Medicaid

Floor Speech

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Mr. GRASSLEY. Mr. President, the Medicaid Program is an important resource for the support of the most vulnerable people in our society, and we intend to keep it for the most vulnerable.

The Working Families Tax Cut Act, passed and signed by the President last year, strengthened the Medicaid Program by cracking down on fraud, waste, and abuse, and by improving access to home and community-based services.

And I would like to give one example of taking care of fraud, waste, and abuse. We learned last year, in looking back, when the Biden administration made eligibility for ObamaCare above 400 percent of poverty, that we found that there were 6-4/10 million people that were put on ObamaCare that were already on Medicaid. Now, you need one or the other, but you don't need both.

So the waste, and maybe fraud, came when agents for insurance companies--health insurance companies--would call you up and say: You can get really low-cost or no-cost insurance now under ObamaCare.

And 6-4/10 million people took that offer up, and we wasted billions of dollars of money with 6-4/10 million people not needing it, if they were already on Medicaid.

So we made those changes to make sure that Medicaid is staying strong for the most vulnerable, the original intention of Medicaid 60 years ago.

Now, to bring you up to date about the legislation--because we hear from our constituents that we are hurting Medicaid by the changes we made--I want to bring attention to lesser known provisions of the law, enabling a broad range of individuals with developmental disabilities to gain access to home and community-based services.

The new law also enabled interim home and community-based service coverage while newly eligible individuals developed their full care plan. The law will cut redtape and provide more services to vulnerable citizens.

While Congress has added new flexibilities to Medicaid in the tax act of last year, I also want to highlight an important milestone in integrating people with disabilities into their local communities. More than 20 years ago, I helped enact legislation that goes by the title of Money Follows the Person Program, helping people with disabilities transition from long-term care facilities into home based in their very own communities of that person's choice.

Rebalancing individuals from institutions to their home community is a very important goal. Iowa began its program with Federal support, more than 16 years ago, and has now transitioned over 1,100 people out of institutional-based care into independent settings in the communities of that person's choice. Last year, Iowa surpassed moving over 1,000 people through this program.

This program, which I said is entitled the Money Follows the Person Program, is helping more people with intellectual disabilities and brain injuries gain independence for the very first time. This also means people are choosing their own daily activities for the very first time, going to work or going to school or participating in other things that you might say are the first in their life.

Iowa is the leader in moving people with intellectual disabilities into the community. In 2025, 96 percent of the people who went through this program were still living in the community a year later.

This program is helping Americans with disabilities find independence in their daily lives.

Whether a new or old program in Medicaid, I am proud to support these efforts that support the original purpose of Medicaid to help those who are the most vulnerable.

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