[Pages S2884-S2886]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                         Budget Reconciliation

  Mr. SANDERS. Mr. President, the American people, whether they are 
Democrats, Republicans, or Independents, understand that we have a 
corrupt campaign finance system which allows billionaires and their 
lobbyists to play an extraordinarily powerful role in electing 
candidates and defeating candidates and in crafting legislation. This 
is through both parties--the Democratic Party and the Republican Party. 
Money talks. But, today, with Republicans in control of the White 
House, of the U.S. Senate, and of the U.S. House, we are seeing day by 
day how this corrupt process plays out for the priorities of the 
Republican Party and for their billionaire campaign contributors.
  Their so-called reconciliation bill--President Trump's ``big, 
beautiful bill'' that the Republicans are putting together right now in 
the House--is a rather extraordinary piece of legislation. In many 
respects, given the crises facing our country, this legislation does 
exactly the opposite of what should be done. It is rather remarkable. 
You have got a problem, and instead of addressing the problem, they 
make the problem worse.
  It is no secret that we have more income and wealth inequality in our 
Nation today than we have ever had. It is a serious problem. Today, the 
wealthiest person in the world--Mr. Elon

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Musk, who is now worth more than $400 billion--owns more wealth than 
the bottom 52 percent of American society. One person owns more wealth 
than the bottom 52 percent of American households. It is rather 
extraordinary. The top 1 percent now owns more wealth than the bottom 
93 percent, and CEOs of large corporations now make about 350 times 
what their workers make. Unbelievably, according to the RAND 
Corporation, over the past 50 years, nearly $80 trillion--that is a 
``t,'' $80 trillion--in wealth has been redistributed from the bottom 
90 percent of the American people to the top 1 percent. So what we have 
seen is that the very wealthiest people in America are becoming much 
richer while, at the same time, 60 percent of Americans are living 
paycheck to paycheck, and many millions of families are struggling to 
just put food on the table. That is the economic reality of today.
  So what does President Trump's and Republicans' reconciliation bill 
do to address this grossly unfair and, in my view, unstable economic 
situation? What are they doing when the very rich are becoming much 
richer while working families struggle?
  Well, here is the answer: This legislation makes the rich and wealthy 
campaign contributors even richer while making life harder and more 
stressful for the working families of our country. This legislation 
provides massive tax breaks to the top 1 percent and large corporations 
and pays for these tax cuts by cutting Medicaid, the Affordable Care 
Act, nutrition, education, and other programs that are life and death 
for working families. Let me just give you one example of how 
outrageous this legislation is.
  As currently written, this bill provides a $235 billion tax break to 
the top two-tenths of 1 percent by increasing the estate tax exemption 
for couples to $30 million. I am not talking about the top 2 percent. I 
am talking about the top two-tenths of 1 percent. The estate tax is 
only applicable to the very wealthiest people in this country who 
inherit substantial sums of money from a relative. Under this provision 
in this reconciliation bill, a couple that inherits $30 million would 
now pay zero tax on that inheritance. Once again, this provision 
applies only to the top two-tenths of 1 percent of Americans--the very, 
very wealthiest people in this country and people who just 
coincidentally, I know, make massive campaign contributions to the 
Republican Party. Coincidence, no doubt, while 99.8 percent of 
Americans would not benefit by one nickel under this provision. This is 
the top two-tenths of 1 percent with $235 billion in tax breaks.
  Further, this legislation would provide a $420 billion tax break to 
large, profitable corporations that are stashing their profits in the 
Cayman Islands and other offshore tax havens and which are, by the way, 
replacing American workers with robots. They get a tax break for 
throwing American workers out on the street and replacing them with new 
technology.
  The bottom line: The tax provisions in this reconciliation bill 
provide huge tax breaks to the people in our country who need it the 
least while doing great harm to ordinary Americans.
  Again, whether you are a Democrat, a Republican, or an Independent, 
you know that our current healthcare system is broken; it is 
dysfunctional; it is cruel; it is wildly expensive. Despite spending 
almost twice as much per capita on healthcare as any other major 
nation, some 85 million Americans are uninsured or underinsured, and we 
remain the only major country on Earth that does not guarantee 
healthcare to all people as a human right.
  So, given that reality--the reality of a broken, wildly expensive 
healthcare system--how does this reconciliation bill address the 
healthcare crisis in America? Does it expand healthcare to more 
Americans and lower the number of uninsured? You have got 85 million 
right now. Does it lower that number? Does it take on the greed of the 
insurance companies and the drug companies that make tens and tens of 
billions of dollars every single year by ripping off the people of our 
country? Is that what this reconciliation bill does?
  Not quite.
  What this legislation, in fact, does do is cut Medicaid and the 
Affordable Care Act by $715 billion, which the Congressional Budget 
Office has estimated would eliminate health insurance for 13.7 million 
Americans. In other words, this legislation makes a very bad situation, 
in terms of our healthcare crisis, catastrophically worse. If we were 
to pass this bill, the number of Americans who would be uninsured or 
underinsured would rise to almost 100 million Americans. In other 
words, instead of lowering the number of uninsured or underinsured 
people in this country, this bill greatly increases that number, but 
that is not all that this legislation does.

