John Thune Rails Against 'Democrat Hysteria' Over Cuts To Medicaid In Big, Beautiful Bill

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During remarks on the Senate floor Thursday, Senate Majority Leader John Thune (R-SD) spoke about Medicaid spending.

Transcript

00:01Thank you, Mr. President.

00:02Mr. President, the Democrat hysteria over Republicans' one big, beautiful bill is in

00:09full swing.

00:11And Democrats seem to have fixated on the bill's Medicaid provisions as a useful tool,

00:19they hope, to attack Republicans.

00:22And they've decided that a good talking point is to blame rural hospital closures, including

00:26current rural hospital closures, on our bill's Medicaid provisions.

00:31Well, there's only one little problem, Mr. President.

00:35The provisions of our bill, the Democrats would like you to believe, threaten rural hospital.

00:41Those provisions don't even go into effect until 2028, two and a half years from now.

00:50Suggesting that those provisions are responsible for rural hospitals closing this month is the

00:54height of absurdity.

00:57Mr. President, I said there was one little problem with Democrats' argument.

01:03But in fact, there are a whole lot of problems with Democrats' argument, starting with the

01:07fact that rural hospital closures are a longstanding problem, not something that is suddenly being

01:14triggered by our bill.

01:16Under President Biden, Medicaid spending soared.

01:20And yet, rural hospitals still closed.

01:23Why?

01:24Because rural hospitals have to deal with a lot of challenges that hospitals in major metropolitan

01:29areas don't have to deal with.

01:32Despite those challenges, many rural hospitals are finding ways to adjust, to keep their doors

01:35open, and to serve their communities.

01:38And we have taken steps with our bill to ensure that they can continue to do so with a $50 billion

01:44fund for vulnerable providers like rural hospitals, a fund that goes into effect this year.

01:54Our goal with this fund is to give rural hospitals and other vulnerable providers the time and

01:58resources to find solutions to some of the challenges they're facing.

02:03And to give state governments the time to look at their budgets and develop ways of assisting

02:08rural hospitals that don't involve pushing state responsibilities onto federal taxpayers.

02:14Now, Mr. President, hopefully what I've said so far brings some much-needed clarity and accuracy

02:22to this discussion.

02:24But I want to step back for a minute and discuss the overall scope of what we're doing with the

02:28Medicaid provisions in our bill.

02:31We are restoring Medicaid to what it was originally intended to be, a federal-state partnership to

02:38support the most vulnerable Americans.

02:42Let me just repeat that, Mr. President.

02:44We are restoring Medicaid to what it was originally intended to be, a federal-state partnership to

02:53support the most vulnerable Americans.

02:57There's been drift on both of those in the past few years, Mr. President.

03:02We've drifted from a federal-state partnership to a situation where the federal government

03:07picks up more and more, sometimes close to all, of the tab.

03:13And we've drifted from a focus on the most vulnerable Americans.

03:17Medicaid was created to serve the most vulnerable populations, the elderly poor, the disabled,

03:24pregnant women, and children in need.

03:28But in 2010, President Obama and the Democrats allowed states to expand Medicaid to include

03:35able-bodied adults earning up to 138% of the federal poverty level.

03:40And they gave states an incentive to do so by promising that the federal government would

03:45pick up almost all of the tab.

03:47Combine that with the Biden Administration's Medicaid rules and waivers, and both the Medicaid

03:53population and federal spending on Medicaid have exploded.

03:59Medicaid spending has grown by more than 50% since 2019, 50% since 2019.

04:10That's utterly unsustainable, Mr. President.

04:12And it threatens the stability of the program for the most vulnerable populations.

04:17And so Republicans implemented several common-sense measures to slow the rate of Medicaid growth

04:22and to refocus the program on Americans most in need.

04:27Note what I said.

04:29Slow the rate of Medicaid growth, Mr. President.

04:35We are not cutting Medicaid.

04:37We are simply slowing the rate of growth.

04:41And Senate Finance Committee Chairman Crapo noted, only in Washington is a smaller increase

04:49in spending considered a cut.

04:52So what did we do in our bill, Mr. President?

04:56We implemented measures to reverse non-citizens, or I should say we implemented measures to remove

05:03non-citizens from the Medicaid rolls.

05:06We implemented an extremely mild work requirement, just 20 hours per week for able-bodied, working-age

05:13adults without young children.

05:17We overturned Biden-era regulations that made it difficult to remove individuals who don't

05:22qualify for Medicaid.

05:25And we took aim at rampant abuse of the provider tax loophole.

05:29Now use of this loophole, which sees states inflate Medicaid service prices in order to garner

05:35a larger reimbursement from the federal government, has been a problem for quite a while now.

05:43In fact, President Obama proposed multiple budgets featuring measures to rein in abuse

05:52of the provider tax.

05:54But states continued to take advantage of the gimmick.

05:57And thanks to waivers that the Biden administration issued to California and other blue states

06:02last year, allowing them to further exploit a similar loophole, taxpayers were on the hook

06:10for tens of billions of dollars in new spending.

06:16And so we took action to rein things in.

06:19We are not eliminating states' ability to use the provider tax loophole, but we are instituting

06:24limits.

06:26The identical limits, in fact, that President Obama proposed imposing.

06:34And we are making states take responsibility for their Medicaid decisions.

06:39States like California, which chooses to spend state funds to have its Medicaid program cover

06:43illegal immigrants.

06:45They should not be able to, in effect, have the federal government bail them out for their

06:52reckless spending decisions.

06:55Resources are not unlimited, Mr. President.

06:59States need to shoulder their share of the federal-state Medicaid partnership rather than pushing

07:04off their costs onto federal taxpayers.

07:07Now, Mr. President, the net effect of all these measures, like removing ineligible individuals

07:13and individuals who refuse to work from the Medicaid rolls and restraining state abuse

07:19of the provider tax loophole, will be able to put Medicaid on a more sustainable fiscal footing

07:28going forward and put a renewed emphasis on the vulnerable individuals this program was

07:33actually created to serve.

07:37Vulnerable individuals will also be helped by the major investment our bill makes in expanding

07:41home and community-based services for individuals with developmental disabilities.

07:47This will reduce multi-year waiting lists for services and allow individuals with disabilities

07:52to access the care that they need at home or in their communities.

07:59Mr. President, the one big, beautiful bill was developed to make hardworking Americans safer,

08:09stronger, and more secure.

08:12When the Medicaid provisions of the bill fit right in with that mandate, by refocusing available

08:19Medicaid dollars on those this program was originally intended to serve, we will make

08:27vulnerable Americans more secure and ensure that this program will continue to be available

08:35to Americans in need long into the future.

08:41That sounds like a good day's work, Mr. President.

08:44Mr. President, I yield the floor, and I suggest the absence of quorum.

08:47Mr. President, Mr. President, I yield the floor.

08:51Mr. President and Mr. President, I will have a good notice to ask a prayer.

08:52Mr. President, I shall virtually in this program back now.

08:54Mr. President, I yield the floor once a quarter for Forced of ٍ車, as we shall

08:55be shown.

08:57Mr. President, I yield the floor here above 4, 7 seconds tomara 1.

08:57Mr. President, if I yield the floor for the reserve.

08:58Mr. President, it is a tribute habr, and I F.

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