[Pages S2159-S2168]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




ESTABLISHING THE CONGRESSIONAL BUDGET FOR THE UNITED STATES GOVERNMENT 
FOR FISCAL YEAR 2025 AND SETTING FORTH THE APPROPRIATE BUDGETARY LEVELS 
                   FOR FISCAL YEARS 2026 THROUGH 2034

  The PRESIDING OFFICER (Mrs. MOODY). The clerk will report the 
concurrent resolution.
  The senior assistant legislative clerk read as follows:

       A concurrent resolution (H. Con. Res. 14) establishing the 
     congressional budget for the United States Government for 
     fiscal year 2025 and setting forth the appropriate budgetary 
     levels for fiscal years 2026 through 2034.

  There being no objection, the Senate proceeded to consider the 
concurrent resolution.
  The PRESIDING OFFICER. The Senator from South Carolina.


                           Order of Procedure

  Mr. GRAHAM. Madam President, I ask unanimous consent that for the 
duration of H. Con. Res. 14, the budget resolution for fiscal year 
2025, the majority and the Democratic managers of the resolution, while 
seated or standing at the managers' desk, to be permitted to deliver 
floor remarks, retrieve, review, and edit documents, and send email and 
other data communications from text displayed on wireless personal 
assistant devices and tablet devices.
  I further ask unanimous consent that the use of calculators--and I 
know we still have them--be permitted on the floor during consideration 
of the budget resolution; further, that the staff be permitted to make 
technical and conforming changes to the resolution, if necessary, 
consistent with amendments adopted during Senate consideration, 
including calculating the associated change in the net interest 
function and incorporating the effect of such adopted amendments on the 
budgetary aggregates for Federal revenue, the amount by which the 
Federal revenue should be changed, new budget authority, budget 
outlays, deficits, public debt, and debt held by the public.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GRAHAM. Mr. President, further, I ask unanimous consent for 2 
minutes of debate, equally divided, prior to each vote during 
consideration of H. Con. Res. 14.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                           Amendment No. 1717

  (Purpose: In the nature of a substitute.)
  Mr. GRAHAM. Madam President, I call up my amendment No. 1717.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from South Carolina [Mr. Graham] proposes an 
     amendment numbered 1717.


[[Page S2160]]


  Mr. Graham. I ask that the reading of the amendment be dispensed 
with.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The amendment is printed in today's Record under ``Text of 
Amendments.'')


                 Unanimous Consent Agreement--H. Con. 
                                Res. 14

  Mr. GRAHAM. Madam President, I ask unanimous consent that for 
purposes of debate time this evening, that all time be yielded off the 
resolution.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Democratic leader.
  Mr. SCHUMER. Madam President, a few minutes ago, for the second time 
this year, Senate Republicans began the process to pass legislation 
eviscerating Medicaid, abandoning our kids, failing our veterans, and 
squandering our future--all for the sake of tax cuts for the ultrarich. 
This is the Republican agenda: Billionaires win; American families 
lose. Billionaires win; American families lose in the Republican plan.
  Republicans have failed to be honest with the country about the true 
nature of their plans. They have tried to hide their Medicaid cuts. 
They have tried to hide their billionaire tax giveaways with budgetary 
gimmicks and distractions. They are tying themselves in knots. They 
don't want the American people to know what their agenda is. Well, if 
Republicans won't be straight with the American people about their 
agenda, Senate Democrats are glad to do it for them.
  Tonight, my colleagues and I will begin to put the Republican agenda 
on trial before the court of public opinion here on the floor of the 
Senate. It is going to be a long few days for Senate Republicans. 
Democrats will expose the dark corners of the Republican plan. We will 
explain the devastating consequences, highlight the many injustices 
that Republicans will inflict on people's healthcare, on their 
financial security, on their children's futures, and on the very future 
of the American dream itself.
  We begin tonight with a topic close to home for all of us: Medicaid.
  It is my honor to join my fellow Democrats to lay the case before the 
American people for how Republicans plan to destroy Medicaid as we know 
it and harm millions and millions and millions of Americans. We will 
share the stories of people back home. We will illustrate the full 
scale of the destruction these cuts would do. And we will make it clear 
to the American people that while Republicans work like hell to 
eliminate Medicaid to cut taxes for the rich, Democrats are fighting to 
protect the healthcare the American people deserve and need.
  Medicaid will be the first--the first--of six different themes that 
we will focus on here on the floor.
  Tomorrow, we will be focused, likewise, as we debate this bill, on 
Republicans' morally bankrupt tax breaks for billionaires and on Donald 
Trump's dumb and costly tariffs, on the need to stand up for our 
veterans and our national security, on the unprecedented corruption 
Donald Trump has unleashed in our government, and finally on the 
existential fight to protect Social Security from the chain saw of Elon 
Musk. These are the themes we will cover today and tomorrow.
  This is the fight the American people need to see because people's 
lives and livelihoods are at stake. The healthcare that protects our 
kids is in danger--our children. Their healthcare is in danger. The 
benefits that keep our seniors whole are at risk. Senior citizens, in 
their golden era, could have Medicaid--the rug--pulled out from under 
them, leaving them in dire straits. The investments that unlock 
America's future now stand on the edge of a knife.
  Why? Why? Why are Republicans doing this? Why are they being so 
cruel? so callous? so thoughtless? Why are those in the billionaire 
bubble who seem to run Donald Trump and Elon Musk--why are they doing 
this? It is very simple. They are trying to give the ultrarich another 
tax break. The Republicans are enthralled with these very wealthy, very 
greedy people, and all they want is a tax break.

  When Donald Trump became President, they got control of the 
Republican Party, and Elon Musk and Donald Trump are in the billionaire 
bubble. And when Democrats expose all of these cuts to healthcare and 
veterans' aid and benefits for the American people to see, the American 
people will think it is sickening.
  So, tonight, let us begin with Medicaid.
  Seventy million--seventy million--people rely on Medicaid in one way 
or another to provide medical care, and tens of millions more are their 
families and friends. That includes not just seniors who are within the 
70 million but also newborns, parents, Americans with disabilities, 
rural communities that have access, perhaps, to a single hospital or 
clinic if they are fortunate. Medicaid--Medicaid--makes all these 
things possible.
  I want to focus on a truly sobering experience I had earlier this 
week when visiting two nursing homes in New York: the Silver Lake 
Specialized Care and Rehab Center on Staten Island and the Carillon 
Nursing and Rehab Center on Long Island. These institutions alone--
there are just 2 of them--serve over 600 residents together and employ 
600 people. They are the lifeline to local communities. They help 
seniors with dementia, with postsurgical rehab, with physical 
disability support, and so much more.
  My visit to these communities was clouded by a shadow of fear and 
anger. I talked to senior citizens who knew that if Medicaid were cut, 
they would lose their healthcare. In fact, the owner of Silver Lake--
one of the most esteemed healthcare facilities on Staten Island--told 
me that if the cut were even half what the Republicans are proposing, 
his home would close. Hundreds of senior citizens would have no 
healthcare, and 300 people would lose their jobs. They were frightened. 
They were scared. They were angry.
  There is no question about it: Even if Republicans pass a fraction of 
the cuts they are pushing, it will devastate these communities.
  We have the heads of major hospitals there--many of them not the same 
party as mine--telling us what would happen if these devastating cuts 
to Medicaid went through.
  On Staten Island, we estimated 18,000 people would lose their jobs. 
Tens of thousands would no longer get healthcare. It would cause a 
recession on Staten Island--like that. Seniors at the centers--new 
seniors who are getting out of hospitals or have a new illness that 
they are just encountering--would be turned away. There would be no 
funding. There would be no beds. There would be no place for them to 
go.
  It is not just the residents at these nursing homes; it is their 
children who now can breathe easy for their parents who helped raise 
them and worked so hard through the years to provide for them.
  Staten Island is a middle-class community, and so is Long Island--the 
two places I visited--but their kids would not be able to care for most 
of them. Most of them need more healthcare than just going back to 
their kids' homes. It is not adequate healthcare for so many of them. 
Others said their children had no extra room for them. What are even 
the kids going to do? On both Staten Island and Long Island, these are 
middle-class communities. They are going to be devastated by these 
cuts.
  Some of the residents said their children might be able to take care 
of them, but the burden would be immense. These families don't have the 
financial means to take care of their parents in their advanced ages. 
They don't have space at home. They don't have the medical know-how to 
meet the needs like a nursing home does.
  For any of you--of the millions of Americans who have a parent who 
has struggled with dementia or physical disabilities--to those people, 
we know that our parents need the help of medical professionals to care 
for them properly. That is why Medicaid is so vital, so important, such 
a lifeline to tens of millions of families across America. The 
Republican Medicaid cuts would be a gut punch to these families.
  It was the same story on Long Island. Senior citizens are scared, 
nervous, angry about what these budget cuts would do to them that the 
Republicans are proposing, that Trump and Musk are proposing. Workers 
worried they might lose their jobs--and they have worked so hard in 
these facilities because they care about the patients they are caring 
for--are told ``No, no more funding'' for no reason. They are doing a 
great job.

