00:03Mr. President, I come to the floor to talk about the action that we're seeing in the House of Representatives today
00:07that will lead to action here in the Senate, and asking our colleagues to reverse course on this reconciliation bill
00:15that I think is going to have unbelievable economic consequences to our economy.
00:21Trillions in red ink that are alarming credit agencies and bond markets,
00:25spiking billions in energy project costs and driving up prices,
00:30and burdening states with billions of dollars of new health care that they can't afford.
00:35Instead, they should be focusing on protecting health care coverage,
00:39lowering costs for American families,
00:41and giving working families the breathing room they need to prosper.
00:47Even now, five years later, out of COVID, we can still see the effects of the pandemic.
00:52That time changed the way we live and took a toll on our economy.
00:57The U.S. economy lost 23 million jobs at the start of the pandemic, leading to a recession in early 2020.
01:05And thanks in no small part to a well-designed bipartisan fiscal policies by both Congress and the Biden administration,
01:14the recession that started was the shortest in history, lasting only two months.
01:20Coming out of it, though, the combined effects and impacts on our supply chains and durable goods
01:27caused inflation to spike to 9 percent by June of 2022.
01:32Again, well-designed fiscal policies by the Fed helped get that inflation back down in just one year to 3 percent by June of 23
01:42and continue to lower and hover just above 2 percent.
01:46We need, though, to continue to make progress on inflation and costs, costs that impact everything from clothes, cars, food, computers, you name it.
01:58And costs may be getting even more expensive because of the impacts of the tariffs,
02:04and they are making their way onto our shelves.
02:07The last thing American families need is to be saddled with even more financial restraint,
02:13particularly as it relates to Medicaid and the policies in the reconciliation bill.
02:19More than 72 million Americans are enrolled in Medicaid, making it the single largest insurer in the United States.
02:26It is critical that it remain a critical part of our health care system.
02:31Depending on the state, the federal government covers somewhere between 50 and 70 percent of the cost of insuring people with Medicaid.
02:42While Medicaid is administered jointly by the federal government,
02:47and in most states, about two-thirds of the funding for the state Medicaid program is federal support.
02:54So make no mistake about it, cutting Medicaid at the federal level is going to have a dramatic economic impact on states.
03:03It is the largest source of federal funding for states.
03:07It is the largest component expenditure across all states.
03:11More than K-12, more than higher education, more than transportation.
03:15And somehow, in an economy with great inflation, you think the idea is to make it more expensive for Americans to get health insurance
03:24and cover their costs and impact the economy.
03:29The bill that is now being cobbled together is a serious attack on Medicaid.
03:35As an assault, they will continue to have ripple impacts on the economy.
03:39It undermines the Medicaid program, shifting the burdens to the state,
03:44and it makes the entire health care system more expensive for everyone.
03:49Medicaid provides financial support to the health care sector, stimulates local economies,
03:54spending that does have a multiplier effect.
03:57Every dollar spent generates more than a dollar's worth of economic activity.
04:03So Medicaid drives employment in the health care sector,
04:06it generates state and local revenue,
04:08and it saves money for the enrollees to spend on more items, not health care.
04:14But reductions in the Medicaid funding, especially as large as $715 billion,
04:20will take a toll on states, on jobs, on revenue,
04:24and it will increase the financial burden on individuals and families.
04:29So it is important to remember that direct recipients of Medicaid
04:32are not just individuals with coverage.
04:35They are a payment system.
04:37They are the benefits of a health care system,
04:40hospitals, doctors, offices, pharmacies, nursing homes.
04:44And so when you cut that funding,
04:45you are cutting those businesses and those opportunities.
04:49The impact on the state economy would be greater than the loss of federal Medicaid funding
04:54because of the ripple effects of the cost across the state.
04:57The Commonwealth Fund estimated that collectively states' gross domestic product
05:02could be cut $95 billion smaller than the total economic output loss,
05:08and that could be even deeper.
05:10So imagine every state now having $2 billion more cost because of Medicaid.
05:16The additional loss in individual income would mean that state and local revenues
05:21would decline by $7 billion.
05:23This would make it harder for states and localities to balance the burden of Medicaid.
05:28And our constituents would also see more far-reaching impacts
05:34as they struggled to provide health care.
05:36Today, 49 states plus the District of Columbia are all part of the system
05:43and counting on these providers and the funds.
05:46But this bill even eliminates the ability for states to adjust the revenue
05:50in any way that would be helpful for them to deal with this crisis.
05:55So this is an extreme approach to cutting American citizens off of the health care.
06:00But think a bit about it for a second on the work requirement.
06:06Also, almost like a surveillance of U.S. citizens trying to make them prove that they're eligible.
06:12Let's be honest.
06:13The provisions are not designed to cut down on waste.
06:16Rather, their primary objective is to prevent people from signing up for Medicaid coverage.
06:21In Arkansas, the casework requirement led to disenrollment of 18,000 people in just four months.
06:27And in New Hampshire, the complexity and administrative burden of the work requirement
06:32costs 17,000 beneficiaries to receive coverage termination in just one month.
06:39Today, Georgia is the only state that has a work requirement for Medicaid,
06:43and instead of expanding Medicaid through the Affordable Care Act,
06:46it allows individuals and households that have income up to 100 percent of the federal work poverty
06:51to get coverage if they work for 80 hours a month.
06:54The results are not good.
06:55A report found that Georgia's model cost taxpayers, taxpayers, not these individuals,
07:02cost the taxpayers $87 million and enrolled only 6,000 people,
07:08about 75 percent fewer than had been projected.
07:12So I ask again, what policy is this that saves money?
07:17It makes health care expensive more expensive for the rest of us.
07:20Nobody defers their health care costs.
07:22They're just going to show up at the emergency room.
07:25Just because we're cutting spending, it doesn't mean that the need magically disappears.
07:31States will have to find their way to make up for these shortfall.
07:35A Kaiser analysis found that the House reconciliation bill, if it is enacted,
07:40the state of Washington would need to spend 30 percent more per Medicaid enrollee to make up the difference.
07:47We don't have those resources.
07:50The same will be true of every state.
07:51For example, Louisiana would have to spend 50 percent more per Medicaid enrollee to make up the difference,
07:57translating into 11 percent increase in the state taxes if they had to do that.
08:03Now is not the time to force our states to jump off of a cliff just because we won't live up to our Medicaid obligation.
08:11I know the president used the F-word, but what is real here on the Senate floor, I'm not going to say it,
08:18but you are making a mess out of Medicaid and we should stop them.
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