On the House floor, Rep. Kim Schrier (D-WA) led a Special Order to highlight Medicaid cuts in the GOP reconciliation budget.
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00:00designee of the minority leader. Mr. Speaker, I ask for unanimous consent that all members may
00:09have five legislative days in which to revise and extend their remarks and to submit extraneous
00:14material into the record. Without objection. Thank you, Mr. Speaker. I'm here as one of the
00:22co-chairs of the Doctors Caucus here in the House of Representatives, and I'm here to
00:29talk straight with you and with the American people and my constituents about this tax plan
00:37that is being worked on by my Republican colleagues that will explode the deficit,
00:45but that will also hurt every single person in this country by making the biggest cuts
00:52to Medicaid and to food benefits ever. And I want to make clear as I talk about this
01:00how reckless it is and that even people who do not rely themselves on Medicaid
01:08will be impacted this. So I'm outraged. We're talking about a $715 billion cut to Medicaid.
01:17That is the largest cut ever. It will kick 13.7 million Americans off of their health insurance.
01:27And let's just be really clear about why they're doing this. This isn't to
01:31balance the budget. It's not to deal with the deficit. In fact, this bill is exploding the
01:37deficit. This is to pay for a gigantic tax break for the wealthiest people in this country.
01:45For example, Elon Musk. And to think about that, that transfer, taking health care away from the
01:54people in my district and across this country and transferring it to the wealthiest Americans,
02:01it is morally bankrupt and it is also fiscally reckless because doing this will essentially
02:13collapse our health care system in the United States of America. That's why just last week we
02:18spent 26 and a half hours in the Energy and Commerce Committee discussing this very thing,
02:25telling the stories of our constituents, painting a picture of what it would mean
02:30to cut 13.7 million Americans off of their insurance. Now, you know, it's interesting
02:37that this whole discussion didn't start until two o'clock in the morning because my Republican
02:44colleagues didn't want to have this discussion during the day when people would actually hear
02:48it. So they waited until the dead of night to bring up this topic of taking health care away
02:55from our constituents. Now, in the state of Washington, one out of three people rely on
03:02Medicaid. I'm going to tell you, most people who do, they don't even know it because in Washington
03:06State it is called Apple Health. So if you ask people if they're on Medicaid, they'll say no. If
03:11you ask them if they're on Apple Health, they will say yes. And this represents the most vulnerable
03:17people. These are kids, they're pregnant women, they're people with disabilities, they're the
03:21elderly in nursing homes. These are the people who need our help the most. So I think about my
03:28patients, I'm a pediatrician, and I think about the ones who have Apple Health. And if they didn't
03:36have that, if they didn't have access to come see me, their primary care pediatrician, and get
03:40diagnosed early with a mild pneumonia or an ear infection or whatever the case may be, they would
03:47be forced to go to the emergency department for that care. It's not like they're not going to get
03:52sick. They're going to get sicker and they're going to go later when things are more expensive
03:58and more complicated. And you know what else? Even if you're not on Medicaid, so I think about my
04:04patients with private insurance, they're going to be waiting in that emergency department line too.
04:09They will have broken an arm, have some other emergency, and they're going to be waiting in a
04:14longer line. We all know that the lines are already long to be seen in the emergency department.
04:20The care there is the most expensive care you can get. The lines are the longest lines and somebody's
04:27going to pay for that care. Otherwise, hospitals go underwater and they go out of business. And who
04:33is that? That's the people who are not on Medicaid, who are paying private insurance premiums, and
04:40those premiums are going to go up. It's going to hurt individuals who buy their own insurance. It's
04:44going to hurt the businesses, the companies that employ those people. And so this hurts everybody.
04:52I want to tell you the story about Isla. This is Isla. She's four years old. She was born in
04:592021 in a rural part of my district after an uneventful pregnancy. But right after she was
05:06delivered, something went very, very wrong. She was in dire straits, was clearly sick, needed emergency
05:14care, and thank goodness this rural hospital has a labor and delivery unit. So they were well equipped
05:20to resuscitate a baby, to stabilize her, and then to lifelight her to a hospital that could provide
05:27the specialty care that she needed. Well, let's just think for a moment about if Medicaid gets cut
05:38and these rural hospitals see a disproportionate share of Medicaid-dependent patients.
05:45Either those hospitals are going to close or they're going to start cutting back services.
05:49And I will tell you that the first service to go is labor and delivery. So what if that had happened
05:56after these Medicaid cuts? What if Kittitas Valley Healthcare didn't have labor and delivery?
06:01What if Isla had been born then, had not had the specialist there, had not had the ability to
06:08resuscitate there in the delivery room? She would not have made it. And that's what we're going to
06:13see when we start or when they start cutting away at Medicaid, closing rural hospitals, fewer labor
06:21and delivery units. More people will get sicker. They will get poorer. Children like Isla would not
06:28make it. And that's what I mean when I say it collapses our whole healthcare system.
