00:00Well Mr. President, Democrats continue to melt down over the reconciliation bill
00:07that Republicans are getting ready to consider. And their statements continue
00:11to be heavy on the hysteria, in short on the facts. And nowhere is this more true
00:19than on the subject of the bill's Medicaid provisions. To hear Democrats
00:24talk, you'd think Republicans were getting ready to rip Medicaid from the
00:27hands of needy children and pregnant women. And nothing, Mr. President,
00:31nothing could be further from the truth. And today I would like to take a few
00:37minutes to set the record straight and highlight the facts on Republicans'
00:42efforts to root out waste, fraud, and abuse from Medicaid and ensure that the
00:47focus of this program is on the people that it was designed to help.
00:51Mr. President, like other federal entitlement programs, Medicaid is
00:57not on the soundest footing. Between Obamacare's expansion of Medicaid to
01:02able-bodied adults, at or above 138% of the federal poverty line, and the Biden
01:08administration's rules and waivers, Democrats have been growing Medicaid
01:13beyond its original scope for quite a while now. And federal Medicaid spending has soared.
01:22Between 2019 and 2023, Medicaid spending grew at more than 50%. And that kind of
01:32unsustainable growth, Mr. President, has consequences. Not just for taxpayers who
01:36are on the hook for huge new amounts of money, but for the people most in need, who have to
01:43compete with a lot of new individuals for available resources. Mr. President, Republicans are committed to
01:52preserving and strengthening Medicaid for the people Medicaid was intended to serve, like vulnerable
01:58children, pregnant moms, and elderly Americans. And to that end, we're making some common-sense
02:07reforms to Medicaid to eliminate waste, fraud, and abuse, and protect the program for the people who need it the most.
02:16And that starts with removing people who should not be on the rolls. That means illegal immigrants,
02:23and other non-citizens. Able-bodied adults who can work, but refuse to work. And individuals who don't
02:33qualify for the program. We're going to rein in federal spending to states that choose to direct,
02:40scare state dollars to illegal immigrants. We will be instituting basic, common-sense work
02:48requirements for able-bodied, working-age adults who should not be relying on taxpayers for their
02:54health care unless they are doing their best to find and maintain a job or contribute to their
03:00communities. And we will be overturning Biden-era regulations that made it difficult to remove
03:05individuals who don't qualify for the program. Are Democrats seriously going to tell us they have a
03:14problem with that? Removing these individuals is just basic, good governance. It's fulfilling our
03:24barest obligation to ensure that Medicaid is working well for its intended recipients. Ms. President, I would
03:31note that while Democrat senators may be melting down over these basic good governance requirements,
03:38some of their states are actually taking similar measures. No less a Democrat state than California
03:45is looking to freeze the enrollment of illegal immigrants in its Medicaid program and charge premiums
03:52for illegal immigrants already enrolled. Why? Because the state can no longer afford to cover these
04:00individuals and maintain its other obligations. And yet Democrat senators here in Washington are
04:07melting down because Republicans are daring to focus limited Medicaid dollars on American citizens
04:14and those most in need. Mr. President, in addition to ensuring that the individuals on Medicaid rolls are
04:22the ones who should be there, Republicans are making several other common sense reforms. Notably, Mr.
04:29President, we are taking aim at rampant abuse of the provider tax loophole. Use of this loophole, which sees states
04:38inflate Medicaid service prices in order to garner a larger reimbursement from the federal government, was already a
04:47problem even before the Biden administration. In fact, President Obama released multiple budgets
04:55featuring measures to rein in abuse of the provider tax. But thanks to waivers the Biden administration
05:02issued to California and other blue states last year allowing them to further exploit this loophole,
05:09taxpayers are now on the hook for tens of billions of dollars in new spending. Neither the Medicaid program
05:16nor taxpayers can afford that burden. And so we're going to rein things in.
05:22Mr. President, our bill makes a handful of other modest reforms to restrain waste fraud and abuse, but those I just
05:31mentioned are the big ones. Common sense reforms to protect and strengthen Medicaid for those who need it
05:39the most. And I would love to know which of these reforms my colleagues object to. We've heard a lot of bluster from
05:51Democrats about how this bill will cost enrollment and cost lives, but we've heard very little from them on the actual
05:59measures included in the bill. And so, Mr. President, I'd like to ask them, do they believe the federal government
06:09should still be giving states an enhanced Medicaid match if they cover illegal immigrants? Do they think individuals
06:17who don't qualify for Medicaid should remain on the rolls? Are they against work requirements for able-bodied working-age adults?
06:27Do they think there should be any limits on states exploiting the provider tax loophole? Exactly which of our common-sense
06:40reforms do Democrats disagree with? Mr. President, Democrats used to support rooting out waste, fraud, and abuse in Medicaid and
06:50getting Americans back to work. So what's changed?
06:55Mr. President, while I can't guarantee the source of Democrats' hysteria, I suspect one or more of the following
07:03things is going on here. One, Democrats are still smarting from their election loss last November and are desperate to
07:13regain ground with voters. And I suspect that Democrats think that if they can successfully, even if inaccurately,
07:24paint Republicans as targeting vulnerable Americans, they might be able to claw back some electoral support.
07:32Two, I think Democrats tend to reflexively oppose anything supported by President Trump, no matter how sensible that policy might be.
07:45And three, I think that with Democrats' increasing embrace of the far left, there are Democrats out there who really do believe that government programs can continually expand without consequences.
08:01And that there's no limit to the amount of taxpayer dollars available for them to play with.
08:08Still, Mr. President, it's incredible that we can't agree on these common-sense reforms.
08:15But we're going to move full speed ahead, protecting and preserving Medicaid for the Americans this program was intended to serve.
08:26I want to thank Chairman Crapel and members of the Finance Committee for their work on the Medicaid provisions of our bill.
08:33And, Mr. President, I look forward to taking up these provisions in the very near future as part of our final legislation.