  This bill, for the first time, forces millions of Medicaid recipients 
who make as little as $16,000 a year to pay a copay of $35 each time 
they visit a doctor when they get sick--up to 5 percent of their annual 
income. Well, what will be the impact of that?
  According to a study from Yale University, some 68,000 Americans die 
every year because they don't go to a doctor on time. I don't know 
about the Presiding Officer, but I have talked to doctors in Vermont 
and all over this country, and they tell me that patients walk in their 
doors very, very sick.
  They say to the patients: Well, why didn't you come in earlier when 
you first felt your symptoms?
  And what the patients will say is, Well, you know, I don't have any 
health insurance or I can't afford the copayment or I can't afford the 
deductible or the deductible hasn't kicked in yet.
  And they don't go. Some of these people walk into a doctor's office 
so sick that they die when that should not have been the case.
  Now, if you are making a good salary--if you are making a couple 
hundred thousand dollars a year--the odds are that a $35 copayment, 
which many people have, will not deter you from going to the doctor. 
You may not like it, but you fork over the 35 bucks, and you go to the 
doctor when you are sick, but if you are a low-income American and if 
you are struggling to pay the rent or you are struggling to buy food 
for your kids or to pay for childcare, that $35 copay may be just too 
much, and the result is that you don't see the doctor when you should.
  When you throw almost 14 million Americans off of the health 
insurance they have and when you force low-income people to pay a $35 
copayment that they can't afford to pay, no one can deny that many 
thousands more Americans will die if this bill is signed into law. If 
this bill is signed into law, we are providing a death sentence for 
many thousands and thousands of people. That is just the simple 
reality, and nobody can deny that.
  Further, when Trump and the Republicans in the House make massive 
cuts to Medicaid, they are also making massive cuts to community health 
centers, which provide primary healthcare to 32 million low-income and 
working-class Americans. In other words, the cuts to Medicaid go well 
beyond the immediate impact on the individuals who will lose their 
health insurance; it impacts the entire healthcare community. Community 
health centers rely on Medicaid for 43 percent of their revenue. When 
you cut hundreds of billions of dollars in Medicaid, you are 
significantly cutting back on the access that millions of low-income 
and working-class Americans will have through primary healthcare.
  Once again, community health centers, which provide healthcare to 32 
million Americans--many of them in Vermont and all over this country--
are struggling today. Make massive cuts to Medicaid, and it will be a 
disaster for these community health centers and the people who utilize 
them for primary care.
  It is not just community health centers that would be devastated by 
this legislation. All across this country, rural hospitals are shutting 
down and facing enormous financial pressure--all over this country. 
This legislation will only accelerate those closures and bring 
increased hardship to rural America at a time when rural America 
already has quite enough problems.
  Here is what Rick Pollack, the President and CEO of the American 
Hospital Association, said:

       These proposed cuts will not make the Medicaid program work 
     better for the 72 million Americans who rely on it. Instead, 
     it will lead to millions of hard-working Americans losing 
     access to healthcare and many of our Nation's hospitals 
     struggling to maintain services and stay open for their 
     communities.


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  No question, this Medicaid cut will result in rural hospitals being 
shut down in increasing numbers.
  Further, I hope my colleagues will listen to what Bruce Siegel, the 
president and CEO of America's Essential Hospitals, said in opposition 
to this bill:

       Hospitals, which already operate on thin margins, cannot 
     absorb such losses without reducing services or closing their 
     doors altogether.

