[Pages S1917-S1918]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                          Trump Administration

  Mr. DURBIN. Mr. President, at this point, Congress is in the midst of 
an important duty: crafting a budget resolution. The resolution is a 
framework that will guide Federal spending over the next 10 years and 
ensure that the United States can fulfill its financial commitments and 
its priorities.
  But under the direction of President Trump, congressional Republicans 
are using this moment as an opportunity to make cuts that hurt working 
families and repurpose the savings to pay for tax breaks for the 
wealthiest people in America.
  And what is the most egregious example of this? The Republican plan 
to slash health coverage for millions of Americans who rely on 
Medicaid.
  House Republicans have proposed $880 billion in cuts to the Medicaid 
Program in order to pay for Trump's tax cuts for billionaires, and 
Senate Republicans have similarly put this program in the crosshairs. 
Why? Not because they want to lower healthcare costs to improve our 
healthcare system but because they want to use Medicaid cuts as a 
source of revenue for tax breaks for billionaires.
  The richest man on Earth, Elon Musk, can dance around a stage with a 
chain saw, cheering cuts to basic healthcare programs, but let me 
explain to you what that really means for working families. Medicaid 
covers 30 million children in America, nearly half of all our kids, 60 
percent of seniors in nursing homes, and it is the largest funder of 
addiction and mental health treatment.
  Let's zero down on that statement: Thirty million kids, half of all 
the kids in America, rely on Medicaid for basic health coverage. And if 
you have a parent or a grandparent in a nursing home or assisted 
living, 60 percent of them rely on Medicaid to pay for it. What happens 
to the family of the parent or grandparent if Medicaid isn't there? Bet 
you know the answer. The family

[[Page S1918]]