[[Page S2161]]

  It is the same on Long Island as on Staten Island, and it is the same 
across all of America in poor communities, which, of course, depend on 
Medicaid.
  For so many people, Medicaid is their only lifeline to healthcare--
for middle-class communities and even well-to-do communities. All of 
them are nervous, scared, angry, furious at what these cuts would do to 
them.
  Why? people ask. Why are they doing this? Why are they being so mean? 
Why are they being so cruel? Why are they being so callous?
  We have to answer: For one reason--they want to give billionaires a 
tax cut. They want to take the money away from working families. They 
want to take things that working families need. They want to take them 
away so there are more tax cuts for the billionaires.
  It angers me. It is infuriating that something so wrong, so callous, 
so detrimental to America could be right here on the Senate floor with 
the support of so many Republican Senators.
  I say to the Republican Senators: Listen to your constituents. Listen 
to your constituents. They don't want this. You know that. Are you 
going to get up on the floor and make a speech that says you are 
cutting Medicaid because you want to give tax breaks to billionaires? 
That is what you are doing. Get up and have the courage to say it. Get 
up and have the courage to say it.
  The senior centers I visited were represented, actually, by 
Republican Members of Congress on both Staten Island and Long Island.
  There, I told every patient, every doctor, every nurse, every 
employee who works in these institutions to call their Congress Member 
and tell them that their jobs are at risk and, if they are a resident, 
to tell them their healthcare is at risk. If they are a child of a 
parent in one of these nursing homes, call.
  I told them to make it clear to their Congressmen that the Republican 
Congressmen and Senators have the power in their hands to stop these 
cuts because there are narrow margins in both the Senate and the House.
  A handful of Senators and a handful of Congressmen, if they have the 
courage to do the right thing--and most of them--or some of them, at 
least, know that it is the right thing even though they are afraid to 
vote yes--they are afraid to vote no and stop this, but they should 
have the courage to do it.
  So I told them. I told everyone I encountered in these two nursing 
homes and in many other places in New York.
  I went to a hospital in the Bronx--one of the biggest hospitals. It 
serves 1.3 million people in the Bronx. It is the only cancer care 
treatment for all of those 1.3 million. The leaders of that hospital 
told me the hospital would probably close if there were a 20-percent 
cut to Medicaid, and the Republicans are proposing a deeper cut than 
that in this budget bill. Close. The only hospital. One of the biggest 
employers. It employees 18,000 people itself. This story could be 
repeated. The Bronx has poorer communities. Staten Island and Long 
Island have more middle-class communities. But every one of them will 
be affected terribly by these cuts. So I told them to call. I tell 
everyone: We have to stop this. Public sentiment is everything.

  Every American in a similar position to those I spoke to should do 
the same. Call your Congressman. Call your Senator. Tell them you don't 
want Medicaid to be slashed. Tell them you don't want nutrition 
assistance to be eliminated. Tell them you don't want our seniors to be 
abandoned. Tell them you don't want to see these cuts--these cruel, 
heartless cuts--just so the wealthiest Americans can get another break 
they don't need.
  That is what the next few days are about: fighting these awful cuts 
done to help the wealthiest Americans get a tax break. That is the 
fight Democrats will have here on the Senate floor. That is the fight 
we will have tonight. That is the fight we will have tomorrow and 
beyond.
  Democrats are fighting every day in every way against these attacks 
against American families, against this plan, which says billionaires 
win; families lose.
  Democrats stand united. We are unified in fighting this awful bill. 
We will fight the Republican anti-family agenda. We will shine a light 
on these terrible cuts that Republicans are trying to pass. The 
American people will be horrified at what they see.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. MERKLEY. Madam President, families lose, and billionaires win. 
That is the Republican plan. It is a plan that slashes $1.5 to $2 
trillion from programs that families depend on. And why? To fund tax 
cuts for the very richest Americans.
  But that is not all the bad news because there are additional tax 
cuts for the best and richest in the country--the richest Americans--
and those are unpaid for, and that means debt.
  How much more debt does this bill create? The current estimate--and 
the estimates keep going up--is $5.3 trillion of unpaid-for tax cuts 
over the next 10 years--$5.3 trillion--trillion with a ``t''--over the 
next 10 years.
  But that is not all. Their plan provides for $37 trillion--at least 
$37 trillion--in additional debt over the next 30 years. This is a 
phenomenal, phenomenal number.
  And, third, they say: We will tell the American people it adds no new 
debt; passing this bill adds no new debt.
  That is quite a set of plans: slash programs for regular Americans, 
enrich the richest Americans, run up an additional $37 trillion in 
debt, and then lie to the American people and say it doesn't cost a 
thing.
  It has become clear, over the last 2 days, about how Republicans are 
going to justify this. They say they are going to use section 312--
section 312--of the law. Section 312, they say, says that the cost of a 
program or the impact of a revenue cut through a tax giveaway to the 
wealthy only costs what the budget chair says it costs. Just take the 
chair's word for it.
  This is the magic wand. It will add $37 trillion to the debt, but if 
the budget chair says it doesn't, then you just pretend it doesn't. It 
is kind of like the situation where the king wears the magic robes--at 
least he thinks he is wearing magic robes, but he is actually walking 
down the street naked because he doesn't have magic robes--in this 
case, again, lying to the public about the cost.
  In the real world, you have real math. In this special new world 
under the Republican plan, you have the magic math.
  This was not the vision that was laid out back 51 years ago, in 1974, 
when the Senate created, along with the House, the Budget and 
Impoundment Control Act.
  That act had three pillars. The first pillar was that in a 10-year 
period, you have to decrease the deficit with the provisions that were 
in the bill. And then, every year after, in every category, it either 
has to be deficit-neutral or reduce the deficit according to the 
provisions that are in the bill.
  Then it said we are going to use honest numbers. Before, there had 
been a lot of smoke and mirrors. There had been a lot of gimmicks. And 
people on both sides said: No, no, we don't want to do that.
  Democrats and Republicans said: Let's use honest numbers. Let's 
create a Congressional Budget Office to give us impartial numbers so we 
can be honest among ourselves, have a real debate about any given 
policy provision or any particular revenue provision, and we can be 
honest with the American people because, otherwise, we will just keep 
running up more and more deficits while pretending we are not.

