[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[House]
[Page 4518]
[From the U.S. Government Publishing Office, www.gpo.gov]




                     REPUBLICAN ATTACK ON MEDICAID

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, one of the most disturbing aspects of 
the Republican attack on the Affordable Care Act and the success we 
have had in extending care to Americans has been the specific attack on 
Medicaid. Fourteen million of the 24 million people who will lose 
coverage under the Republican bill are under the Medicaid program. 
Medicaid is critical to the provision of health care in the United 
States. Medicaid covers more people than Medicare.
  Medicaid expansion has been transformational in the 31 States that 
took advantage of the provision in the Affordable Care Act to provide 
coverage to people who make up to 138 percent of poverty--roughly 
$16,600 for a single individual and almost $34,000 for a family of 
four.
  Until then, Medicaid has provided extension of care to the elderly, 
to the poor, and to the disabled. It was helpful, but very restrictive. 
In some cases, people who earned a modest sum--$7,000, $10,000, 
$12,000--were ineligible, especially in those 19 States that refused to 
take advantage of the opportunity to expand the Medicaid coverage at 
Federal expense.
  Mr. Speaker, this is America. So even though these poor, disabled 
people did not have access to Medicaid, many of them did ultimately 
secure health care. But they got it too late. They got it in the 
emergency room. They didn't get it in a clinic in a timely fashion. 
And, of course, the cost for that charity care in emergency rooms or in 
clinics was borne by the rest of us in increased costs for our 
insurance.
  The Republican draconian provisions, even before they put into effect 
an absolutely unnecessary and unenforceable work requirement, will be 
devastating to millions. Bear in mind, these people now are receiving 
care in an appropriate clinic session. They will be getting it now when 
it is too late, and that burden shifted on to the rest of us.
  There will be a tax credit that doesn't help people who don't have 
enough money to buy meaningful coverage in the private market. Under 
the Republican plan, coverage will become worse, deductibles and copays 
will become higher, and we risk destabilizing the insurance market for 
the rest of us.
  Now, we have heard on the floor, in committee, and on the news shows 
our Republican friends and the President talking about the Affordable 
Care Act is in a death spiral and that the insurance industry is 
collapsing. Hardly.
  There was a fascinating article in the weekend New York Times that 
looked at the insurance industry. Since March of 2010, with the passage 
of the Affordable Care Act, the overall stock market has more than 
doubled. It has increased 136 percent. But the managed care health 
organizations have increased their stock value almost 300 percent. The 
largest, UnitedHealth, 480 percent.
  A signal of an industry in a death spiral?
  Absolutely not. The companies are healthy and investors are bidding 
up their stock. The CBO report that our Republican friends did not want 
us to have before we voted on the bill in committee in the middle of 
the night testifies to this underlying stability of the insurance 
market and the Affordable Care Act.
  Medicaid under the Republican plan will be shifted back increasingly 
to the States, which have repeatedly proven that they are incapable of 
maintaining high eligibility funding to help the poor and the near 
poor. And when budget crunches hit, it is the poor who suffer most with 
restrictions in their coverage.
  We have also heard that the Republican plan will provide much-needed 
flexibility. That is nonsense. There is already ample flexibility under 
the Affordable Care Act. I represent Oregon. We were able to negotiate 
an agreement with the Federal Government under the 1115 waiver program 
that other States have that represented a unique partnership with the 
Federal Government to achieve better care, better results, and restrain 
Medicare costs. We have got the flexibility. There is no need to 
destroy the program.

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