06:33Our healthcare system, it's like a three-legged stool. One of those legs is Medicaid.
06:40And if you start taking that away, the whole system collapses. And that's what we're talking
06:45about. Hospital closures, taking away services, long waits in the emergency departments, and a
06:50population that is sicker and that needs more care, and that care becomes more expensive. It
06:57hurts us all. And that's why I'm so outraged that this is the mechanism that my Republican
07:03colleagues want to use to pay for a tax plan that will give gigantic cuts to the wealthiest
07:12taxpayers in this country, a la Elon Musk. And that is unconscionable. I wanted to start with
07:21that. And I'm really honored to yield time to our Speaker Emerita, Nancy Pelosi, from the
07:27great state of California. And I will yield her five minutes. Thank you very much. Mr. Speaker,
07:35I'm pleased to receive time from the distinguished Congresswoman from Washington State. She is a
07:41pediatrician. We have all learned a lot about how public policy has a direct impact on the
07:50health and well-being of the American people. And when I hear them talk about cutting
07:56over $700 billion in Medicaid, and it's just waste, fraud, and abuse, this beautiful child
08:03is not waste, fraud, and abuse. I will talk about a little child in my remarks who was not waste,
08:09fraud, and abuse. This special order comes together to shine a bright light on the Republican plan
08:17to fund tax breaks for billionaires by making huge cuts to Medicaid. Now, that's what it looks like.
08:26But the fact is, they will still, with their tax bill, be adding nearly $4 trillion to the national
08:35debt to cover their tax break for the wealthiest people in our country. This is fiscal engineering
08:43to reduce the role of government in the lives of the American people, where it is most needed.
08:49Where it is most needed. This is Robin Hood in reverse, taking resources from where it is most
08:56needed, the people who need it most, and giving it to those who need it less, the billionaires
09:03in America. This is shameful, and it is a fraud, and it's a shame. Now, President Johnson reminded
09:10the American people when he signed Medicare and Medicaid, he traveled to Independence, Missouri
09:18to be in the presence of President Truman, former President Truman, who had worked on this when he
09:24was president, but it came to fruition under President Johnson, and he went there and he
09:29signed the bill in the presence of Harry Truman. And he said never to be, he said this, he said,
09:36President reminded the American people of a shared tradition, never to be indifferent toward despair,
09:44never to turn away from helplessness, never to ignore or spurn those who suffer
09:50unintended in the land that is bursting with abundance. Indeed, Medicaid saves lives as a
09:57pillar of health, security, and justice for tens of millions of Americans. People often think of
10:04Medicaid as health care for poor children. That would be justification enough, health care for
10:10poor children. But it also is a middle income benefit for nursing home residents and people
10:18losing, needing it for long-term care services. They get that largely through Medicaid.
10:26And Medicaid is also a benefit for people with disabilities. The Republicans' devastating
10:32budget plan would push for about 14 million Medicaid recipients off life-saving health care
10:39and leave countless vulnerable families exposed to catastrophic medical bills. This is terrible
10:46because this is about health and financial health that is being devastated. Working families and
10:52children with low-income households would face ruinous consequences, as would rural hospitals,
11:03as the distinguished Congresswoman has mentioned, families seeking opioid addiction treatment for
11:08their loved ones, and middle-class Americans with long-term care needs. Mr. Speaker, I ask
11:15unanimous consent to insert a statement from the California Medical Association into the record.
11:21This is what they have said about this. California Medical Association, Shannon President,
11:29issued the following statement regarding House Republicans' proposed care cuts in Medicaid.
11:35The latest federal proposal to gut Medicaid is reckless. Physicians and hospitals will be pushed
11:41to the brink, forced to close their doors, and unable to continue care for their patients.
11:48Because, you know, when this funding leaves those rural hospitals, not only do the Medicaid
11:55patients lose, but all of the patients in that rural area lose. That's my injection here.
12:01Back to the statement. These would be the largest Medicaid cuts in history and will leave veterans,
12:14seniors, the disabled, children, and working families without health care coverage, as the
12:20distinguished physician colleague has said, making emergency rooms the only point of care for
12:28millions of people. Communities will be devastated. Lives will be lost. This is the CMA. Congress
12:35must reject these cuts and instead focus on strengthening the safety net that protects us all.
12:41Otherwise, at least 13.7 million people will lose health care coverage.