  My Republican colleagues initially said: Do you know what? We will 
just put a clause into the budget resolution. It is called a scoring 
rule, and that scoring rule will simply say that we are going to say 
this costs nothing, that there is no additional debt.
  A scoring rule has been used in the past. OK, it has been used in 
multiple years, but it was used to resolve little anomalies in tricky, 
little twists and changes in revenue bills or in policies' programs. It 
was always narrow. It always was honest about what it was trying to 
solve and explainable to the public. It was always consistent with the 
law, and it was always involving modest sums--modest by standards of 
the national budget.
  Certainly, now, this scoring rule that had been proposed by the 
Republicans, it was not bipartisan. It was not narrow. It was not 
improving the budget. It, in fact, was lying about the budgeting. It 
was not consistent with the law. And it was massive--$37 trillion.

[[Page S2162]]

  So my colleagues across the aisle, when we pointed this out, they 
said: Yes, we had better not do that. That is just wrong.
  OK. Thank you. Thank you for deciding not to put in a scoring rule 
that was completely wrong and designed to destroy the budget process.
  But now my colleagues across the aisle have said: We will use a 
different provision called section 312. We won't use the scoring rule. 
Instead, we are going to go in a different direction that says simply 
that the cost is what the chair of the Budget Committee says it is.
  Now, I want to turn back the clock a little bit. I want to turn back 
the clock and point out that there were core principles in that 1974 
bill, and they were driven by growing bipartisan concern about deficits 
and debt.
  In the 1958 to 1968 decade, the average deficit was about $5 billion 
per year. That doesn't sound like much now, by our standards, when we 
are looking at $2 trillion per year, but it was a lot compared to the 
past. And folks said: Do you know what? That $5 billion per year over 
that 10 years exploded to an average of $20 billion a year in 1971 
through 1973. Oh, my goodness, it quadrupled. We have got to get a 
handle on these deficits. We don't want to run up the debt--this 
fourfold increase in annual deficits adding to the debt.
  So Democrats and Republicans came together, and they passed the 1974 
Budget and Impoundment Control Act. It created a superhighway for this 
special effort to reduce deficits--a superhighway; a super, filibuster-
free highway.
  Now, you all may remember Robert Byrd of West Virginia. Robert Byrd 
was always the fiercest defender of the filibuster. But he, along with 
99 other Senators, said: We will create one exception, and that 
exception will be to reduce the deficit.
  And it had these three pillars, which I will mention again. It has to 
reduce the deficit. The provisions of the bill have to reduce the 
deficit over the first 10 years. They have to be deficit-neutral in 
every category in each year after the first 10 years. And we have to 
use honest numbers.
  And to have those honest numbers, we will create the Congressional 
Budget Office, an impartial body. We will no longer use smoke and 
mirrors, pretend that things don't cost money when they do cost money.
  But then what happened? I will tell you. For 22 years, it worked 
pretty well. Then along comes the Gingrich revolution, the 1994 
election. Now we have the 1995 through 1997 biennium. Some things 
happened then that, well, one maybe couldn't have foreseen. Maybe they 
could have. There was an effort to do a balanced budget amendment. It 
fell one vote short here in the Senate Chamber. It needed 67 votes; it 
only got 66.
  Then there was: We will do a line-item veto--and that was passed. But 
that gave the power to the President to strike down any line.
  The Supreme Court said: No, you can't do that. You can't delegate the 
power of the purse. The power of the purse belongs with Congress. So 
that fell.
  Then the Republican caucus in charge said: We are going to, instead, 
do a big tax bill giving enormous benefits to the richest Americans.
  Then they said: You know, the problem with that is the Democrats 
won't work with us. They won't give us 60 votes to do that. Oh, I know, 
they said, we will do a nuclear option. We will repurpose the deficit-
decreasing bill from 1974 and say that it can be used in order to 
actually increase deficits with tax cuts.
  And they succeeded. They had the votes. They repurposed the bill. 
They blew up the first pillar of those three pillars. That first pillar 
was the reconciliation process, this special process created in 1974 
that can only be used to reduce deficits in the first 10 years.
  They blew it up and said: OK. Nuclear option. We have reinterpreted 
the rule. It can be used to increase deficits.
  Well, that was a huge, huge damage to the goal of reducing deficits, 
and deficits have gone up ever since.
  When that happened--when that happened--there was a big protest on 
the floor. The first Budget Committee chair who passed the 
reconciliation bill consistent with decreasing deficits was South 
Carolina Senator Fritz Hollings. He said:

       The whole idea of reconciliation--and I am giving you 
     firsthand history: It is honest as the day is long--was to, 
     by gosh, to cut back on the deficit.

  That is what it was for. So the Republicans blew up that pillar, all 
designed to reduce the deficits, and, instead, repurposed it for 
increasing the deficits. Pillar No. 1 drops.
  But, at the same time, the second pillar, that no increase in 
deficits could occur after 10 years, was sustained by the Chair sitting 
and presiding over the Senate, and that was Senator Daschle.
  Senator Daschle said--well, actually, he asked the question. He was 
asking the question of the Republican Chair.
  He said:

       If this reconciliation bill does not find a way to end or 
     offset its tax cuts in the years beyond 2002--

  That is beyond 10 years--

       would the bill violate the Byrd rule?

  And the Presiding Officer responded:

       Yes, it would.

  So the second pillar, no deficits in any category beyond 10 years, 
was preserved--until now.
  That was in 1996, and here we are, 29 years later. Now there is a 
goal to destroy the second and third pillars of the 1974 bill.
  I must say, this is extremely extraordinary and disturbing that my 
Republican colleagues, who run on fiscal responsibility, destroyed the 
first pillar of the special system to reduce deficits in 1996, and 
tonight, they are proposing to destroy the second and third pillars.
  In that second pillar, no deficits beyond year 10; every category, 
every year has to be deficit-neutral or reduce the deficit.
  We can compare that to the law that has just been put forward--or the 
guidance that has just been put forward. We can look at year 11, the 
instructions that go in every category--year 12, year 13, year 20, year 
100. It goes on forever, into the future, and the Republican bill 
guidance fails the Byrd test.
  Now, the Byrd test really gets applied in a second stage of the 
reconciliation process. We are in the budget resolution that sends 
instructions to committees. Those committees will send back specific 
revenue provisions: increase this revenue here, reduce it there, 
proceed to add this policy program, reduce this policy program. When it 
comes back, every category--that is, every title--of the reconciliation 
bill, in every single year, by the Byrd rule, has to be deficit-neutral 
or decrease the deficit.
  So we will have that debate, but we will have that debate when the 
reconciliation bill comes back from committee to this floor because my 
Republican colleagues decided to postpone that debate by taking the 
scoring rule out of their proposed budget resolution and said: We will 
kick it down the road to the next stage.
  And, certainly, we will be here, fiercely defending the deficit-
reducing vision of pillars 2 and 3--pillar 2: no deficit in any 
category or any title of the bill beyond year 10; and pillar 3: use 
honest numbers from the Congressional Budget Office. That pillar has 
survived since 1974. We even put that pillar into law specifically in 
1985 in a bipartisan way. We wanted to emphasize how important that 
was.
  Just think about how much more important this process of deficit 
reduction, special rule of the reconciliation bill, is today than it 
was back in 1974. In 1974, the debt-to-GDP ratio: 23 percent. Tonight, 
in 2025, it is 100 percent. It is equal to the entire gross domestic 
product of the United States. In 1974, the annual deficit was about $6 
billion. Today, it is $2 trillion. In 1974, total debt: $475 billion. 
Today, it is $37 trillion.
  Now, consider this: All of the debt run up over the last 249 years 
since the Declaration of Independence, right now, is just a little bit 
less than $37 trillion. In this single bill--this single bill--
Republicans are saying we will add $37 trillion more--at least that 
much. When the numbers really come out, we expect it to be higher, but 
$37 trillion more to the debt. That is a much bigger burden on the 
future.
  And what do the economists say about that bigger burden? They said it 
will increase interest rates that families have to pay on their 
mortgage and on their car loan since it will decrease the capital 
available to private industry and slow down our economy.

