results in
people being kicked off this care, their Medicaid care, even if they
meet the new requirements.
So they are going to impose all these work requirements. For example,
in 2018, Arkansas implemented work requirements for their Medicaid
recipients. It flowed, again, from this idea that somehow people on
Medicaid should have to come forward and tell, you know, the
bureaucrats on a regular basis that they are trying to find work, that
they are working, et cetera.
Well, according to the Kaiser Family Foundation, 18,000 people--or 25
percent of the population--in Arkansas subject to the work
requirements, et cetera, lost healthcare coverage as a result.
Here is what happened. The vast majority of those who lost coverage
met the underlying requirements but were unable to overcome the
bureaucratic reporting process the State required--a process that cost
the State millions of dollars to implement because they had to create
an entire bureaucracy to keep track of everybody.
So, unsurprisingly, those who lost Medicaid coverage in Arkansas were
less likely to be able to afford medication, delayed needed care, and
struggled to pay off medical debt as a result. So without healthcare
coverage, they ended up going to emergency care, straining the
hospitals providing such care. That is common sense. Don't you think
that that would happen?
The negative experience in Arkansas didn't stop the Senate
Republicans recently from imposing similar requirements on Medicaid
recipients nationwide. See, they didn't learn from the experience in
Arkansas that you create this massive bureaucracy and kick out
thousands of people who actually met the requirements to become
Medicaid recipients but couldn't meet really the continuous
bureaucratic requirements--but no lesson learned there.
Now the Republican Senators decide they should impose these kinds of
requirements nationwide. So thanks to Senate Republicans, millions of
Americans will lose their Medicaid coverage, which is what happened in
Arkansas. Republicans know that thousands of their constituents will
meet this fate.
In fact, one of my Republican colleagues said that his constituents
were going to lose their Medicaid coverage, and he thought that was
unconscionable, so he is not even running for reelection. But his
colleagues didn't learn from what happened in Arkansas, didn't listen
to their colleague. But what they did do while they imposed this work
requirement, they delayed the implementation of the majority of the
Medicaid cuts until after the 2026 midterms.
I wonder why. I think they are hoping that by the time the pain of
these cuts actually hurts their constituents, they are hoping their
constituents will have forgotten who caused the pain--Republicans.
But the people are paying attention. They see that we have a regime
hellbent on dismantling government from Medicaid to Social Security.
You heard my colleague from Rhode Island talking about what is going to
happen to Medicare, cuts to the Department of Education, USAID, the
National Weather Service, so much more. Trump and his Republican allies
are attacking programs that our American people rely upon.
They are, in the words of President Johnson, allowing Americans to
suffer needlessly, all to line the pockets of their billionaire
buddies. And note that while they want Medicare-Medicaid recipients to
have work requirements, I mean, they have to do something in order to
get these benefits, the billionaires who are going to get these massive
tax credits don't have to do a damn thing to line their pockets. It is
shameful. And it will result in real harm to millions of Americans.
For 60 years, Medicaid and Medicare have made our country and our
communities stronger. When you have healthy people, your community is
stronger, it stands to reason.
So when Republicans wage war on Medicare and Medicaid, they are
waging war on our communities, on us. So we need to fight back. We all
need to stand up to this regime and stop them from dismantling the
programs that our communities rely on.
I yield the floor.
The PRESIDING OFFICER. The Senator from Colorado.
Mr. HICKENLOOPER. Mr. President, the United States is the wealthiest
country on Earth. I think it is fair to say it is the wealthiest
country in the history of the world, probably in the history of the
solar system. What we do with that wealth speaks volumes about who we
are as a country, about

[[Page S4874]]