12:47Republican attacks on health care impact real people, including little children. My guest at
12:54the President's State of the Union Address was Elena Hung, mother of Xiomara, a courageous
12:59little lobbyist of 11 years old. Xiomara has complex medical needs, including chronic lung
13:07disease, chronic kidney disease, and global development delays. She has a tracheostomy,
13:22a ventilator, and oxygen dependent, and uses a feeding tube. Access to quality, affordable care
13:30ensured that Xiomara received the care she needed during the extended hospitalization,
13:36and can now live at home with her family. And Medicaid has helped Xiomara receive the
13:41therapies she needs to catch up with her developmental milestones, including physical
13:46therapy, occupational therapy, feeding therapy, and speech therapy. But these very lifelines
13:52from Medicaid and more are what Republicans are working to destroy to give a tax cut for
13:58billionaires. Democrats are standing strong against the administration's many attacks against
14:04family health care. This is just one of them. And with this special order, thank you,
14:11Dr. Colleague, we are calling out Republicans to either vote to protect their constituents'
14:18health care, or vote to take it away. That's the choice. In stark contrast to the President
14:24and Republicans in Congress, Democrats will always fight to lower health care costs. We
14:29are unified and ready to use every tool to stop this GOP scheme. And we will always work to
14:36strengthen pillars of health and financial security in America. That includes Social
14:40Security, Medicare, and Medicaid. We will always fight for Medicaid. I just want to go back to that
14:48one thing. They're still adding nearly $4 trillion to the national budget to give tax breaks to their
14:57wealthy billionaire friends. In the bill that they passed when Trump was President before,
15:03oh, I said his name, and the Republicans were in power, when the Republicans passed that bill and
15:11President signed it into law, 83% of the benefits went to the top 1% adding $2 trillion to the
15:24national debt. They're doubling down on that, getting to almost $4 trillion to the national
15:29debt. And saying, we've got to give all this money to billionaires and call children waste,
15:35fraud, and abuse in our Medicaid system. It's really sinful. It's really sad. And it is something
15:42that I hope the Republicans will reject. And I hope their constituents will call them. Because
15:47these Medicaid people are in Republican districts. One of our colleagues in California has,
15:53out of all of our constituents, he has nearly 500,000 people on Medicaid. And yet he voted
16:00with the Republicans on this. Well, you can be sure he'll be hearing from his constituents
16:05because people know. And I'll close by saying Lincoln said, public sentiment is everything.
16:11With it, you can accomplish almost anything. Without it, practically nothing. But for public
16:15sentiment to prevail, people have to know. And we are making sure that your constituents know
16:23and that they are informing you of their knowledge of what you are doing.
16:28Reverse Robin. Republican reverse Robin Hood. Thank you very much for the opportunity to share
16:34some thoughts about this. And for sharing the story of this beautiful little girl. Thank you.
16:39I yield back to you. Well, thank you, Madam Speaker Emerita Pelosi, for your moral clarity
16:48and your fiscal pragmatism and painting a clear picture of what is going on right now.
16:55I would like to yield.
17:00I'd like to yield three minutes to Representative Valant from Vermont.
17:18Thank you so much, Representative Schreier. Happy to be here. You know, just this morning,
17:22President Trump said the Republicans aren't cutting anything meaningful in their budget.
17:29Wow. What a thing to say. What a shocking thing to say when these cuts will hurt so many Americans.
17:39I'm having a really hard time understanding how taking away health care from nearly 14
17:44million Americans isn't meaningful. It's not meaningful that rural hospitals across Vermont
17:52and across this country are going to be at risk of closing. You know, just today,
17:57I met with Vermonters from a little town called Coventry, and they're deeply concerned
18:04that they are going to lose access to labor and delivery health care at their local hospital.
18:09Republicans are so out of touch with the reality of American families right now,
18:15and it's shocking to call these cuts not meaningful when their bill will hurt working families.
18:23It takes away food and health care from millions and millions of people, their own voters,
18:31but yet they are not meaningful cuts. These cuts are certainly meaningful for all the kids
18:39and veterans who will go hungry because of this cruel and what I think very cynical bill.
18:45And why? Why are my Republican colleagues making the cuts? That's what we all want to know.
18:50To give the very wealthy another big tax cut and deliver tax breaks to billionaires and
18:57corporations. People who absolutely don't need any more assistance. So taking that money
19:05from people who desperately need help and giving away to the people who don't. People who are just
19:12struggling to get by are having precious resources taken away from them. And right now across this
19:19country, Americans are trying to figure out the math. Are they going to be able to afford groceries
19:25for the kids? They're trying to decide whether they can afford to go to the doctor. And while
19:31that's happening in real time, my colleagues are spending time demanding more work requirements
19:38for Medicaid recipients when we know that almost half of adults on Medicaid are already working.
19:44They act like they're not working. They're working. And 27% of those working age adults
19:51on Medicaid are disabled. They're doing the best they can here, folks. It couldn't be more obvious
19:58that they are just looking to remove more people from the Medicaid rolls in order to have more
20:05money to give tax breaks to billionaires and corporations. And it's sick. These are people,
20:12real people that we're talking about tonight in every congressional district who cannot handle
20:18these cuts. It's as simple as that. And the reality is Americans can't pay for the rent right now.