[[Page S2163]]

  This magic math goes by the name of ``current policy baseline.'' It 
sounds very academic, but it is essentially the big lie.
  Consider this: You sign a contract to rent a home for a year, and 
renting that home costs $2,000 per month so you know you are going to 
have to pay $24,000 over the year. And at the end of the year, you say: 
You know what, I am going to renew that agreement to rent this 
apartment. And your spouse says: You know what, that is going to cost 
us another $24,000 in rent.
  And you say: No. I am using the Republican magic math. It won't cost 
a single dime because we will just pretend that a year ago we had 
planned to rent the apartment for a second year; and therefore, it is 
no more than we thought we would pay a year ago--except a year ago you 
said you were only going to rent the house for a year. In other words, 
it is a big lie.
  It is the very smoke and mirrors, the very gimmicks that Democrats 
and Republicans came together and stopped back in 1974. Fifty-one years 
ago, we said this game of lying to the public has to end. But tonight, 
my Republican colleagues are saying that game will continue if they 
have their way.
  Well, we say they must not have their way. We are going to stand up 
and say no to families lose and billionaires win. We are going to say 
no to magic math that lies to the American people about the cost of 
their bill, driven by massive tax cuts to the richest Americans.
  It is a simple request: honesty and integrity. We should not be 
engaging in a big lie, and Democrats will have no part of it. We are 
going to be honest about what every provision of the reconciliation 
bill costs. We are going to be determined to make sure that the Byrd 
rule stands.
  The PRESIDING OFFICER. The Democratic whip.
  Mr. DURBIN. Madam President, this has been an amazing week in the 
U.S. Senate, and I have served here for over 25 years. Just 2 days ago, 
our colleague Cory Booker, from the State of New Jersey, ended a 
filibuster on the floor after 25 hours--broke the record, longest 
speech in the history of the Senate. And an impassioned speech it was. 
I was happy to be here for a major part of it.
  There was a big celebration on our side of the aisle. The Galleries 
were filled in a way I have never seen before, cheering Cory Booker for 
his achievement. It is a moment all of us who are lucky enough to serve 
in the Senate will remember the rest of our lives. But I remember 
another moment that affected more people than this miraculous feat by 
Cory Booker.
  It was July 28 of 2017. It was 2:30 in the morning. I was seated at 
this desk, and a historic vote was about to take place. The vote was 
whether or not we would keep the Affordable Care Act--or ObamaCare, as 
it was known then--extending health insurance to millions of Americans, 
some of whom had never had it.
  At the time, President Trump was in office, and he and the majority 
of the Republicans were determined to eliminate the Affordable Care 
Act, to eliminate the insurance that millions of American families 
depended on to protect their kids and themselves.
  It was the closest possible vote. In the end, at least three 
Republican Senators voted to save the Affordable Care Act, but the one 
key vote and the one I remember was John McCain's. John McCain, an 
extraordinary man, served this country in ways that we could hardly ask 
anyone else to serve: a prisoner of war for over 5 years during 
Vietnam, came battling back, and was elected to the U.S. Senate from 
Arizona.
  And he was a real maverick. You never knew where John was going to 
end up, but you always wanted to end up with him, if you could, because 
it was always a spirited contest, and he usually won it.
  And this vote was dragged out for a long period of time--2:30 in the 
morning, for goodness' sake. And somebody said: John McCain is the last 
person to vote, but he has been called off the Senate floor to go into 
a room behind and take a telephone call from Donald Trump.
  Donald Trump, President, in his first term, was asking John McCain to 
cast the deciding vote to eliminate the Affordable Care Act, health 
insurance coverage for millions of Americans.

  Madam President, I sat here, and I watched as John McCain came in 
from that phone call. And no one knew what he was going to do. Really, 
no one knew. John was the kind of person, you could never quite be 
sure.
  And he walked in the well near the table where the Republicans gather 
for votes, and he stood there. And he barely raised his left arm--
because it was broken while he was a prisoner of war--just enough to 
get his thumb up and go ``no.'' No. That was it.
  John McCain, with that ``no'' vote, saved the Affordable Care Act, 
and millions of Americans' health insurance was protected.
  This was during Trump's first administration, and he had other 
priorities, and they certainly didn't include ObamaCare. He wanted to 
eliminate it. John McCain's courage came through that night. He broke 
with his party because he knew what was at stake. He knew that, for 
millions of Americans, there was no alternative when it came to health 
insurance--it was the Affordable Care Act or nothing--and he had the 
guts to vote no.
  Oh, he was pilloried and criticized by the Republican faithful from 
one end of the country to the other, but those of us who believe he did 
the right thing will never forget that moment of courage.
  In a strange way, today--Thursday, April 3, 2025--we are returning to 
that moment in history. The Republicans under President Trump, in his 
second term, want to perpetuate his tax cut that he gave primarily to 
the wealthiest people in America and add to it at the expense of 
healthcare for America.
  When we talk about healthcare in America, one of the programs that is 
so critical is called Medicaid. In days gone by, Medicaid was a rarely 
used health insurance plan for the poorest and disabled people in 
America, but it has changed. It has become much different. And let me 
tell you why that is an interesting context for where we stand now.
  Many Americans from coast to coast followed the stock market today. 
The reaction of the stock market to the Trump tariff tax and the chaos 
that has been created since he announced we were going into a trade war 
with virtually every nation on Earth--they watched carefully as the 
stock market reacted to it today.
  The Dow Jones Average, which is supposed to be an indicator of the 
state of the economy, lost 4 percent of its value today. I don't know 
what that means for most people, but I know that most people watch it 
because it involves their own retirement plans: IRAs and 401(k)s and 
other plans that they have based on the value of stock. There has to be 
a sinking feeling--I am sure there is--in many households and families 
across America to see so much of the value that they have saved up for 
a lifetime disappear in one day reacting to the Trump tariff tax and 
what it meant across the country.
  And here we come this evening, the same day as this Dow Jones plunge 
of 4 percent, to discuss--what?--healthcare, again, under President 
Trump. And this time it is connected to retirement and savings and the 
future of a lot of families.
  Let me tell you a story about one. I am going to try to mask the 
details because I don't want anyone to reflect on the actual person. 
But he is a friend of mine, and he is a professional in Illinois, a 
wonderful guy, a community leader. And he had a beautiful family--he 
still does, for that matter--but his wife developed Alzheimer's. This 
lovely woman reached the point where she had to be put into a care 
facility to take care of her day-to-day. It breaks my heart to even 
think about it, but it was a fact. He didn't see it coming. There is no 
way he could have.
  But, for years now, she has survived physically while mentally she 
has deteriorated to the point where she cannot communicate with him or 
others. It is an expensive undertaking, that type of care facility. He 
can afford it, but many people can't.
  So what do they do? What happens when your mother or grandmother, 
when someone you dearly love in your family, reaches a point where they 
need this kind of care? Well, you do what you can, the best you can, 
with your own savings and your own resources. But, ultimately, the 
major source of funding for people who are in these facilities is 
Medicaid.

