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Floor Speech

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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.

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