20:25They can't pay for their groceries. They're too high. Prescription drug prices are too high.
20:31And costs for consumers and small businesses are just going to go up because of the asinine
20:37tariff regime that we've been dealt. And of course Americans feel like it's rigged against them
20:44because it is. And that's why we have to be here fighting for them. That's why we have to be here
20:50raising the alarm about what is happening in this bill with Medicaid. What Americans want
20:57is fairness. What they need is fairness. And we owe them that. And they want and need affordable
21:04health care. And we owe them that. And they want and need a fair shot, a better life for their
21:10kids. And we owe them that. This bill that cuts Medicaid, it is a statement of values. It shows
21:19exactly what and who the Republicans are caring about. And it's not you and your family. And it's
21:26not me and mine. It's about propping up billionaires and kicking the rest of us in the teeth
21:32while they do it. And I ask you, what kind of leaders take away health care and food
21:40from working people so that the wealthy can get even more money? What kind of leaders?
21:46Not strong leaders. Not leaders of conscience. It's shameful. I yield back.
21:59Well, thank you, Representative Ballin. For that clarity, I so appreciate drawing that distinction
22:07that Speaker Emerita Pelosi referred to as reverse Robin Hood. That is exactly what's going on here.
22:13Who are you standing up for? We saw with the last Republican 2017 tax cut that the vast majority of
22:22that benefit went to the wealthiest. And it did not trickle down to people. People are already having
22:28trouble affording rent, home prices, food, and other goods. Putting this kind of financial
22:34pressure, not just on Medicaid recipients, but on everybody else because insurance rates and
22:40medical costs are going to go higher, only makes that squeeze worse. I am going to yield
22:47now three minutes to Representative Takuda from Hawaii.
23:02Thank you, Mr. Speaker. I rise today with a warning, not a plea. Rural America is already
23:09in crisis. People there die younger, mothers face greater risk giving birth, and hospitals teeter on
23:16the edge of collapse. Medicaid is the thin lifeline that fragile systems are using to hold itself
23:24together. Cut it, and people will die. At Adventist Health Castle in Kailua, 75% of patients rely on
23:32Medicaid and Medicare. They've weathered already the storm of COVID, but with new GOP-led cuts to
23:38provider fees, they may be forced to shut down essential services, obstetrics, pediatrics,
23:44emergency services, care that literally keeps babies and people alive. But this is not just
23:51about one hospital in Hawaii. This is a national crisis. Rural Americans face significantly worse
23:57health outcomes and health disparities. In too many rural counties, life expectancy is a decade
24:03shorter than that of their urban neighbors. Maternal mortality in rural areas is nearly
24:08double that of urban areas, and more than 200 rural hospitals have closed their doors since 2005,
24:16and over 450 more are currently at risk of shutting their doors. This isn't hypothetical.
24:23It's happening right now. And let's be clear, when these providers and hospitals close their doors,
24:30everyone in those communities, including, by the way, some members of Congress and their families,
24:36will lose their health care. And it won't bring me or anyone impacted any comfort or peace to say,
24:43I told you so. Suma Metla, a pediatric physical therapist and mom, treats kids with complex needs.
24:5140% of her patients are on Medicaid. She told me plainly as she sat in my office today with her
24:58one-year-old Kashi, if these cuts pass, we will not survive past this year. Already, speech
25:06therapists and other specialists are shutting their doors in Hawaii and across the country.
25:10Her own practice is buried in a two-week backlog, and one of two hospitals that offer similar care,
25:16and we only have two throughout the state, has a hundred child waiting list right now.
25:22Suma has traveled to Lanai to treat children no one else could reach. She tried to keep care going
25:27through telehealth, but when Congress let those tools expire, families were left stranded. Or let's
25:34talk about the preschool teacher in my district whose son was born weighing less than two pounds.
25:39Five months in the NICU, emergency surgeries, feeding tubes, a hospital bill 50 times more than
25:46she will make in a single year, covered by Medicaid. That little boy is now three years old,
25:53full of life and laughter and love, obsessed with music and trucks. He is only alive because Medicaid
26:01was there. We cannot forget, my friends, what is at stake. These are not just numbers on a page.
26:08They're real lives, real children, real families, and real communities. People like you and me.
26:16Slashing Medicaid won't balance the budget. It will close hospital doors. It will rip care from
26:22those who need it most. It will end lives. We must not let this happen. Find the courage,
26:29have a conscience, vote no. I yield back.