[[Page S2164]]

  If you cut the Medicaid reimbursement, it limits the opportunity for 
these people to get good, professional care--people you love, people 
who it has broken your heart because of their illness, but you want to 
give them the very best in the parting years of their lives.
  So when you cut Medicaid, which is going to be proposed by this 
Republican budget resolution, it is at the expense of families' peace 
of mind and resources they have saved for their own future, their own 
retirement.
  That isn't the only one. In the State of Illinois, half of the 
children who are born in the State are paid for by the Medicaid system. 
What happens if you cut back on Medicaid reimbursement in those cases? 
It means less prenatal care; the likelihood, I am sorry to say, that 
kids, some, will be born with problems that could have been avoided 
and, more seriously, whether or not these children will even survive 
birth. That is what Medicaid is all about.
  We are talking about cutting health coverage for those in care 
facilities, as well as those in hospitals or giving birth.
  Why? Why would the Republicans even suggest that we cut this just 
like they did years ago when John McCain cast that deciding vote? Why 
under a Trump Presidency do they go after healthcare first? Why is that 
their target?
  They believe that the vulnerable people who receive this kind of 
healthcare assistance won't be able to fight back--and they are 
desperate to raise more revenue for what purpose? To give tax cuts to 
the wealthiest people in the America.
  For goodness' sakes, Elon Musk does not need a tax cut. He is a 
multi-multibillionaire, the wealthiest man in the world. Why in the 
world would he cut back on any kind of healthcare for Americans to give 
a man in that station in life a tax break? That is what it is all 
about. But there is more to the story.
  I am honored to represent Illinois. I love the whole State. It is 
where I was born. And I am honored to represent the great city of 
Chicago. Oh, it is controversial. There are some people in downstate 
Illinois that say they ought to go off and be their own State, retire 
them. I am not one of those people. I am proud of the fact that Chicago 
is part of our State.
  But my roots are in downstate Illinois, born in St. Louis, raising my 
family in Springfield. I have lived in and represented the smaller 
communities downstate in the rural areas. That is how I got to Congress 
in the first place, and that is how I stayed in the U.S. Senate.
  What are these cuts Republicans are proposing in Medicaid going to do 
to rural and downstate Illinois and other rural and downstate areas 
around the Nation? The reality is very clear: Fewer resources to 
hospitals in sparsely populated areas mean that many of those hospitals 
will not survive. Today, more than half of those hospitals are hanging 
by a thread, operating in the red. To cut Medicaid reimbursement to 
those hospitals is literally going to close their doors and turn out 
their lights.
  How important is a little hospital in a community downstate? It is 
the economic engine. It is the hub of life for the economy of that 
area. Take away that hospital, and it not only endangers the people 
living around it, it also means a lot of jobs are lost, too, and 
businesses that the people frequent often are going to be threatened as 
well.
  So why would we cut Medicaid reimbursement and close these downstate 
hospitals, giving a tax break to the wealthiest people in America? It 
makes no sense. Where are our priorities? Where is our humanity to even 
consider that?
  I don't understand on the other side of the aisle how Republican 
Senators--many of whom represent smalltown America, too, and really 
care in their hearts about it--can stand by and let this happen. The 
net result of this is going to be the quality of life threatened by the 
people who live in those areas.
  I want to tell you a story about a community I visited 2 weeks ago--
two communities. One was Taylorville, IL. And I asked the hospital 
administrator in Taylorville, which is about 30 miles from Springfield, 
to come and invite other hospital administrators from the area and tell 
me what the Medicaid cuts proposed by the Republicans to give tax 
breaks to the wealthy will mean to these hospitals. To a person, they 
said the same thing: They may survive, but it is a big question.
  And what difference will it make? Well, in some of these hospitals, 
it means that, instead of 30 minutes' drive to the hospital to deliver 
the baby, it will be an hour and 30 minutes. I can still remember our 
first babies in my family. The thought of being in the car for an hour 
and a half with my wife in labor would scare me to death. That would be 
the reality for people, and alternatives are just not available.
  Why in the world would it reach a point where we would cut that kind 
of coverage, that kind of protection, that peace of mind to give tax 
breaks to the wealthiest people? It makes no sense.
  Medicaid and the CHIP program cover nearly 40 million children, half 
of all the kids in America. Medicaid provides health coverage for 60 
percent of seniors in nursing homes, the ones I mentioned earlier, and 
it is the largest funder of addiction and mental health treatment.
  I will tell you, I know the cases pretty well of people who are 
desperate for addiction treatment. They realize that they are addicted. 
They realize they have a problem, and they are anxious to get started 
and cleaning their lives up. Medicaid is the source of funding for that 
kind of counsel, and to cut back on that is to really sentence these 
people to a lifetime of fear and, sadly, cost many of their lives.
  In Illinois, 3.4 million people are enrolled in Medicaid, 1.5 million 
children. Under the Republican plans to slash Medicaid, 775,000 adults 
in Illinois who gained health insurance thanks to the Affordable Care 
Act, the same one that John McCain saved in the first Trump Presidency, 
would lose their coverage almost overnight. How would you like to be in 
a situation where you don't have health insurance at a critical moment?
  I know. I was there. I was a student at Georgetown Law School. I got 
married in my second year. God sent us a beautiful little baby girl 
right away. We were so happy. And then a few weeks after she was born, 
we learned she had a serious congenital heart defect. I was a law 
student. I didn't have much income, and I had no health insurance. So 
my wife and I took our baby girl over to Children's Hospital here in 
Washington, DC.
  We sit in the charity ward, and we waited until our name was called. 
And we saw a doctor who I prayed to God would be able to save our 
baby's life. I never felt more helpless in my life than I did at that 
moment, to have this little girl come into this world and her father 
couldn't provide health insurance.
  Luckily, she survived. Great people did great favors for our family 
that I will never forget. I have never forgotten when there is a health 
crisis or health issue that is debated on this floor.
  All of us want good health insurance, and to cut the programs for no 
reason other than to give tax breaks to the wealthiest people makes no 
sense whatsoever. It is not sensible. It is not thoughtful. It is not 
humane. That is what this debate is all about.
  Are we going to protect health insurance for Americans so that they 
have some peace of mind that they have access to good care, or are we 
going to cut them off, and tell them they are on their own, whether it 
is mental health counseling, addiction counseling, or the birth of a 
child, or basic healthcare? That is what is at stake here. That is what 
is at stake.
  So I would plead with my colleagues--and I know that it is unlikely. 
I have seen the votes. I know the party discipline. I have seen it on 
my side of the aisle. I am sure it is on the other side of the aisle. I 
am praying to God there is going to be one or two John McCains who are 
going to step forward and lift their hand enough to vote and save 
health insurance for Americans across the board. I know some people 
would be unhappy; in fact, some may threaten to defeat you politically 
because of it.