the responsibility we feel to our fellow Americans; it define us.
Earlier this month, Republicans passed, I would call it a truly
devastating budget bill that gives many of the wealthiest people in
this country and many who don't want a tax break--it gives many of the
wealthiest people in this country and corporations a $4.5 trillion tax
break. That was their goal. They just needed to find a way to pay for
it. Well, actually, they only paid for a small part of it. But in doing
so, they cut more than a trillion dollars from Medicaid, the Affordable
Care Act, and food stamps--the programs that help struggling Americans
meet their most basic human need for food and healthcare--again, just
so they could pass the largest transfer of wealth from the poor to the
rich in the history of our country.
That speaks volumes about whom this administration values, but what
does the bill mean for Americans? Over time, 15 million Americans are
likely to lose their health coverage, and 241,000 of them live in
Colorado. Hundreds and hundreds of hospitals around the country are at
risk of closure, many of them in Colorado.
Take the Sunrise Monfort Community Health Clinic in Evans, CO. We
were there in May, and Sunrise's network of 14 rural health clinics
serves 43,000 patients across a broad swath of Northern Colorado.
Seventy percent of them are enrolled in either Medicaid or Medicare.
Now, we spoke with their CEO back in May, and we were told point-blank
that gutting Medicaid--dramatically making cuts to Medicaid--will force
them to dramatically cut services.
They estimate that those cuts in Medicaid will force between 7,000
and 14,000 of their patients off of healthcare. That is a quarter of
their patients. Again, all because lawmakers in Washington have decided
to give still bigger tax cuts to the ultrawealthy and, again, many of
whom don't want or need tax cuts. It is nuts.
The administration knew taking healthcare away from many Americans
would be unpopular. So they crafted and snuck in a provision to solve
that. Most of the Medicaid cuts won't take place until 2027. ``Well,
why wait till 2027?'' you might ask. Well, because it is after the
midterm elections at the end of 2026.
They basically gutted our social safety net system and then made sure
that Republicans wouldn't be--well, they found a way to make sure that
Republicans would be insulated from the immediate political costs from
their voters. That is why, right now, they are building a massive
public relations campaign to go out and sell the bill to Americans.
They, so far, completely deny that this bill is going to harm
Americans in any way. Instead they say it is about efficiency,
government efficiency, and cutting out waste, fraud, and abuse.
Well, listen, I am all for making government more efficient. When I
was mayor of Denver, we made the city smaller. We had a hiring freeze
for 2\1/2\ years. We asked the workers to do more with less, and they
did that. But we did it in increments, and we worked to make sure
people knew how much they were valued and they could make a difference.
When I was Governor of Colorado, we balanced our budget every single
year. We went through every board and regulation that we could find on
the books, 24,500 rules and regulations, and we simplified or
eliminated 11,000. We did all this without cutting services and without
cutting resources that people rely on.
Now, Republicans knew they were going way beyond waste, fraud, and
abuse. That is part of the reason it took 24 hours of voting and arm-
twisting to pass this, what we call in my family, ``God Awful Bill.''
They knew they were going to be hurting their constituents and
Americans. I mean, the bill itself is a prime example of a--what my
grandfather used to call a drunken spending spree. It is going to cost
the American people more than $4 trillion when you consider the
interest payments on the national debt.
And none of the arguments the Republicans have used have legs.
Ultimately, the bill isn't just a trillion dollars in cuts for Medicaid
and the Affordable Care Act. It really, through these rules and
paperwork, creates new barriers to access. That means more paperwork,
more hoops for families to jump through.
Under Trump's ``Big Ugly Bill,'' government efficiency just means
rolling out the redtape, miles and miles of it. And who pays the price?
Well, rural Coloradans are going to pay some price. People living in
Cortez and Lamar or Rifle will pay a price when their closest
healthcare center closes. Pregnant women who have to drive 50 miles to
give birth after their closest hospital will be forced to close their
birthing centers and kids who lose their healthcare because their
parents had to navigate so much redtape to prove they do, in fact, meet
the requirements will pay the cost and adult children who can't provide
sufficient proof that their full-time job is taking care of a disabled
parent.
Now, listen to this, if you are a single adult in Colorado, you don't
even qualify for Medicaid if you earn less than $1,735 a month. That
means making less than $10.01. If you make $10.02 an hour, you already
don't qualify for Medicaid.
So people making less than $10 an hour have to fill out reams of
paperwork to demonstrate that they qualify. It is not just, they should
be able to show their W-2 and say, hey, I am making $9.50 and that
should be enough, but somehow there is a worry that people making less
than $10 an hour should fill out all this other paperwork.
In what kind of a bizarre world do we live in? Bottom line,
Republicans are cutting costs by punishing the poorest and most needy
in our country when they can't keep up.
They are making the people who suffer the most suffer more. That is
not the America that I believe in. The Medicaid system is not perfect,
but it exists in our country because that country, our country, decided
that no matter where you live or how little money you make, working
Americans deserve basic healthcare. Who knows, someday we might get
everyone covered. It is a vow we need to make. And certainly when we
created Medicaid, it was a vow we made to help take care of the
neediest people--or many of the neediest people in our country.
Now, because our country is measured by how we treat people--let me
put this a better way. Because our country is measured by not how we
treat people at the top but how we treat large numbers of Americans who
start at the bottom, striving for a better life, that is how our
country should be, and that is the dream we are all chasing.
And, ultimately, it is the American people that are going to have the
final word.
I yield the floor.
The PRESIDING OFFICER (Mr. Schmitt). The Senator from Oregon.
Mr. MERKLEY. Mr. President, I appreciate the comments from my
colleague from Colorado. I don't think it is unique to the States out
West, be it Oregon or Colorado or California or Idaho or Nevada or so
forth. I think people in every single State care about access to
healthcare.
Now, I came to the Senate in 2009, and in that year, we decided to
make a major effort to fill in huge holes in our healthcare system.
Well, we had Medicaid for the least affluent, but then folks who were
just above that, they couldn't afford private insurance; they also
didn't qualify for Medicaid, so we created extended Medicaid and made
it a State option that covered a lot more people.
And then when you came to the middle class, you had folks who had
insurance through their employer but not every employer provided
insurance. And so we created the healthcare exchange where you could
buy insurance and you could do so with tax credits to help you make the
payments so that they were affordable.
Well, that plan was pretty straightforward, but a man named Frank
Luntz--he was a pollster and messagemaker for the Republicans--put out
a memo. And I was one of the first Members of the Senate to see this
memo. It was April of 2009. And the memo said: Whatever the Democrats
come up with to improve healthcare, we are going to call it a
government takeover because we have done focus groups, and that scares
Americans. It makes them dread this.
And it doesn't matter what the policy is, we will call it a
government

