Senate Reconciliation Bill Sparks Historic Medicaid Coverage Debate

Mr. DURBIN. Mr. President, what is the hurry? What is the big hurry on this Big Beautiful Bill that President Trump wants to see the Congress pass? Well, the hurry is to make sure we don’t stop and read it. It is 1,000 pages. And as we read it, we discover things included in that bill that passed the House of Representatives which may not be appealing to the people across America. The House of Representatives passed this bill by one vote. It ends up having a direct impact on many people across this country. Just imagine this, if you will. They are considering a bill, a tax bill, that will eliminate health insurance coverage for 16 million Americans. More people and families will lose health insurance coverage by virtue of this Big Beautiful Bill than any legislation we have passed in modern memory. In fact, just the opposite has been true. I have been here under the Affordable Care Act with President Obama when we expanded the reach of health insurance. Now, President Trump has us going in the opposite direction. Some Republican Senators, like Josh Hawley in my neighboring State of Missouri, have criticized this because he realizes how many people he represents count on Medicaid, the basic government program for health insurance. Senator Hawley says, even as a Republican, he can’t support that provision. No one should support that provision. If you ever lived in a moment in your life with a sick child--seriously sick child--and no health insurance, you will never forget it. I know. I have been there. To think that 16 million families would lose their health insurance is impossible to imagine. We received a report from the Congressional Budget Office just last week. They are neutral. They are not Democrats; they are not Republicans. They revealed that the Republican proposal would cost 16 million families their health insurance coverage, the biggest cut to healthcare in American history. No wonder then that Republicans want to move this bill quickly. They don’t want to talk about the impact it is going to have on the Medicaid Program. Medicaid, of course, is a program that provides health insurance based on a person’s income. Lower income individuals qualify for it; those in higher incomes don’t. The facts are coming out now that many of the Republicans in the House are saying: Well, we didn’t read the bill when it went through there. They have a chance to read it now. Republican and Democratic Senators have a chance to read it here. To make sure that the Senate Republicans don’t make the same mistake as the House, here is a more detailed breakdown. With this analysis from the Congressional Budget Office, we have new estimates on how this bill impacts each and every State. Two hundred ten thousand people in my neighboring State of Missouri, Senator Hawley’s State, could lose their health insurance coverage--210,000. In Iowa, nearly 100,000 people can lose their health plans. And our neighbor Indiana, 250,000 Hoosiers could lose the peace of mind that comes with having health insurance. It is the same story coast-to-coast: 40,000 people in Maine, 26,000 Alaskans, they are all going to be victimized. You say to yourself, What is it that is so compelling that the Republicans feel they can stand up and tell 16 million people in America you lose your health insurance? What will they use that money for? What will they take it to the bank for? For something very basic, tax cuts for the wealthiest people in America. Oh, there they go again, Democrats talking about tax cuts. Many of the Republicans deny that this is going to happen, but the facts are there. They estimate that the top 0.1 percent of wage earners in America under the Republican plan that passed the House will get an annual tax break of $400,000. Republicans quickly add: Go ahead and tell the rest of the story. Everybody gets a tax break. OK, let’s go down to the other end of the spectrum: $400,000 for 0.1 percent wage earners. What about those making minimum wage? What will they get as a tax break? Twenty dollars a month. Twenty bucks a month while the cost of healthcare goes up and the cost of their margins go up--$20 a month. This, to me, is absolutely indefensible. Friday, I visited a hospital in Chicago. It is a special hospital. It is La Rabida, a children’s hospital on the South Side of the town right on Lake Michigan. It is a wonderful hospital. Ninety percent of the families that bring their children to La Rabida Hospital qualify for Medicaid. These are families of limited means, and they turn to this highly professional hospital which has a reputation of caring for the poorest kids as well as the richest kids. They treat them all the same, and they treat them well. When I visited the hospital, they told me a story of one of their patients. Her name is Leyone. She was born prematurely, 26 weeks. When she was born, she was only the size of the palm of your hand. She was given just days to survive. She needed a ventilator, tracheotomy tube, central line, an IV-like device that brought medicine to her heart, and much, much more. Today, Leyone is 4 years old. It is a miracle. Thanks to the incredible care provided by La Rabida and the love of so many people, she is here. Leyone’s family was covered by Medicaid, the most highly targeted program for cuts in this Big