Executive Calendar

Floor Speech

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Mr. WYDEN. Mr. President, before Senator Casey leaves the floor, I just want to make a couple of remarks, as the senior Democrat on the Finance Committee, a ranking member. I particularly want to praise Senator Casey for being our go-to person on the whole issue of Medicaid.

Ever since we began to see the substantial cuts in 2017, as Senator Casey knows, he has been the person we have said is our go-to leader for the most vulnerable Americans who count on Medicaid being there for them.

I want to tell a short story about one of Senator Casey's many contributions to those who find Medicaid to be just a healthcare lifeline. When the Trump administration began its attack on Medicaid benefits, I had been the director of the Gray Panthers at home before I got involved in public service, and a lot of folks came to me. They said: Ron, that probably isn't a big deal for seniors because Medicare covers most of those nursing home bills. And I had to say: Gosh, that is really not the case. Medicare really covers only a small fraction of nursing home bills. It covers the bills that are essentially for hospital-like services, and most of nursing home care in America really ends up getting picked up by Medicaid. Something like two out of every three beds in long-term care facilities, which are custodial facilities, end up being funded by Medicaid.

Senator Casey basically took it upon himself, as part of this effort, to lead the Democrats on the Finance Committee and to lead the Democrats in our caucus to go out and talk about what this really means to the most vulnerable people in America. As my colleagues know, probably 4 or 5 months into this debate with this relentless attack on Medicaid coming week after week after week, most Americans began to understand a little bit about what was on the line for millions of senior citizens.

I thank my colleague because he really began the effort to make the point that growing older in America is really an expensive proposition. Even when you save and you scrimp, you don't go on a vacation, you don't buy the boat, and you don't do the extra, growing older is really an expensive proposition. So if you have a widower on the corner in your neighborhood, and he always mowed his lawn, and he always helped with the sports teams and the like, and now he is getting kind of frail and may need some nursing home care, now we still have a safety net, an essential safety net for those people.

I am going to talk a little bit about some of the challenges of Medicaid. But I would like particularly to begin my remarks--Senator Cardin has been an advocate in the Finance Committee, as well, on Medicaid--by pointing out that Senator Casey, really, at the very outset of this discussion, began the effort to make the case that a lot of people weren't aware of, and that is that Medicaid is a safety net for millions of older people.

Here is the story of Medicaid in 2019. For the vulnerable in America, our people want to make sure that there is more access to Medicaid. Unfortunately, on the other side of the aisle, Republicans are taking that very access away. Just for a few minutes, I am going to draw out this contrast because there is quite a difference of opinion between how the majority party in the Trump White House are working against the interests of vulnerable folks across the country.

As I mentioned, 2016 saw the beginning of this all-out attack by Republicans on Medicaid--hundreds of billions of dollars in cuts, proposed caps, block grants, basically an unravelling of the program as we know it today.

Essentially, from Portland, OR, to Portland, ME, people said: No way. We are not going to support this kind of attack on Medicaid. So in some States, like Utah, they chose the ballot box to actually expand Medicaid under the Affordable Care Act. The voters chose more access to Medicaid, not less. But Republican lawmakers in Utah had decided to deny them their choice. Just think about that one.

I sure hear a lot of talk on the other side of the aisle about States' rights and empowering people at home. This is an example of where voters chose more access to Medicaid, not less. The Republican lawmakers said: Hey, we know better than that. We are not going to give folks that choice. So Utah lawmakers took a hatchet to the plan that voters approved on election day and started carving it out. The only expansion they would allow is a lot smaller than what voters wanted-- spending more money to cover fewer people.

Then lawmakers in Utah followed a path cleared in other Republican- controlled States, and that was to punish those who were enrolled in Medicaid with essentially bureaucratic water torture, with such a barrage of paperwork that it was almost impossible to penetrate what was really necessary to get through the program. This has been seen in Arkansas, Kentucky, and elsewhere.

All of this, of course, is not couched in the bureaucratic maze of redtape it actually is. The discussion is always: Well, this is just about work. That is just not true. It is about getting people kicked off their healthcare.

When you talk about Medicaid patients, you are talking about people who are working and people who want to work. What we are up against are a host of Republican schemes that are basically putting stacks of paperwork between those who need healthcare and their doctors.

These are busy working people with kids to raise, older parents to care for, and bills to pay. Yet lawmakers are trying to force them to fill out stacks and stacks of paperwork just to make sure that somebody can actually find their way through the maze and see a doctor.

If you look at what happened in Arkansas in 2018, you get a sense of how destructive these bureaucratic schemes are to people's healthcare. There were 18,000 people who lost their Medicaid coverage--18,000 people. Trump officials swore up and down that those paperwork requirements wouldn't hurt anybody, but as we saw when the Secretary of Health and Human Services came before the Finance Committee earlier this year, they shrugged when you asked why so many people lost their coverage in Arkansas after the paperwork requirements were put in place.

A Federal judge even weighed in, blocking all of this paperwork, while the Trump administration continued to push the States to take them up. The schemes spread to States across the country, and it was not just paperwork.

With the Trump administration's blessing, Tennessee is the first State trying to turn its Medicaid Program into a block grant. This basically takes a sledgehammer to Medicaid as we know it now. Medicaid block grants mean putting nursing home care--which I just outlined earlier in discussing Senator Casey's important role here--at risk for millions of seniors. You risk children and people with disabilities having to be cut off from their healthcare. But block-granting Medicaid is one of the top goals for Republicans in the Trump administration.

Finally, Trump administration budget slashers are trying a new, additional scheme that is going to hurt so many people across the country. In this particular area, they basically are trying to bring some mathematical sleight of hand so they can change key economic measures in ways that boot vulnerable people off Medicaid and off food stamps.

What they are doing here--again, this is all shrouded in language that just sounds eminently reasonable--is basically talking about where the poverty line ought to be, and then they want to find an artificial way to push the poverty line down without doing anything to lift people out of economic hardship. So you are talking about parents who work long, hard hours and still struggle to make ends meet, people who are trying to find affordable housing, who have practically given up the idea of being able to save for retirement, and who are still trying to pay college tuition. What does the Trump administration say? These people just have life too easy.

The impact of this change would be enormous. Three hundred thousand children could lose comprehensive health coverage, and a quarter million adults could lose their coverage.

Colleagues, this is the Medicaid agenda for Senate Republicans and the Trump administration: Let's go out there and look under every possible rock to find a scheme to restrict access to Medicaid. That is the agenda. Find a way to cut the funding, to deny expansion after the voters approved it.

We now have two members of the Finance Committee with a long, long history of advocating for vulnerable people facing health challenges, so I am going to close and just say this: Ever since I was director of the senior citizens--the Gray Panthers--I always said that the single most important issue in America is healthcare. Whether it is North Dakota or Michigan or Maryland, if you and your loved ones don't have your health, everything else pretty much goes by the board. Somehow that message has not gotten through to the majority here in the Senate because under this majority and under the Trump administration's healthcare agenda, they are buying into a completely different set of principles. They are willing to set millions of Americans back with respect to their healthcare needs. On this side of the aisle, we are going to keep fighting to protect Medicaid.

As I indicated, our next two speakers have a long track record of advocating for the vulnerable. I am just going to make a unanimous consent request. Senator Cardin has been very patient with respect to waiting to speak.

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