[[Page S4875]]

takeover. And I came down here to the floor, at that point my desk was
much farther over here, around the corner, and I waved this around and
said: Is this what America has come to? Instead of working together to
improve the healthcare system, instead, we are so polarized that the
minority wants to stop us from improving healthcare, even if it makes
sense. And they are going to make up a falsehood and sell it across
America.
Well, apparently, that is what America had come to because they did
promote that falsehood all across America.
Now back home in Oregon, I have made a commitment to go to a townhall
in each of my 36 counties every year, open hour. People can come and
share whatever they want.
I am out in Prineville, OR, where, normally, there would be, like, 30
or 50 people at a townhall and about 500 people show up. Why? Because
they are terrified of a government takeover of the healthcare system.
There was about 200 people inside the room. There are several hundred
people outside who can't get in because the room is completely packed.
And they are angry. They are very angry.
And one man shouts out and says: Why won't you listen to us and stop
this government takeover?
And I said: I will listen to everybody in this room. I will describe
major features of the plan, and you all can respond to me: Step forward
or step backward. So I said: How about requiring insurance policies to
cover pre-existing conditions? Step forward--80 percent of the people
in the room raised their hand. Step backwards--about 10 percent.
Another 10 percent didn't vote.
I said: How about having preventive tests free because an ounce of
prevention is worth a pound of cure? Step forward--80 percent yes.
How about having children on your policy to age 26? Again, 80 percent
yes.
How about having a website where you can compare private insurance
policies so you can pick the best one for your family? Again, 80
percent yes.
Well, by now, people are looking around the room going: Well, this
all sounds pretty good. Of course, they came, and they were very angry.
I said: Let's talk about the economics of this. How about providing
tax credits to help middle-class Americans buy insurance from private
companies? Again, 80 percent yes. People liked that idea.
How about expanding Medicaid because we have the least affluent in
our society who are trapped between just a little too affluent to
qualify for Medicaid, but they certainly can't afford private
insurance.
Oh, no. That sounds good too.
And so I would say then: Thank you very much for the feedback on the
major features of the plan. There is no government takeover in it, but
you have all expressed to me your support for many of the features, and
that is why I am supporting it.
Well, this was the year 2009. You had a blue trifecta that said:
Let's fill in the holes on healthcare, and we went about and did it.
And now let's fast forward to 2025. You don't have a blue trifecta; you
have a red trifecta. And the red trifecta knows how important health
insurance is, so they made some promises. And the promises were: We
will not touch your healthcare. We will not force people off insurance.
And, in fact, they did exactly the opposite.
In 2009, the House, the Senate, the Oval Office working together to
fill in the holes and make sure everybody could get healthcare; 2025,
the red trifecta, the Oval Office, Republican leadership in the House
and Senate say: We are going to tear down your access to healthcare.
And that is what they did in the one big ugly betrayal of a bill voted
a few weeks ago right here in this Chamber, tearing down your
healthcare. And 15 million Americans are going to lose access to
healthcare because of this bill.
Here is the philosophy we saw: Roll out the red carpet for the rich
and powerful. Roll out the redtape for the less affluent. Wow. What a
horrific strategy to rip healthcare away from 15 million people.
What does that mean to a family when they lose health insurance?
Well, I will tell you. It means that they don't go to the doctor. And
when they don't go to the doctor, that lump they ignored becomes
ravaging breast cancer with horrific consequences for the woman, the
family, the children. It means diabetes delayed is diabetes that is
much more severe and hard to treat. It means all sorts of risks for the
individual and all sorts of consequences for the family and the stress
of knowing you have a healthcare condition and you should go to a
doctor but you don't go because you can't afford to go.
Or maybe you do buy a policy, but now it is more expensive. Here is
what is going to happen on the healthcare exchange in Oregon. The cost
is going to go up by 68 percent, an estimated $1,300 per family,
because the big ugly betrayal of a bill raised the cost of buying
healthcare on the exchange because it didn't extend the premium tax
credits that were in the bill previously, that were in the system
previously.
Well, that is a shocker. If people spend the money there, it may well
be that they don't have the money for their rent, may not have their
money to purchase the prescription pills that the doctor they went to
said they need to buy, or maybe it is an impact on groceries.
And I will tell you what else happens. With so many people losing
Medicaid--in Oregon, the Oregon Health Plan--and in Oregon, the
estimate is 150,000 to 200,000 people will lose Medicaid.
Well, now in your rural clinics and hospitals, we have a situation
where the revenue that flows to that clinic or hospital drops
dramatically.
This is from the Sheps Center for Health Services Research,
University of North Carolina--real experts on rural healthcare. And
what do they say in this study? They say that more than 300 rural
hospitals are at risk of either closing or significantly reducing their
services because of the big ugly betrayal of a bill.
Oregon, four rural hospitals or clinics. Almost every state is listed
here. Is that really what we want to do? We want to shut down rural
healthcare?
And when you shut down a clinic, when you shut down a rural hospital,
you aren't just affecting the least affluent who were on the State's
Medicaid plan; you are affecting everyone in the community. Every
single person loses access to the healthcare when the clinic or
hospital shuts down.
We lost, 2 years ago, a maternity care ward in Baker City, OR. Tragic
for the community. If you are getting ready to have a child, now you
are thinking about the fact, to have it delivered, I have to go at
least 70 miles down I-84, and I-84 is often closed in winter due to ice
and snow.
Is that the stress? We want to rip healthcare out of our rural
community and put on the stress?
And I will tell you what else happens: People simply don't get down
the road for the medical treatment that they should be accessing.
So here is the story. This is wrong, so we are going to introduce a
bill that reverses this and says: Everything that was ripped out of
American healthcare by the big ugly betrayal of a bill, we are going to
restore it. And we are going to add in the same tax credits people had
access to last year. That way, there won't be a 68 percent increase for
people buying healthcare on the exchange on Oregon, a $1,300 increase.
That way, the middle class will still be able to afford to buy
policies, and the less affluent will still have health insurance so
they will get the care that they need, and the rural communities will
still have the cash flow to be able to keep their clinics and hospitals
open.
That is the right vision, not the vision of: Families lose and
billionaires win. That is the whole vision of the big ugly betrayal of
a bill. No, but, instead, a better vision. And what is that better
vision? Families thrive and billionaires pay their fair share. Let's
fight for that vision.
The PRESIDING OFFICER. The Senator from Maryland.
Mr. VAN HOLLEN. Mr. President, on this day 60 years ago, President
Lyndon Baines Johnson signed the law that created Medicare and
Medicaid, protecting the health and well-being of hundreds of millions
of American families.
Those were our predecessors here on the floor of the U.S. Senate, and
they passed that bill by the overwhelming vote--at least by today's
standards--of 68 to 21, with support from Senators of both parties. And
they did that because