  But I am sure that after John voted no to save the Affordable Care 
Act despite President Trump's telephone call in his first term, John 
had the satisfaction of knowing that, for millions of Americans, he was 
the man and his

[[Page S2165]]

vote was the vote that made the difference. It might have denied some 
tax breaks for some wealthy people, but for others, it gave them peace 
of mind. John was just enough of a maverick to be willing and able to 
do it. He will be fondly remembered in history as a result of it.
  Madam President, I am going to close by saying that this is an issue 
that is near and dear to my heart, and I think a lot of other people 
too. They have gone through experiences much like my own. I know they 
realize that we have few moments of opportunity of service in the 
Senate to really make a difference in the lives of American families, 
to give hope to people who have given up because of a mother who is in 
a nursing home or because of a child with an illness.
  I received letters. Sophia, a single mom from Palatine, IL--17 years 
of age, she gave birth to a baby boy. Her son was born with many 
medical complications. He had to undergo two surgeries in his first day 
of life. Can you imagine?
  By the age of 4, he had undergone eight separate surgical procedures 
to address ongoing medical challenges. How did Sophia of Palatine 
afford the lifesaving care for her son? He was covered by Medicaid.
  She wrote to my office. She said:

       I don't want Medicaid. My son needs [Medicaid]. I could not 
     be able to afford the thousands of dollars of medical care 
     [to keep him alive without it].

  Amber from Springfield, IL, told my office in no uncertain terms: You 
cut Medicaid, you endanger my sick child's life.
  That is what it is. It is a life and death issue. It is not how many 
dollars you have leftover when you file your taxes. It is a life and 
death issue that we are debating.
  I want to thank those who have spoken this evening already--Senator 
Schumer and Senator Merkley--for their leadership on this issue. I 
plead with my colleagues on the other side of the aisle: Please, there 
has got to be someone over there who will step up and have a McCain 
moment that will save healthcare for millions of Americans, and I am 
praying that it happens.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wisconsin.
  Ms. BALDWIN. Madam President, I rise today on behalf of the 1.2 
million Wisconsinites who rely on Medicaid--or as we call it in 
Wisconsin, BadgerCare--for their health insurance. And I rise today in 
their defense because their healthcare is under attack.
  I really want to focus right now kind of taking off where Senator 
Durbin left off talking about our children, our babies. One in three 
children in Wisconsin rely on Medicare for their life insurance. That 
is one in three children in Wisconsin's urban, suburban, and rural 
counties who need Medicaid just to see a doctor to get regular checkups 
or to get vaccines and to stay healthy.
  I have traveled across Wisconsin, meeting with constituents who are 
terrified about what these cuts will mean for their families, their 
finances, and their health. I would like to share a few of those 
stories with you this evening.
  I think about people like Megan from Wisconsin, a single mother of 
two young children who relies on Medicaid so that her kids can get 
regular check-ups to see the dentist. She reached out to me to share 
that without Medicaid, her entire paycheck would go to just keeping her 
children healthy--with nothing left over to pay for rent or keep food 
on the table.
  I heard from Shelley in Lake Holcombe, WI, who reached out to me 
about her 17-year-old daughter Chloe. Chloe was diagnosed with leukemia 
last October. Chloe receives chemotherapy 5 days a week, and her 
parents drive her almost an hour each way to Eau Claire, WI, so that 
she can get the treatments that she needs. Without Medicaid, the cost 
of Chloe's treatment would force Shelley and parents like her to make 
an impossible choice between financial ruin or not getting the care 
that they need for their children.
  I have also heard from dozens of Wisconsin families whose children 
live with disabilities. They are terrified of what financial cuts will 
mean for their kids' future and their family's finances.
  Jennifer in Wauwatosa wrote to my office about her son Will. Will is 
a 15-year-old sophomore at Wauwatosa West whom she described as vibrant 
and loving. Will also has Down syndrome which, among other medical 
care, has meant that he has needed a total of 11 ear tube surgeries 
just so that he can hear. Jennifer wrote me that the math on those 
costs to their family is pretty simple. Eleven surgeries which cost 
$10,000 each, without insurance, would cost her family $110,000. She 
said without Medicaid, she and her husband would struggle to give their 
children the lives they deserve, including paying for their other son's 
college tuition.
  She wrote:

       If Medicaid is cut, we will struggle financially. We will 
     not be able to get Will the support he needs to be 
     independent, get a job, and go to college. It could even mean 
     one of us having to leave our full-time employment which 
     could hurt even more. Please don't cut Medicaid.

  I also heard from Brooke in Thorp, WI. She shared that because of 
Medicaid and the speech therapy for her 4-year-old son that he 
receives, she has, for the first time this year, heard his voice utter 
more than one syllable.
  Imagine that.
  She wrote:

       It marks the first time I have been called Mom by him, and 
     I have heard ``I love you'' come from him three times--all 
     occurring in the last 12 months. He receives speech therapy 
     five days a week to learn how to express himself, [to] 
     process emotions, and [to] regulate. This has changed his 
     life. And these therapies are paid for by Medicaid. Don't 
     allow people like me to only hear ``love you'' a handful of 
     times simply because of a budget cut.

  We can talk about the number of children who will be impacted by cuts 
to Medicaid, a total of over 30 million nationwide. While that number 
is staggering, it is important to remember that every single child who 
relies on Medicaid has a story like Chloe's or Will's. And they have 
parents like Megan and Brooke who just want what is best for their 
children and are terrified about their future if Medicaid is taken 
away.
  If my colleagues on the Republican side want to go through with 
cuts--the ones laid out in the House's budget plan--it is these 
families Republicans must answer to.
  Donald Trump and congressional Republicans can explain why they are 
planning to rip away healthcare for children so that the top 1 percent 
can get richer.
  I, for one, would like them to answer for the chaos, for the fear, 
for the heartache that they are causing families in my State.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. HASSAN. Madam President, I want to thank my colleague from 
Wisconsin, Senator Baldwin, for such excellent, poignant, moving 
descriptions of the real cost of this budget plan that we are on the 
floor to consider tonight.
  I rise today to join my colleagues and the people of New Hampshire in 
standing up against the attempt by the Trump administration and some of 
my Republican colleagues to effectively end Medicaid as we know it and 
add $37 trillion over the next 30 years to our national debt, all in 
order to pay for more tax giveaways for corporate special interests and 
billionaires.
  Americans of every political stripe are alarmed because this bid to 
end Medicaid as we know it will lead to more families, more children 
becoming sick and unable to get care, and because ending Medicaid as we 
know it will devastate our economy, weaken our workforce, and, most of 
all, make our people less free.
  Medicaid is a pillar of America's healthcare system. Tens of millions 
of Americans, including working Americans, pregnant women, and millions 
of children depend on Medicaid every day for routine care, for 
treatment for chronic illnesses, for lifesaving care from serious 
illnesses, for treatment for addiction, and for much more.
  No legislation has done more to allow more Americans to live longer 
and healthier lives than the bills that established Medicaid and 
Medicare and the efforts that followed to strengthen both of these 
landmark laws.
  So before we proceed, let's take a step back for a moment and 
remember that Congress created Medicaid for two simple reasons. Prior 
to Medicaid's creation, a great swath of our country--tens of millions 
of Americans--were