Beautiful Bill. Ninety percent of the patients that come through the doors of La Rabida Children’s Hospital in Chicago are on Medicaid. What is going to happen to that hospital? I will tell you what the hospitals tell me. Many of them are barely getting by, barely--not just in the city of Chicago but my downstate areas as well. They came out to see me 3 weeks ago, 20 hospital administrators from downstate Illinois. On their own, they wanted to tell me the story that the bill that passed the House of Representatives--the big beautiful Trump bill, the tax bill we are talking about here--will be devastating to these hospitals. Some of them won’t survive. What does it mean to a small- or medium-sized city that is lucky enough to have a good hospital and lose it? Well, the obvious: If you need emergency medical care, it is a longer drive. If that baby is about to be born, it is a longer drive. When it comes down to treatment, these hospitals provide the first in urgent care, and if that hospital closes, what happens? Well, it takes longer to get that care. In addition to that, it also means that a major part of the local economy is gone--gone. How are you going to attract a business or keep a business when you lose your hospital? That is what is at stake here because of the cuts in the Medicaid Program. So the Trump Big Beautiful Bill is designed to cut the program that these hospitals rely on most--the Medicaid Program. Now it turns out that because they add so much to the deficit--trillions of dollars to the deficit--for this tax cut, you are also facing the possibility of something called sequestration. What that means is that there will be less coverage for Medicare. Medicare is a program created in the 1960s under President Lyndon Baines Johnson that provides for families who are elderly and need some help in paying medical bills. It worked miracles. People started living longer and being healthy and being able to survive. But now they want to cut back on Medicare as part of sequestration. This would be devastating to the many people who count on it. It is not just La Rabida that would face devastating consequences under these Medicaid cuts; red States and blue States will also suffer. When you cut $800 billion out of Medicaid, hospitals that are on the edge close. Already today, 26 rural hospitals in Kansas--26 hospitals in Kansas--and 9 in Missouri are at risk of immediate closure. This Big Beautiful Bill could push them over the brink. According to America’s Essential Hospitals, uncompensated care costs for hospitals will increase by $42 billion in a single year under this Republican Big Beautiful Bill. For the rural hospitals that are hanging by a thread, this bill could permanently close their doors. Hospitals are not the only ones. The Medicaid Program provides for help in paying the bills of over half of the people who are in nursing homes. So if your parents or grandparents are in a skilled care facility or in a nursing home and you are happy with where they are and you want to keep them there, you have a new challenge. If the Big Beautiful Bill providing tax cuts for the wealthiest people in America passes, the compensation to that nursing home will go down. When that goes down, many of these nursing homes are going to close, and the choices for someone you love in your family will be limited. As if an increase in healthcare premiums isn’t enough, the cost of basic goods will skyrocket under this Republican plan. The ``Big Beautiful Betrayal’’ will raise energy bills up to $400 a year for families and 10 percent for businesses. Remember what I told you the tax break was for people who are on a basic income in this country--20 bucks a month? Well, it turns out $400 a year, which is dramatically more than 20 bucks a month, is going to make it even harder. It will increase costs by hundreds of dollars a year for 80 million households, all while giving $400,000 to Elon Musk and the wealthiest Americans. If housing weren’t already too expensive, many Americans will see their mortgages increase by $600 a year. Want to follow your passion and start a business? Small business loans are estimated to increase under the Big Beautiful Bill by $1,000 a year. Tariffs are estimated to raise costs for American households by around $2,500. If this last election were about the cost of living and giving families a fighting chance to survive paycheck to paycheck, this bill is devastating for those who aren’t the wealthiest in America. I urge everyone to learn the facts and know what effect this Republican tax bill will have on families across my State and others. This year, for the Fourth of July, the most American thing we can do is, on a bipartisan basis, stop this disaster. What does it take to say pause? stop? We don’t want to cut Medicaid. We don’t want to take health insurance away from 16 million people. We don’t want to see the expenses of families going up. What does it take? It takes four--four--Republican Senators who will step up and say: This is a mistake. Donald Trump is trying to rush us into something which is not good for American families. It is good for billionaires. If you happen to be in that category, this is a great day for you. But for ordinary families who are struggling with their regular bills they have to pay, the Big Beautiful Bill is a big, beautiful betrayal of American families.