[[Page S4876]]

they understood how vital access to affordable healthcare is for all
Americans.
It was 15 years ago that Democrats and President Obama built on that
legacy with the Affordable Care Act, which expanded Medicaid and
delivered affordable healthcare to 45 million more Americans.
Taken together, Medicare, Medicaid, and the Affordable Care Act are
three parts of one promise, a promise of health and a measure of
economic security for seniors, for people with disabilities, for the
most vulnerable Americans, and for Americans working hard paycheck to
paycheck.
So 60 years ago, one Senator explained that the promise of Medicare
and Medicaid meant this:

We do not intend to kick you out on the street. We are
going to see you through. You are not going to become
forgotten people.

That is how one Senator explained his vote to make sure we provided
coverage under Medicare and Medicaid.
Well, 3 weeks ago on the Senate floor, President Trump, with allies
among the Republican Senators, forgot about those people, those people
for whom that law was passed 60 years ago today. Because 3 weeks ago,
right here on the Senate floor, Republicans passed what Donald Trump
calls the Big Beautiful Bill.
It certainly is beautiful if you are a billionaire or a very wealthy
person. For everybody else, it is an ugly betrayal. Because that bill,
passed about 3 weeks ago, here on the Senate floor, slashed Medicaid.
It cut into the Affordable Care Act and, combined, cut over a trillion
dollars in healthcare to fund tax breaks for billionaires and very
wealthy people, taking healthcare coverage away from 10 million
people--even more if you count the failure to extend the tax credits
from the Affordable Care Act which will expire at the end of this
year--but 10 million on the terms of that bill alone, including nearly
246,000 of my fellow Marylanders.
And as others have said, this will increase the cost of healthcare
for everybody else because it has a ripple effect throughout the
insurance markets. When you start denying affordable healthcare to
people on Medicaid, it puts upward pressure on premiums for everybody
else as people go to get emergency care in hospitals and other places.
Now, one of our Republican colleagues reportedly said to members of
the Republican caucus:

I know a lot of us are hearing from people back home about
Medicaid, but they'll get over it.