[[Page S2166]]

forced to try and get by without healthcare. For many working people 
and their families, the kind of routine and preventive care that many 
today take for granted, were luxuries. Serious illnesses were often 
left untreated, becoming virtual death sentences.
  We established and later expanded Medicaid because we understood 
that, in a country as great as ours, we don't turn our backs on our 
neighbors. But we also created Medicaid because we know that it is in 
all of our economic interests to have more healthy people. When more 
people are healthy and able to work, they can get ahead and stay ahead, 
provide a better life for their family, join the workforce, and, in so 
doing, make our economy stronger.
  There is, of course, much more work to do to make healthcare more 
affordable for all of our people. But Medicaid saves lives. Over the 
course of the program's history, Medicaid has allowed hundreds of 
millions of Americans who otherwise would be uninsured to live 
healthier lives and to build a future.
  But now the Trump administration and some of my Republican colleagues 
are poised to end Medicaid as we know it in order to pay for tax breaks 
for corporate special interests and billionaires.
  The Republican plan to eviscerate Medicaid would be devastating to 
our country. The Republican plan is, unsurprisingly, short on details. 
But they have put forward proposals that, if you do the math, mean 
cutting a third of Federal Medicaid funding, all to give billionaires 
and corporate special interests a tax break.
  Now, let's look at what this decidedly unreasonable, outrageous, and 
dangerous plan would do. Cutting Medicaid by a third means living in a 
country where millions of children no longer have healthcare; a country 
where more of our friends and neighbors get sick and can't afford to 
see a doctor; a country where more of our friends and neighbors stay 
out of the workforce because they can't afford treatments for chronic 
conditions like lupus, making them too sick to work; a country where 
families who have children with disabilities can't find adequate 
coverage to provide the kind of complex care, both at home and in 
school, that these children need. One issue, in particular, I want to 
highlight is the way in which slashing Medicaid would weaken our fight 
against addiction.

  New Hampshire has been hit hard by the fentanyl crisis. These 
Medicaid cuts could kick hundreds of thousands of people struggling 
with addiction off of Medicaid, out of treatment, and off the road to 
recovery. This will, among other things, make law enforcement's job 
even harder, and it will make our children less safe.
  So let's be clear about what the Republican plan to slash Medicaid 
will do. It will make people less healthy. It will weaken our workforce 
and hurt our economy. The fight against fentanyl will only get tougher, 
and more people will die who otherwise could have lived.
  In the administration's plan to eviscerate Medicaid, the cuts only 
appear on the page as percentages and dollar signs, but their impact 
will be felt by real people.
  My office, as has Senator Baldwin's, Senator Kim's, and Senator 
Durbin's, has been deluged with letters and calls from constituents who 
are concerned about the administration's attack on Medicaid.
  I could tell you hundreds of stories, but instead I will just give 
you three.
  There is Michelle from Manchester. She was diagnosed with a rare and 
frequently fatal form of cancer that upended her career and her life. 
To go through the long process of cancer treatment by paying out of 
pocket would be daunting, perhaps even prohibitive for most anyone. But 
Michelle was covered by Medicaid. She got the care that she needed. She 
got healthy. She was able to go back to work. She is now cancer-free 
because of her courage and strength and because she was covered by 
Medicaid.
  Then there is Noa from Merrimack. Now, Noa is 20 years old and 
experiences disabilities and is blind. She has had to face challenges 
that few of us can imagine. But thanks in part to the support that she 
has received through Medicaid, she has been able to have many of the 
opportunities that all parents want for their kids and that all kids 
want for themselves.
  She has a part-time job at a nearby bank. She does charity work 
delivering flowers to seniors. She loves horseback riding and has 
competed as a Special Olympian. She accomplished all this thanks to her 
bravery, optimism, and generosity, but she may not have even gotten 
that chance without Medicaid.
  And then there is Cheri from Lebanon. Like other Granite Staters, she 
has had struggles with addiction, as well as mental health challenges, 
but Cheri was eligible for Medicaid. She got treatment and went into 
recovery. She was able to go back to work. Today, Cheri is a perinatal 
peer support educator and coordinator for Dartmouth Health. She helps 
families every day. Because she got care when she needed it, she is now 
working to provide care for others, touching untold and unknown numbers 
of lives through her work. And she was my guest this year at the 
President's joint address to Congress. But none of her recovery, 
employment, and lifesaving work would have been possible or happened 
without Medicaid.
  So if the administration intends to eviscerate Medicaid, if they 
intend to go through with their plan to cut Medicaid by a third to pay 
for a tax break for billionaires, then before they do, they should at 
least stop and explain to these three people--Michelle, Noa, Cheri--who 
is the one that they want to kick off of Medicaid.
  How would any of us be better off if any of these three people are 
forced to go without healthcare?
  Most Americans are proud of our capacity to come together and ensure 
that our friends and neighbors can get healthcare and be able to work 
and raise families. But this administration evidently considers the 
provision of lifesaving healthcare to Americans from all walks of life 
to be a problem.
  Now, beyond the huge pricetag of this budget plan--a plan that 
explodes the deficit by 37 trillion more dollars over 30 years--and 
let's be clear: The Republican budget writers are going to use 
accounting gimmicks to try to hide this cost. And let's be clear too 
that the $37 trillion in additional debt won't be used to improve 
healthcare. It is to pay for tax breaks for billionaires.
  But there is another cost to the President's attacks on Medicaid, 
because as important as it is that we protect the healthcare provided 
by Medicare--and that is tremendously important--protecting Medicaid 
healthcare marks neither the beginning nor the end of what we need to 
do to improve healthcare in our country and make it more affordable.
  We need to confront real challenges in our country's healthcare 
system. Big Pharma keeps drug prices too high. We have the best doctors 
in the world, but too few people can afford to see them. Too many 
Americans live with chronic diseases.
  Labor and delivery centers across our country are more and more 
scarce, and rural hospitals are struggling. Americans need to summon 
our best ideas and our best efforts to meet these challenges, but we 
will not make progress so long as this administration continues to keep 
us trapped in old debates and tries to unravel bipartisan support for 
the progress that we have already made.
  Of course, it doesn't have to be this way. When I was Governor of New 
Hampshire, we managed to expand Medicaid and balance the budget at the 
same time, and we did both on a bipartisan basis. We did it with the 
support of many business leaders and law enforcement leaders who didn't 
always vote the same way come November, but they did agree that we are 
all better off when people are healthy.
  President Trump and congressional Republicans are presenting us with 
a false choice. We don't have to choose between keeping the status quo 
on the one hand and blowing up our healthcare system on the other. We 
don't have to buy the falsehood that, somehow, we have to close rural 
hospitals and throw seniors out of our nursing homes to improve our 
healthcare system. There are better ideas, and a whole lot of them are 
bipartisan.
  There are bipartisan bills right now to lower the costs for patients 
when they go to the doctor by implementing something called site 
neutrality. There are bipartisan bills that will lower drug