26:36Well, Representative Takuda, thank you for bringing up that particular issue of children
26:41in the neonatal intensive care unit where I have worked. And I think about this frequently,
26:46that when over 40 percent of births in this country are covered by Medicaid, I think about
26:52what it would mean for a family to be bankrupt for the rest of their lives if they had a premature
26:58baby or a special needs baby. And I also think about what would happen if those babies didn't
27:03get the right care. Sometimes this is not a matter of life and death, but a matter of
27:09life, death, and lifelong disabilities. And that's what a good NICU care will mean and make
27:17a difference for with these babies who are relying on Medicaid. I'm now pleased to yield
27:22to my colleague, Representative Desanier, from the state of California.
27:28Thank you. And thank you, Doctor. I'm reminded of the first oath you took before you got here,
27:33first do no harm, that I wish my Republican colleagues would take that oath. Because the
27:39harm that this proposal does to the least amongst us in this country is unfathomable. It's cruel.
27:46And it's madness from a financial perspective. When everyone is cut off Medicaid, where will
27:52they go? They'll go to public hospitals that already are underfunded and trying to serve
27:58the least amongst us. So all the stories you've heard, I want to put some numbers and
28:03think of multiplying these numbers to the stories you've heard. But particularly for people who are
28:10the least amongst us as Americans. There are 78.5 million people enrolled in Medicaid
28:16and the Children's Health Insurance Program across America. This is 10% higher than in February 2020
28:23pre-COVID. One in three people with disabilities, one in three people with disabilities, 15 million,
28:30have Medicaid. Comparatively, 19% of adults without disabilities have Medicaid. These are
28:36the people that Republicans and Democrats in the past have tried to protect. Now we are being cruel
28:46and dismissive of their needs. One in five Medicaid enrollees have a disability. Two-thirds
28:51of Medicaid enrollees do not receive SSI benefits. 10.3 million people would lose Medicaid
28:58coverage in the next 10 years if the budget reconciliation bill of the Republicans passes
29:04because of its punitive work requirements. Most of these people are already working. In 2022,
29:10Medicaid covered two-thirds of all home care spending. 4.5 million people receive Medicaid
29:17covered home care services each year in America. Medicaid cuts, as proposed under the Republican
29:24budget, threaten optional benefits the most, including long-term services and supports that
29:30help the disabled and the elderly and home and community-based services that help protect these
29:36Americans who need our help. They live with disabilities in their own communities and get
29:42the support, love, and affection of those communities and their families. In California
29:47alone, almost 15 million Californians are on Medicaid. 1.1 million 906,300 Californians on
29:57Medicaid have a disability. Of those, 992,000 people are working, age 19 to 65. A million
30:06people in California with disabilities who get Medicaid are working, and now they're going to
30:11be forced to go through a bureaucracy that supposedly the majority wants to make more
30:17efficient. That's not efficiencies. That's cruelty to the least amongst us. 68 percent of California
30:23adults on Medicaid have a job. In just my district, which is the fifth wealthiest district in the
30:30House, 131,634 people are on Medicaid and are at risk of losing care under the Republican budget.
30:3945,916 of those are children, 19,000 are seniors, 10,000 are people with disabilities,
30:4848,300 adults on Medicaid due to ACA expansion. Mr. Speaker, this is madness.
30:59Doctor, colleague, thank you for bringing this to the floor, and thank you for your spirit and
31:04your personal testimony to what this will mean to a million of Americans who are the least amongst
31:10us. Well, thank you for your comments and putting this in a very personal way. I'm wondering for
31:19people out there watching, if they're thinking, gosh, I wonder, is this really true? I mean,
31:25are hospitals really going to close? Are we really going to lose labor and delivery and have to
31:30drive hours to get to the nearest hospital to deliver a baby? I mean, in my district,
31:36the hospital I talked about earlier is between two mountain passes, and if it's snowing,
31:41there's really nowhere to go except by life flight. And it's not hyperbole. I have sat with
31:49the heads of school-based health clinics and community health centers, with heads of hospitals,
31:57with nursing homes. And by the way, these hospitals, we've been referring to rural hospitals,
32:01but you know what? There are urban hospitals and suburban hospitals that are also highly dependent
32:08or have a very high percentage of Medicaid-dependent patients. And we're already seeing
32:15cuts of hundreds of employees in the Seattle area because of these impending cuts to Medicaid. So,
32:22I want to be just crystal clear. This is absolutely true. We are hearing this across the board,
32:29that when Medicaid gets cut, we all lose. We lose our local labor and delivery service. We lose our
32:38local emergency room. We lose the ability to be seen quickly in the event of an emergency
32:45because somebody who could have been taken care of by a primary care physician a couple of days
32:50earlier with an uncomplicated illness is now in the emergency room ahead of you in line,
32:57making you wait when you're having a heart attack. And it was completely preventable
33:02by using the leanest, most efficient healthcare service and insurance that we have called
33:08Medicaid. I want to tell you another story. This is the story of Miguel.
33:21Now, we talked about Isla before, a little four-year-old girl.