That was the quote from a Republican Senator. I can tell you, from
talking to my constituents and hearing from my colleagues all over the
country, the American people are not going to get over it.
Because of this bill that was passed 3 weeks ago, millions of
Americans are going to lose their coverage, not because they are
ineligible but because Republicans purposefully put up all sorts of
bureaucratic hurdles to assess accessing those healthcare needs. That
is increasing the costs and making it harder for people to access
healthcare.
And because of the failure to extend the tax credits for the
Affordable Care Act, a big part of those tax credits which will expire
at the end of this year, another 20 million Americans will see their
premiums jump an average of $700 starting in January. And in my home
State of Maryland, I mentioned that about 246,000 Marylanders are going
to lose access to healthcare because of the bill passed 3 weeks ago.
And if we don't fix the issue of the expiring ACA tax credits by the
end of the year, 70,000 Marylanders could lose their healthcare
coverage altogether, and they will see their premiums increase 68
percent.
As others have discussed, rural hospitals were already in a very,
very tough position across the country, and now hundreds could close.
We are also seeing seniors put at greater risk in nursing homes
because of cutbacks on the number of nursing staff we normally require
to make sure that people's elderly loved ones get the care they need
and deserve, and these cuts will make families face impossible choices.
Again, all of that--those cuts to Medicaid, the cuts to the
Affordable Care Act--is for one purpose: to partially offset the cost
of tax breaks for billionaires and wealthy people. I say ``partially
offset'' because, even after cutting Medicaid, we are going to see an
increase in the national debt of $3.5 trillion over the next 10 years,
and that doesn't include additional interest on that debt.
By cutting Medicaid so deeply, President Trump and Republicans are
hurting people at every stage of life. You know, doctors take an oath
to make sure they help people at every stage of life, from cradle to
grave. What happened 3 weeks ago is going to hurt people from cradle to
grave. For many, it will be an early death sentence by denying access
to important care, including preventive care. Officially, death
certificates may read ``died from late-stage cancer'' or because of an
accident in a nursing home, but when you look behind that, you will
find that it is because that late-stage cancer wasn't detected earlier
or because the nurse who should have been there at the nursing home
wasn't there. That will be as a result of the bill that passed 3 weeks
ago.
We believe that Donald Trump and Republican Senators know better. We
certainly know that they heard from their constituents about what would
happen if this bill passed. Like many, I received letters from hundreds
of constituents, saying: Please don't pass this bill.
I am just going to read two short excerpts from a few of my
constituents.
Mary, from Carroll County, said:

My 52-year-old son is battling colon cancer and has to
undergo chemotherapy every two weeks. He has been sick since
2019 and lost his business and cannot work. He lost
everything and is living with me and on Medicaid. The chemo
is enabling him to have one good week out of two. If they
take his Medicaid away, it will be a death sentence.

That is what Mary from Carroll County said.
Frank, from Cecil County, said:

PLEASE, PLEASE do not pass the budget, I have an autistic
son who can only work part time at a grocery store. He is on
Medicaid. If he loses his [insurance], we will not be able to
cover him. Please do not let this happen. PLEASE!

I received these heart-wrenching letters from many constituents, and
I know that all of us in this Senate did as well. Unfortunately, we saw
over 50 Senators look the other way in the face of all of those letters
and, instead, vote for a bill that cut healthcare for millions of
Americans in order to partially finance tax cuts for the very wealthy.
We cannot allow this to continue. In fact, we need to reverse it.
That is why I am joining others on the Schumer-Wyden bill to repeal the
healthcare cuts that were enacted in that betrayal of a bill 3 weeks
ago and to permanently extend the Affordable Care Act tax credits,
which will otherwise expire at the end of this year.
Again, 60 years ago, former Senators passed the Medicare and Medicaid
law. They enacted that, improving the lives of millions of Americans.
Three weeks ago, we saw the opposite happen--the great betrayal. We
need to make sure that we reverse the damage that was done. Then we
need to build a better healthcare system for every American. That is
what we should be doing at this point in our history: building on the
legacy of the Senators 60 years ago and building on the legacy of the
Affordable Care Act.
I yield the floor.
The PRESIDING OFFICER. The Senator from Nevada.
Ms. CORTEZ MASTO. Mr. President, as my colleagues have mentioned,
today marks 60 years since Medicare and Medicaid were signed into law.
Democrats and Republicans alike should be celebrating the lives that
have been saved as a result of these critical programs. Members of both
parties should be sharing stories about Americans who have benefited
from the healthcare they have received thanks to Medicare and Medicaid.
Unfortunately, today, my Democratic colleagues and I are not
celebrating. We are angry. We are angry that President Trump lied when
he said he would cherish Medicaid and that his allies in Congress
wouldn't touch this essential program. We are angry that President
Trump and congressional Republicans slashed nearly $1 trillion from
Medicaid so they could hand billionaires a tax cut and add $4 trillion
to our national deficit. We are angry that their new law is about to
kick 17 million Americans off of their health insurance.