has to pay for it or mom can't go where you think the best care is 
offered. That is what Medicaid is all about, 60 percent of folks in 
nursing homes, and it is the largest funder of addiction and mental 
health treatment.
  How many times have we said that we are so enlightened these days, 
unlike previous years, that we talk honestly about mental illness and 
dealing with it? My family, like most families, had a history of mental 
illness, but it was a deepest and darkest secret. Now we are open about 
it, and thank goodness we are because it is an illness--it is not a 
curse--and an illness that can be treated if you can pay for it.
  Medicaid pays for more mental health counseling than any other 
source. And when it comes to narcotics addiction, we talk about 
fentanyl, we talk about heroin, all these different narcotics, and God 
forbid, any family has to face that, but if they do, where do they turn 
for counseling?
  It turns out, the biggest source of counseling from narcotics 
addiction is paid for by Medicaid. So if you cut down the coverage of 
Medicaid, you reduce the likelihood of good professional care for 
people who are suffering from mental illness, addiction, or other 
serious medical problems.
  In Illinois, 3.4 million people are enrolled in Medicaid, including 
1.5 million children. Under Republican plans to dramatically cut the 
Medicaid Program, 775,000 adults who gained health insurance coverage 
under the Affordable Care Act would lose coverage almost overnight.
  When I think back to things that I have been part of as a U.S. 
Senator from Illinois, I am particularly gratified to remember when we 
passed the Affordable Care Act. Too many Americans at that time had no 
health insurance coverage.
  I found myself stuck in that situation as a law student here in 
Georgetown many, many years ago. My wife and I were blessed with a 
little baby girl that was born with a serious health problem, and we 
had no health insurance.
  So where did I go? I went over to the Children's Hospital in this 
town with my wife and baby and waited in what they called the charity 
ward for the opportunity to see some doctor--any doctor--that might be 
able to treat my little girl.
  I never felt more worthless as a parent without health insurance with 
a sick little child. It is a terrible feeling. I have never forgotten 
it to this day. I wouldn't wish it on anybody.
  And I certainly wouldn't take health insurance away from somebody who 
couldn't afford it otherwise in order to give a bigger tax cut to a 
wealthier person. I want to help working families, that is for sure, 
but tax cuts for Elon Musk--come on, he doesn't need it. He wouldn't 
even notice it. What we ought to be focusing on is that family and 
their needs.
  And for other children, elderly, and disabled Illinoisans who depend 
on Medicaid may no longer be able to access lifesaving medical 
treatment with the cutbacks that are being proposed.
  The Republicans are ignoring another obvious point. Medicaid is the 
absolute lifeline for children's hospitals and rural hospitals in their 
communities.
  You pick a State, in Illinois, 60 percent of our 102 counties are 
classified as rural, smalltown America. Rural hospitals are the 
backbone of communities in downstate Illinois. Rural hospitals anchor 
the local economy. They often are the largest employer in town, in the 
county, sometimes. And they are critical access points for healthcare.
  If you suffer a farm accident or face a complication with a birth in 
your family, you can't afford to drive that extra hour or two to find 
the nearest hospital.
  That is why I worked for years to improve access to healthcare in 
rural areas, working to strengthen rural hospitals and recruit more 
doctors, dentists, and nurses. But rural hospitals in Illinois and 
across this country could be at risk of closure if Republicans put 
Medicaid on the chopping block.
  Last week, I had a series of press conferences back in my State. I 
first went to Taylorville, in Central Illinois, and then down to 
Cahokia Heights, near the St. Louis area, and met with hospital 
administrators who told the story: They didn't know whether they could 
keep the doors open if the cutbacks proposed by the House Republicans 
go through. It will be a cutback that they feel personally.
  Already, half of rural hospitals in America operate in the red. They 
are not getting by with current reimbursement, and with even less, 
fewer hospitals will be available. For many rural hospitals, Medicaid 
covers a large percentage of their patients and accounts for a large 
portion of the hospital's budget.
  For HSHS St. Francis Hospital in Litchfield, IL, Medicaid pays for 53 
percent of all hospitalizations. For OSF St. Clare Hospital in 
Princeton, IL, Medicaid pays for 45 percent of all hospitalizations. It 
is 22 percent for Jersey Community Hospital in Jerseyville, IL. And the 
list goes on and on.
  And it isn't just rural, smalltown areas affected by these Medicaid 
cuts. It also goes to the inner city. Hospitals struggling to survive 
won't be able to.
  So do you see the picture here? Cuts to Medicaid put rural hospitals 
and inner-city hospitals in danger. And if rural hospitals close 
because of Republican budget cuts, communities will suffer, and 
families will suffer. Children seeking cancer treatments won't be able 
to access local care when they need it. Pregnant women will have to 
drive further to deliver their babies. And your grandparent will have 
to wait months to get in to see that diabetes specialist.
  Of course, Americans of all political affiliations rely on Medicaid, 
and, increasingly, Republican Members of Congress are recognizing how 
unpopular it is going to be to cut Medicaid to pay for tax breaks for 
the wealthy.
  Senator Tommy Tuberville of Alabama acknowledged in an interview that 
cutting Medicaid would ``decimate'' his home State of Alabama, where 
three out of five kids are on Medicaid. He then said that Congress has 
to find a way around cutting it.
  Senator Roger Marshall of Kansas similarly expressed his support for 
Medicaid, saying that, rather than cutting it, ``we will try to 
strengthen Medicaid for the future of all those who need it the most, 
the most vulnerable.'' And Senator Marshall, of course, is a medical 
doctor.
  Slashing lifesaving healthcare will hurt Americans in blue and red 
States. I hope my Republican colleagues will not cave in to the 
President's pressure and legislate away the health and well-being of 
the people they represent. If Republicans push forward with their cruel 
and unpopular funding plan, working families will lose, and a handful 
of billionaires will win. It is simple and devastating math.
  It is not too late. As we consider the budget resolution, as soon as 
this week, Congress has the ability to do the right thing and protect 
Medicaid from cuts in our Federal budget.
  The numbers in Congress make the difference. In the U.S. Senate, of 
100 Members, there are 53 Republicans and 47 Democrats. When it comes 
to these budget decisions, three Republicans moving over to vote with 
Democrats to save Medicaid can save and keep open these hospitals I 
have talked about, can give these kids access to healthcare, can help 
families pay for mom's and their grandmother's nursing care, can make 
sure that we have counseling for mental health and addiction.
  Three Republicans--that is all it takes. We hope that they will 
listen to the people they represent, carefully.
  I have. I think it is clear.
  Medicaid is a popular program. Over 80 percent of the American people 
reject the idea that we should cut Medicaid--over 80 percent. That goes 
way beyond any single party. They understand that this gets down to the 
basics.
  How would you like to be sitting in that waiting room with no health 
insurance, at a hospital far from your home, hoping that your child is 
going to survive?
  Stick with the families of this country. The billionaires will take 
care of themselves.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. THUNE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.