33:29Miguel is at the other end of life. He is a senior. He is a constituent who is dependent
33:38on Medicaid. He's actually a 76-year-old widower who lives in Wenatchee, the apple capital of the
33:46world. Now, after Miguel's wife passed away, he relied solely on his Social Security check to
33:53cover his living expenses. He's a retired orchard worker, and so he worked hard to earn that Social
34:03Security, and he spent decades doing physically demanding labor without access to a pension later,
34:11and private insurance was never affordable. He still depends on Medicaid to stay in his
34:18modest home, receiving regular in-home nursing visits, and help with daily tasks like bathing
34:25and cooking and managing his medications. And without Medicaid's coverage for home-based care,
34:32which by the way is far more affordable than nursing home-based care, he gets that home-based
34:40care and transportation and care coordination through Medicaid. And without that, he would have
34:45no way to attend his checkups, manage his diabetes, and function through the limitations that he
34:54suffered because of a stroke. Miguel fears losing access to the services that allow him to live at
35:03home with dignity, with independence, in familiar surroundings, and he deserves that. And frankly,
35:10that is the most cost-effective way to help Miguel. For seniors like Miguel, Medicaid,
35:18it's not optional. It's their lifeline. It's how they keep dignity. It's how they stay at home.
35:26And unfortunately, Miguel's fears are not unfounded. The rural hospital that he depends on
35:32treats patients who are more likely to be on Medicaid or Medicare. In other words,
35:39they have a disproportionate share. And if these patients, those Medicaid patients,
35:45lose their health insurance because of this bill, the cost of their care gets absorbed by the
35:52hospital. And for hospitals in rural areas that are already struggling, barely keeping their heads
35:59above water, this could be the death blow. This will force them to first cut services. And we
36:06talked about labor and delivery. We could also talk about mental health services and opioid
36:10treatment. Those are often the first to go. This would leave Miguel without access to care.
36:18I am not trying to fear monger or deceive Americans, but this is scary. It is real. I
36:25am simply telling you what our community health centers and our hospitals and our nursing homes
36:30and our school-based health clinics are telling you, that the Republicans' budget
36:34will take health care away, health insurance away from 13.7 million Americans, while therefore
36:42increasing costs for everyone, decreasing access to care, and leaving us all sicker and poorer.
36:52Now, we haven't even talked, really, about the impact on nursing homes and on our seniors.
37:01As Speaker Emerita Pelosi touched on this, but I also want to be really clear that three out of five
37:09middle-class, working-class Americans in nursing homes depend on Medicaid to pay those bills.
37:20We already in Washington State don't have enough nursing homes. In fact,
37:24people who should be in nursing homes are now filling hospital beds because there's nowhere
37:28else to go. Well, just imagine if more nursing homes close. What that will do to hospitals,
37:33what that will do to those patients. But then think about this. I'm in the sandwich generation.
37:40If I had a parent who relied on Medicaid to be in a nursing home and could not otherwise afford
37:48that, I would need to leave my job to take care of my parents. And that's not what they would want
37:55for themselves or for me or for my family. And this is what millions of families out there will
38:02go through if these Medicaid cuts happen. I would be honored to yield to Speaker Emerita Pelosi.
38:11Just briefly, I just want to make this further point. You have been so eloquent,
38:16and all of us associate ourselves with your remarks and the professional knowledge that you
38:21bring, the intellectual resource you are on all of this. I just want to add one thing that is just
38:28at the same time as the Republican reverse Robin Hood plan is taking from those who need it most,
38:37giving it to those who have the most, they are also taking nearly $300 billion from SNAP.
38:47SNAP, food, that's for food. Food is medicine. You cannot make, you're going to make people
38:54even more sick if they don't, these children don't have food. There was one time when Medicaid
39:01first began that one of the people who was starting community health centers around the
39:07country insisted with the federal government that food be counted out of them as medicine,
39:16because it is about health. And children who do not have access to food are the ones who suffer
39:23the most. I see that our colleagues have arrived. I'll just say this one thing. People ask me,
39:30what is your why? Why did you ever decide to leave home and come to Congress? I have five
39:35children, and the idea that one in five children in America goes to sleep hungry at night, lives
39:42in poverty and goes to sleep hungry at night, and this, the greatest country that ever existed in
39:48the history of the world, I just couldn't handle that. So that is what took me from kitchen to
39:56Congress to the housewife to house speaker, to feed the children. So this thing, what Matthew
40:03said, when I was hungry you fed me, the gospel of Matthew. What do we do with that? Just tear it up.
40:11This is immoral. It's sinful for us to be taking food out of the mouths of babies to give tax cuts
40:17to rich people. But you know what? It isn't about that. They're giving those tax cuts anyway.