[[Page S4877]]

In my home State of Nevada, that means up to 120,000 Nevadans will
lose their healthcare; 100,000 of those Nevadans will lose their access
to Medicaid; and another 20,000 Nevadans will lose their affordable
health coverage if Republicans continue to refuse to work with
Democrats to extend the Affordable Care Act tax credits. There are a
million reasons this new law of gutting Medicaid is terrible for
Nevadans and for our country as a whole, but, today, I just want to
focus on one--Hannah.
Hannah is a young girl who lives in Nevada, and her parents shared
her story with me. Now I want to share it with you.
Hannah was diagnosed with a congenital kidney disease while still in
utero. The first few years of her life were full of hospital rooms,
doctors, and machines trying to keep her alive. At just 2\1/2\ years
old, Hannah underwent major surgery that finally gave her the
opportunity to live like a normal kid, and she did for a few
years. Then, at age 9, Hannah fell into a coma. Imagine. Imagine being
her parents, watching--completely helpless--as your daughter fights
something that you can't protect her from.

Hannah did eventually wake up but with a new diagnosis--diabetes--a
condition that nearly 270,000 Nevadans manage every day, not just the
disease itself but the crushing weight of the costs associated with it.
Over the next 2 years, Hannah's parents spent more than $5,000 out of
pocket because their insurance refused to cover all of their costs to
their daughter. Hannah and her family sacrificed so much just to be
able to afford medication that would allow Hannah to lead a normal
life.
But just when they thought they would never be able to financially
recover, they were able to enroll in Medicaid and receive the support
they needed to care for Hannah at home. Now Hannah is able to live the
life she wants to lead without the fear of medical debt pulling her
family back underwater.
I want to read to you what Hannah's parents wrote me:

But without Medicaid, [Hannah's] insulin would cost more
than our mortgage. Let that sink in. The price of the
medication keeping my child alive is higher than the roof
over her head--even after insurance. How does that make
sense? America should be about neighbors caring for
neighbors. But instead, we are pushing people with
disabilities to the back of the line, treating their lives as
less valuable, their futures as an afterthought. I beg you--I
beg you--to save Medicaid not just for my Hannah but for
every child like her.