[[Page S2167]]

costs by bringing more generic drugs to market. But these ideas only 
help if there is a functioning healthcare system to build on--a 
functioning healthcare system, as challenged as it is, that includes 
Medicaid.
  As Americans, we don't shrink from challenges. We don't surrender to 
cynicism and lies. We work together. We do hard things. We do what it 
takes to build a better future for our country, and we do it in a way 
that brings all of us along together, and that includes ensuring that 
all of us have healthcare. That is the way we created Medicaid. That is 
the way we expanded Medicaid. And it is through that same spirit of 
hard work and optimism that we can overcome the healthcare challenges 
of today if we can summon the political will to do it.
  A will has been so sorely lacking since this President arrived on the 
scene. The Senate should not pass a budget that rips healthcare away 
from millions of Americans--60,000 of whom live in my State--just to 
give tax cuts to billionaires, but that is what this budget will do. It 
is un-American, and it is shameful.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Jersey.
  Mr. KIM. Madam President, I rise today to tell the stories of the 
nearly 2 million New Jerseyans who rely on Medicaid for their critical 
care. I do this because their care is at risk. I do this because the 
care of more than 72 million Americans across our country enrolled in 
Medicaid is at risk. They are at risk because Republicans in the House 
and the Senate have chosen to take away their care so that Elon Musk 
and the very richest Americans can pay a little less in taxes.
  That is the choice they have thrust upon the American people. It is a 
choice that I don't believe they truly understand, so I would like to 
take some of my time today on the floor to explain what happens when we 
choose Elon Musk's well-being over the people we have sworn to serve.
  To truly understand this, you need to understand that for tens of 
millions of Americans, Medicaid is their lifeline from the womb to 
their final years.
  In New Jersey, nearly one out of three births is covered by Medicaid. 
But even before that birth takes place, mothers receive prenatal care 
covered by Medicaid. That means that for millions of parents across the 
country, the first images they see of their child in those early 
ultrasounds are because of Medicaid. It means that prenatal vitamins 
that provide the folic acid necessary to ensure proper development are 
because of Medicaid. It means that if there is a complication in a 
pregnancy, those parents can focus on their health and the health of 
their unborn child, not whether or not they will be able to cover the 
costs of their care. That is because of Medicaid.
  So when Republicans are saying we need to cut Medicaid, remember that 
it is Elon Musk who wins and those expecting parents who lose.
  When those children are born into the world, tens of millions rely on 
Medicaid. Nationally, about 40 percent of children are enrolled in 
Medicaid or CHIP. In New Jersey, one-third of children--one in three 
kids in my State--are enrolled in Medicaid.
  As a father of a 7-year-old and a 9-year-old, I can tell you that the 
most important thing is knowing that your kids are healthy.
  There are a lot of things that are outside of your control as a 
parent. You can do everything right, but sometimes you just need help. 
Kids get sick, and having that assurance that they can get the care 
they need is an important thing.
  When you take away Medicaid, you are not just taking away care, you 
are taking away the peace of mind that parents deserve. You are taking 
away the ability for parents to look their kids in the eye and say: It 
is going to be OK.
  I wanted to share with you two stories that have stuck with me. I 
heard from Nicole, a mother from New Jersey who has a developmentally 
disabled son, Jordan. Jordan is 24. His mother said that a Medicaid cut 
would be ``catastrophic.'' She said that the care she receives from 
Medicaid is ``vitally important.''
  That sense of importance and urgency I heard from Nicole I saw echoed 
from Jamie from Hazlet. Jamie's son David was born paralyzed, 
nonverbal, and he is relying on a feeding tube. Jamie told reporters 
that one of David's medications ``can cost up to $1,000 a month.'' She 
said that if Republicans are successful in cutting Medicaid, ``we would 
have to choose--are we going to eat? pay the bills? or keep him 
alive?'' She said, ``It is a life-or-death situation.''
  So when Republicans are talking about cutting Medicaid to hand tax 
cuts to the wealthiest Americans, the choice they are making is to 
leave people like Nicole and Jordan, like Jamie and David behind.
  At some point, our children grow up and leave, but even then, so many 
across this country rely on Medicaid for their basic care. In New 
Jersey, one in seven adults between the ages of 19 and 64 is covered by 
Medicaid.
  When you look at the choice ahead of us between care and tax cuts for 
the superrich, I want you to think about Caroline from Mount Holly. 
Caroline called my office asking that I oppose this budget plan. When 
she outlined her reason for not cutting Medicaid, she spoke in the 
clearest possible terms:

       I will die if there are cuts to Medicaid.

  Caroline is disabled. Her daughter takes care of her through the 
Managed Long-Term Services and Supports Program.
  She ended her message by saying:

       Please, I need help. A lot of us need your help.

  These are the people that need help, not Elon Musk, not the 
billionaires.
  It is people like Caroline from Hackettstown. Caroline called my 
office because her brother is on Medicaid. He is scheduled to get heart 
surgery in the next couple of months--something that is scary enough 
when you have the certainty of healthcare. But Caroline doesn't have 
that if her brother's Medicaid is cut.
  She said:

       I'm really scared for him. I'm really scared for my parents 
     who are about to retire. . . . I'm scared for myself, someone 
     who also has multiple health issues and is trying to keep 
     down a full-time job despite it all.

  These are the people that need help.
  Our neighbors who sometimes need the most help are those who are 
disabled. In New Jersey, one out of every three working-age adults with 
a disability is on Medicaid.
  Just last month, I invited Kevin Nunez--a disabled New Jerseyan and 
an advocate for his community--down to the Capitol. Kevin relies on 
Medicaid for his care, his caregiver, his basic quality of life. I 
brought him to the Capitol because I wanted Donald Trump to have to 
face someone whose healthcare he was threatening to take away.
  But it wasn't just Kevin there at the Capitol; we saw his caregiver 
Edna there. The work she does every day is truly incredible.
  We should support our caregivers, should honor their service, and 
cutting the funding that allows them to do their job is not the way to 
do that.
  Kevin is 1 of more than 15.5 million people across America with a 
disability who are covered by Medicaid. He is 1 of approximately 4.5 
million people who use Medicaid for home care workers like Edna.
  The choice we are facing is abandoning those Americans like Kevin and 
Edna, who just need basic care, or giving another tax cut to those at 
the very top. For me, that is not a choice.
  Finally, as we go through adulthood and age, Medicaid becomes more 
important than ever. Seniors across our Nation are relying on Medicaid 
for the care they need to live. Sixty percent of nursing home residents 
in New Jersey use Medicaid to pay for care. When seniors are on a fixed 
income, like so many of them are, Medicaid can be the difference 
between life or death.
  Annie, a teacher in New Jersey, called my office recently. Her mother 
is on Medicaid--71 years old, recently had hip surgery. She has no 
other income than her Social Security and asked that we do everything 
we can to make sure that her Medicaid isn't cut.
  As someone who is not just a father of two young kids but as a 
caretaker of an older parent, it weighs on me, and I understand the 
challenges that are there, knowing that you have to do everything you 
can to make sure the people you love have the care they need.
  Life is hard enough. Care is hard enough. The point of Medicaid, the

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point of government, is to make it a little easier, a little more 
bearable.
  So when Republicans come to the floor with a budget that threatens to 
cut Medicaid so they can give tax cuts and tax breaks to the ultrarich, 
the choice they are putting before us is making your lives worse and 
make their lives better. It is making your healthcare worse to make 
their bank accounts bigger. It is making your future more uncertain to 
make their futures brighter.
  That can't be an acceptable choice, and it is not one we have to 
make. We can reject this budget resolution and save Medicaid and save 
healthcare. We can reject this budget resolution and choose to support 
that expecting mother who just wants to give birth to a healthy child. 
We can reject this budget resolution and choose to support that child 
as they grow. We can reject this budget resolution and choose to 
support our neighbors who work hard but just need that little bit of 
help to stay healthy and achieve the American dream. Finally, we can 
reject this budget resolution and choose to support our seniors. We owe 
the best care to them in their golden years.
  This is the moment to show the 2 million New Jerseyans on Medicaid, 
the nearly 80 million Americans on Medicaid, and every other American 
across this country that we choose their well-being over the wealth and 
power of those who already have plenty. Let's reject this budget 
resolution and do the right thing for them.
  I yield the floor.

                          ____________________