40:24They're fiscally engineering the shrinking of the compact that we have with the American people
40:32that developed countries have with their constituents. We are behind the rest of them
40:39in many of these regards when we have to take food out of the mouths of babies to say that we're
40:44going to give a tax cut to the wealthiest, but we just really are taking food out of the mouths of
40:49babies because we don't want to feed them. And that's what this is about. A trillion dollars,
40:55700 billion or more for Medicaid, 300 billion for SNAP.
41:05Reverse Robin Hood a la Republicans. I yield back.
41:11Thank you. I so very much appreciate those comments and Speaker Merida Pelosi's dedication
41:18to children in every way. And just to put an even finer point on that, food is medicine.
41:26Cutting SNAP benefits not only takes food away from hungry people, it also undermines our economy
41:32because those dollars are spent at our local grocery store. But I also have to just mention
41:38that food banks, which are the next line of support, are also under threat because Doge
41:46and Elon Musk and Donald Trump have cut the food going to those food banks, leaving shelves
41:53bearer and leaving food banks having to ration foods. And they canceled the program where local
42:00farmers can provide their food to the local food banks, which is the healthiest and local and fresh
42:07food. And all of this just adds up once again to hurting people in need in order to fund a tax cut
42:16for the billionaires in this country. I'm now going to yield to my colleague, Dr. Kelly Morrison
42:23from the state of Minnesota to give her perspective about Medicaid.
42:29Thank you, Representative Schreier. Mr. Speaker, today I rise alongside my colleagues in the
42:34Democratic Doctors' Caucus and as the first and only pro-choice OBGYN here in Congress
42:40to speak out against the Republicans' disastrous budget proposal and to fight for our families'
42:45women, children, and families. For more than 20 years, I've had the honor and privilege of taking
42:50care of patients as an OBGYN. And one of the great joys of my job is caring for my patients during
42:56their pregnancies and helping them grow their families. I carry my patients and their stories
43:01with me, and they inform my work here in Congress. I think about them and all the challenges new
43:07parents face during pregnancy and then after they head home with their new baby, recovering from the
43:12delivery, adjusting to life with a little one, accessing the care they and their family need,
43:17balancing caregiving and work, making ends meet, the cost of raising children in the United States.
43:24It's a lot. And I think about all the babies I've delivered whose moms got their health care
43:29through Medicaid and how critical that was to help them get off to the best possible start.
43:36And it's because of those patients and patients all across the country
43:40that I stand here today both incredulous and outraged that the Republican majority in Congress
43:46is shoving a budget through that will gut Medicaid, the very health insurance program
43:52that covers 40 percent of all births and insures almost half of all children in our country.
43:59As an OBGYN, as a mother, as a member of Congress, as an American, this is unconscionable to me.
44:08We already have a maternal health crisis in our country. Let's look at the facts about that
44:13maternal health care crisis we face now. And remember, that is before we got Medicaid. In more
44:19than half our country, women do not have a place to go to get obstetric care. Among our peer nations,
44:26the United States has the highest rate of both maternal and infant deaths. In 2022, there were
44:33more than double and sometimes triple the rate of maternal deaths in the United States
44:38compared to most other high-income countries. And unacceptable disparities exist. Black and
44:44American Indian and Alaska Native women are three to four times more likely to die from a pregnancy
44:50related cause compared to white women. And most of these deaths, more than 80 percent, are preventable.
44:58So what is the Republican majority doing to address this unacceptable crisis?
45:04Instead of working to find ways to improve women's health and to help moms and babies,
45:08they are shoving a budget through that will devastate our nation's maternal health care
45:12and decimate many of our hospitals and clinics. It will unequivocally make our nation's maternal
45:19health crisis worse. And why in the world are they doing this? Why are they choosing to harm
45:25women and children? They're doing it to pay for tax cuts for the ultra-wealthiest among us.
45:32That is literally why. To make the math work to cut taxes for billionaires. They are choosing to
45:39sell out the health of women, moms, new babies, the future of our country, to pay for tax cuts
45:46for billionaires. Choosing to take health care away from moms and their babies. And let's be
45:52clear, this won't just be devastating to the moms and new babies who get their health care
45:56coverage through Medicaid. It will be devastating for maternal health care across the country.
46:02All of this coming from the party that calls itself pro-life and pro-family. It's hard to
46:07imagine a more anti-family policy. So instead of wasting time musing around ridiculous ways to
46:14persuade women to have more children, like giving medals for having six or more babies, I would like
46:20to remind my Republican colleagues that they could start with something real, meaningful,
46:24and impactful right now by not gutting the health insurance program that covers almost half of all
46:30births and half of all children in our country. The Republican majority needs to make their
46:35pro-family rhetoric match their policy, put America's moms and babies first,
46:41and stop these proposed cuts to Medicaid. I yield back.