My Democratic colleagues and I worked hard to save Medicaid, and we
tried to reach across the aisle to protect the 17 million Americans
just like Hannah who could lose their insurance because of this bill
Republicans and Donald Trump signed into law. Unfortunately, President
Trump insisted that congressional Republicans pass his tax cuts for
billionaires, and they did what they were told. So now Hannah and her
family and millions more like them may be forced back into medical
debt.
To the proponents of this new law who insist that kids like Hannah
aren't the ones they are targeting to kick off coverage, I would say
that either they are being dishonest or they simply don't understand
how Medicaid actually works. These cuts shrink the entire pot of money
States rely on to fund Medicaid. Nevada and every State in this country
will be forced to stretch fewer dollars to cover everyone. That almost
always means tightening eligibility or cutting services so kids like
Hannah end up losing coverage even if they weren't the type of people
Republicans singled out for cuts. It is just shameful, and it is un-
American. We are better than this as a country.
Now, my Democratic colleagues and I will do everything in our power
to restore the healthcare funding Republicans have gutted. You heard
them on the floor today. You are going to hear from more of my
colleagues. I will say this: We will not let our colleagues forget what
they did. We will not let them forget the millions of Americans,
whether they are in our States or their States, who are losing access
to healthcare but who just want to get ahead and be able to afford
their healthcare and have access to healthcare for themselves and their
families. That is worth fighting for.
I yield the floor.
The PRESIDING OFFICER. The Senator from Minnesota.
Ms. KLOBUCHAR. Mr. President, 60 years ago today, President Lyndon
Johnson and Vice President Hubert Humphrey, of Minnesota, whose desk my
hands sit on right now, traveled to Independence, MO. President Johnson
signed Medicare and Medicaid into law. He chose that city for a reason.
He wanted to make clear these programs delivered what their birthplace
promises: independence, health, and security for millions of Americans.
Before that day 60 years ago, there was no comprehensive government
health insurance in the United States. If you didn't get insurance
through work, you were on your own. Before Medicare, no insurance
company wanted to provide coverage to seniors. Most Americans without
job-based coverage faced illnesses and injuries, knowing they would
have to pay out of pocket, and millions, especially older Americans,
kids, and low-income families, went without the care they needed. They
risked their health and their financial security.
Today, over 110 million Americans, including more than 1 million
people in my State, depend on Medicare and Medicaid. These programs
cover everything from hospital visits to lifesaving prescriptions to
long-term care that allow seniors to remain in their homes. These
programs, along with Social Security, have driven poverty among seniors
to record lows, but that promise is under a renewed threat.
My Republican colleagues have passed laws that have cut Medicaid and
Medicare, which millions of Americans rely on. They have voted to cut
healthcare by over $1 trillion to pay for a bunch of tax cuts for
billionaires. These cuts will throw more than 15 million Americans off
of healthcare and threaten the independence not just of our seniors but
of kids, people with disabilities, rural families, and working
families.
As you know, the Medicaid cuts were right there for all to see. The
Medicare cuts came out of a trigger. Because they added so much to the
debt at $4 trillion, it triggered an automatic Medicare cut of $500
billion. That socks rural hospitals right there, and we are already
seeing the effects of the anticipation of that because rural hospitals
can't wait a year. They have got to show the people who run their
hospitals what is going to happen. If they think they can't make it
because of these cuts and what is happening, we lose these rural
hospitals, and, suddenly, moms who want to deliver babies have to drive
2 hours, and people who want to go to an emergency room have nowhere to
go.
In my State, 170,000 people from all walks of life risk losing access
to the care that keeps them healthy and self-sufficient. Cuts like
these nationally could close over 300 rural hospitals, 200 health
centers, and over 500 nursing homes. Families caring for kids with
special needs, kids with disabilities, could be left without the
support that allows them to thrive, and people once again will be
forced to choose between putting food on the table and filling a
prescription.
As my Republican colleagues attack these programs, I have heard from
countless Minnesotans who are among the 71 million Americans who rely
on Medicaid in particular. More than one in five in my State gets
access to care through Medicaid, and for seniors in assisted living, it
is one out of two.
When it comes to people who rely on Medicaid, one example is Lola,
whose daughter was diagnosed with leukemia. A social worker advised
Lola that her employer-based insurance may not cover the cancer
treatments that her daughter needed and connected her with Medicaid.
She said, ``Medicaid helped completely'' with the transfusions, the
surgeries, the T-cell therapy, and ongoing care. Lola added: Using my
own insurance would have caused delays, and ultimately I would have
been, for my daughter, in a life-or-death situation without Medicaid.
Another is Robby, who, after years in adult foster care, now lives
independently with a roommate because of Medicaid's disability waiver
and community-based services.
For these Minnesotans, this isn't about politics. When they call our
office, we don't ask if they are a Democrat or a Republican; we just
help them. When they send us a letter with their stories and pleading
for help, we