  That is exactly what rural America does not need. We don't need more 
hospitals shutting down. We cannot allow that to happen.
  Let's be clear. It is not just hospitals and community health centers 
that are opposed to this legislation; physicians throughout this 
country have also come out in strong opposition to this legislation.
  Let me read from a statement issued today--today--in opposition to 
this bill from the American Academy of Family Physicians, the American 
Academy of Pediatrics, the American College of Obstetricians and 
Gynecologists, the American College of Physicians, and the American 
Psychiatric Association:

       Our organizations, representing more than 400,000 
     physicians who serve millions of patients, are alarmed by 
     proposals to implement cuts or other structural changes to 
     Medicaid during the budget reconciliation process. Cuts to 
     Medicaid will have grave consequences for patients, 
     communities and the entire health care system. With reduced 
     federal funding, it will be harder for patients to access 
     care, states will be forced to drop enrollees from coverage, 
     and it will limit the health care services patients can 
     access and cut payment rates.
       The impact of cuts to Medicaid funding is significant and 
     wide-reaching, and it must be reconsidered.

  That is what medical organizations in our country, representing 
400,000 doctors, are saying about this disastrous piece of legislation.
  Further, at a time when some 22 percent of our seniors are trying to 
survive on less than $15,000 a year--I will never understand how 
anybody, let alone a senior, can survive on less than $15,000 a year--
this legislation will make it much harder for seniors and people with 
disabilities to receive the care they desperately need in nursing 
homes.
  When Medicaid provides over 60 percent of the revenue nursing homes 
rely on, slashing Medicaid will be a disaster for seniors and the 
disabled who need to be in nursing homes and their kids as well.
  When you cut Medicaid, it is not just throwing up to 13 million 
people off of the health insurance they have; it is going to be very 
destructive for community health centers to provide the healthcare they 
need, very destructive to hospitals all over this country, especially 
small rural hospitals, and destructive to nursing homes as well.
  That is not all that this legislation is doing. For the vast majority 
of Americans, including myself, who believe that women should have the 
right to control their own bodies, this bill essentially defunds 
Planned Parenthood, which provides vital healthcare to millions of 
women.
  It is not just our healthcare system that would be devastated under 
this legislation. While this bill provides massive tax breaks to 
billionaires, it would cut $290 billion from nutrition programs. That 
would take food away from an estimated 4 million children and about 
half a million seniors.
  I don't know if there is any religion in this world where it would be 
morally appropriate to take food out of the mouths of hungry kids and 
frail seniors in order to provide more tax breaks to billionaires. That 
is simply and grossly immoral.
  Further, for the many young people in our country struggling with 
student debt and others who wonder how they will ever be able to afford 
to go to college, this bill cuts Federal funding for education by more 
than $350 billion.
  Now, what does that mean? Among other things, it means that the 
average student loan borrower with a bachelor's degree in America would 
see his or her loan payments increase by about $3,000 a year or some 
$244 a month. So at a time when college is now unaffordable for 
millions of young people, at a time when we desperately need a well-
educated population and the best educated workforce in the world, this 
bill moves us in precisely the wrong direction.
  Finally, at a time when we already spend more on the military than 
the next nine nations combined and when everyone knows--whether you are 
Republican, Democrat, or Independent, everyone knows there is massive 
waste and fraud in the Pentagon. The Pentagon has not been able to take 
an independent audit for God knows how many years. This bill increases 
defense spending by $150 billion.
  Let's be clear. This is just some of what is in this terrible bill. 
There are other provisions equally damaging which I have not touched 
upon.
  It seems clear to me and I expect the majority of Americans that this 
bill reflects exactly what is wrong with our current corrupt political 
system.
  When we have massive income and wealth inequality, our job is to 
demand that the wealthy and large corporations start paying their fair 
share of taxes, not do as this bill provides--give huge tax breaks to 
the very rich.
  When 85 million Americans are uninsured or underinsured, our job 
should be to guarantee healthcare to every man, woman, and child in 
this country, not throw 13 million Americans off of the healthcare they 
currently have.
  When children and seniors in this country go hungry here in the 
wealthiest country on Earth, our job should be to make sure that all 
Americans have the nutrition they need to live healthy lives, not 
increase the level of hunger in our country.
  In many respects, this bill represents exactly why so many Americans 
are giving up on democracy and have such contempt for Congress. At a 
time when the richest people have never ever had it so good, they see 
Republican leadership working overtime to make the billionaire class 
even richer.
  At a time when a majority of Americans are struggling to put food on 
the table and pay for healthcare, they see Republican leadership making 
life even more difficult for average Americans.
  This is a disastrous piece of legislation. I urge my colleagues to 
oppose it.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Vermont.