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just help them. It is about whether we as a country honor our promise
that every American deserves independence, dignity, and security.
Medicare and Medicaid are overwhelmingly popular with Americans and
overwhelmingly needed by Americans. It is about caring for one another.
It is about ensuring that every American can live with peace of mind
and have dignity--dignity--in their senior years and strengthening
health and prosperity in every corner of our country.
On this 60th anniversary, we should be strengthening these lifelines,
not dismantling them.
As a nation, we have already made progress--capping out-of-pocket
drug costs with the last administration; passing my bill to empower
Medicare to finally negotiate drug prices--if this administration will
continue this program that already, for the first 10 drugs, saved
billions of dollars; making healthcare affordable; saving families
thousands of dollars on therapies and hospital stays for complex
illnesses,
Yet, today, on this milestone anniversary, we are again called to
defend the very promise that began in Independence, MO, 60 years ago.
To paraphrase Minnesota's Happy Warrior Hubert Humphrey, who was
there with President Johnson when he served as Vice President after he
was Senator from the great State of Minnesota--he once said this: The
moral test of a government isn't just how it treats the young and
healthy; it is also how it treats the sick, the elderly, and people
with disabilities.
That is definitely true for government, and I believe it is a moral
test for all Americans.
I urge my colleagues, let's protect the health and security that
Medicare and Medicaid provide for Americans of all ages. Let's keep the
spirit of Independence alive so every kid, every family, every person,
no matter their story, can count on Medicare and Medicaid for
generations to come.
I yield the floor.
The PRESIDING OFFICER. The Senator from New Mexico.
Mr. LUJAN. Mr. President, I rise today for every American who is
scared--scared about losing their health insurance, scared about making
ends meet after the passage of the Republican budget betrayal.
This August, my Republican colleagues are going to have to return
home, and they are going to have to face their constituents. Let's see
how many of them have the courage to hold townhalls and actually have
real conversations with their constituents and take real questions.
I hope my Republican colleagues are ready to explain why they gave
the ultrawealthy a $250,000 tax break--you heard that right, a $250,000
tax break--while gutting Medicaid--a gut punch to people who depend on
Medicaid to be able to get the care they need for themselves or for
their kids, maybe some other loved ones; the same Medicaid which helps
cover the births of nearly half of America's children.
I hope my Republican colleagues can answer how they can take from
veterans, seniors, and children with disabilities just to hand more
money to the top 0.1 percent. The top 0.1 percent--they are the
wealthiest people in America. They are the ones who were rewarded with
the taking of this money.
Meanwhile, Democrats have been listening to our constituents and
hosting townhalls--even in Republican-led States--and fighting back
against a law that does nothing for working families and everything for
the ultrarich.
Senate Democrats are offering Republicans another chance to reverse
the devastating cuts they just passed--cuts that will close rural
hospitals and decimate Medicaid because Republicans have turned
healthcare into a privilege reserved only for the most wealthy in the
country.
That is not the way it has always been. Sixty years ago, Democrats
and Republicans on this very floor came together to save seniors living
in poverty and Americans who were suffering or dying prematurely
because they didn't have health insurance and they couldn't see a
doctor. This promise our government made to our Nation has saved
millions from illness and undue financial burdens.
Senate Republicans broke that promise to the American people. Senate
Democrats know that every American needs healthcare to survive.
Back home in New Mexico, families are learning what this law means
for their daily lives. Some are already living their worst fears. They
are checking their bank accounts. They are calling their doctors. They
are trying to refill prescriptions while they still can.
Moms and dads of very sick kids are wondering how they are going to
afford care when these cuts go through. One of those moms is Karisa
from Las Vegas, NM. Her daughter Aurora was born with a chromosome 16
disorder. She had to have open-heart surgery. She spent her first year
alive on oxygen.
Aurora is a fighter, but without Medicaid, Karisa could never have
afforded the surgeries that saved Aurora's life. Because of Medicaid,
Aurora isn't just surviving; she is thriving. She is going to birthday
parties. She is playing on the playground and dancing to her favorite
cartoons. That is what the fight is all about.
As Senators, we have the privilege to represent our constituents, but
it comes with the responsibility to ensure that families like Karisa's
can focus on healing instead of having to focus on the bills they can't
afford.
Look, New Mexicans aren't looking for handouts. They work hard. They
care for one another. I know it because I have lived it. When I was a
kid, we moved in with my grandparents, Celedon and Nestora Lujan. I
didn't understand it then, but I understand it now. We lived together
because we had to. Now, don't take that wrong--we were also blessed to.
It is how families get by in New Mexico.
Medicaid is not a handout; it is a lifeline. Medicaid is American
dignity--the dignity of parents focused on caring for their children,
not having to argue with an insurance company; the dignity of a senior
not having to choose between medicine and groceries.
Earlier this month, Senate Republicans all voted to gut Medicaid and
the Affordable Care Act.
I mean, heck, some Senate Republicans are now even introducing
legislation to roll back the very Medicaid cuts that they voted for on
this floor just 3 weeks ago, trying to cover their tracks.
By the way, these same Senate Republicans all said on this Senate
floor in one way or another that they promised they were not going to
cut Medicaid. Well, I am tired of saying ``Well, it is not completely
true'' or ``Oh, well, they misspoke.'' No. They lied. And growing up,
my father told me that the coverup is worse than the lie. I hope when
they go home, they have the courage to face their constituents.
So, Democrats, we are all standing here today to do what is right.
Our bill will restore the Affordable Care Act's premium tax credits,
which will bring down costs. It will reverse Republican cuts to
Medicaid, remove redtape, and prevent the closures of rural hospitals--
something I think we all agree on.
So I urge my Republican colleagues, vote for your constituents, vote
to save our rural hospitals, and vote to restore dignity to every
American.
Let's work together and reverse the damage of the Republican budget
betrayal.
I yield the floor.
The PRESIDING OFFICER. The Democratic whip.
Mr. DURBIN. Mr. President, I ask unanimous consent that the following
Senators be permitted to speak prior to the scheduled votes: Durbin for
up to 15 minutes, Cotton for up to 5 minutes, Patty Murray for up to 5
minutes, and Mark Warner for up to 5 minutes.
The PRESIDING OFFICER. Without objection, it is so ordered.