46:45Well, Representative Dr. Morrison, thank you for that perspective. From the perspective of an OBGYN
46:53who has taken care of pregnant women and new babies and really paints a very clear picture
47:00about maternal mortality in this country, what cuts to Medicaid mean for that. You know, it's
47:07interesting. All of us in the Doctors' Caucus have been talking for years, in fact, for the
47:13whole time I've been in Congress, trying and trying to improve Medicaid reimbursement, to make
47:19it so that Medicaid reimbursement can match Medicare reimbursement, so more children can
47:24have a medical home, about expanding Medicaid care for pregnant women until one year postpartum to
47:30make sure that they are healthy and plan their pregnancies, and that we can cut down this
47:38outrageous incidence of maternal mortality in this country. And now we're just fighting to keep
47:46Medicaid. That's the situation we're in now, because Republicans want to gut Medicaid and
47:52take health insurance away from 13.7 million Americans to pay for a tax cut for the wealthiest
47:59Americans. That is just plain wrong. I'd like to talk for a moment about another constituent of
48:06mine paints just a different angle on what it looks like to cut Medicaid. And I will tell you
48:14that our phones, they're ringing off the hook. People understand what is going on. They're
48:19worried for their health, for the health of their families, for the health of their parents. They
48:24get what will happen to their local rural hospital if these go into effect. So I want to tell you
48:30about Kathleen, who graciously shared a story about her own mother. Kathleen's mother lived to
48:37be 92 years old. She was a widow for 42 of those years and helped care for five of her grandchildren.
48:46Kathleen's mom, well, she lived through the deprivations of the Great Depression and World
48:51War II and was never one to complain. She lived simply. In the last decades of her life, she had
49:00a number of serious, complex medical conditions that presented real challenges for her medical
49:07team and for her specialists and, of course, for her. Medicaid simply did not work for her.
49:14Medicaid supplemented her traditional Medicare plan in the last years of her life and allowed
49:21her to get the medical care that she needed. She was treated with care and with respect.
49:28When Kathleen's mom injured herself in a fall, Medicaid covered the rehabilitation facility
49:35and later in-home physical therapy and occupational therapy so she could be in her own home.
49:41Later, she had a life-threatening event and was hospitalized. Eventually,
49:46she was well enough to move to an outpatient rehabilitation facility followed by in-home care.
49:53Again, Medicaid was there for her. The care was safe and reliable and appropriate. It gave
50:01tremendous relief to her and to her family. In the last months of her life, Medicaid provided
50:08hospice care. The nurses and home health aide and OT and PT and case manager were her guardian
50:17angels. They treated her with compassion and dignity. Isn't this the type of treatment and
50:25care, the care made possible by Medicaid that all of us deserve, that all of us want, that we want
50:32for our friends and our family and for ourselves? For so many seniors in this country, this type of
50:40care is made possible thanks to Medicaid. It is unfathomable that my Republican colleagues want
50:48to deny our seniors the type of comprehensive and compassionate and thoughtful care that Kathleen's
50:56mother received. That sort of brings us full circle to how these cuts to Medicaid, Apple Health
51:06and Washington State, something a lot of people out there think, well, I'm not relying on Medicaid
51:13and so maybe it doesn't affect me. What I want, the message I really want to deliver,
51:19Mr. Speaker, I'm actually going to look at the camera to speak directly to the American people,
51:24that cuts to Medicaid or to Apple Health, they impact every single person in this country.
51:32They impact you if you are the son or daughter or spouse of a senior who needs to be in a nursing
51:39home because nursing homes will close and you will have to leave your job to take care of your ailing
51:45parent or spouse. They impact everybody who lives in a rural community or in an urban community
51:54where there's a lot of patients who rely on Medicaid insurance because when Medicaid doesn't
52:00pay the bills for those people, the hospital gives away that care for free and then either
52:06they cut services or they close or more likely a combination of all these and your insurance
52:14premiums go up because somebody's got to pay and who's going to make up the difference? Private
52:20insurance. That means your insurance rates go up and they're already high. Everybody hurts from
52:27this. Even if you're not paying your own health insurance, I bet you at some point you're going
52:31to the emergency room and those patients who don't have Medicaid, they're now getting sicker,
52:37waiting longer and getting their care late in an emergency department. If you think the
52:45waits are bad now because hospital beds and ER beds are full of patients in mental health crises
52:53or with fentanyl overdoses or with nursing home patients who don't have a nursing home to go to,
52:59if you think the waits are bad now, just wait till 13.7 million Americans lose their
53:06health insurance. We are all impacted. If you live in a rural area, you have private insurance,
53:12you're doing fine, but the labor and delivery department closes at that rural hospital and you
53:20maybe have a high-risk pregnancy and need obstetrics care and might have a complication
53:26with that delivery, you might have to go live in a more urban area for the month before that
53:33delivery just to make sure that you're safe and that your baby is safe. This is something that
53:40none of us should have to worry about in the United States of America. This is a prosperous
53:45country. We have excellent health care here. And to think that my Republican colleagues want to
53:51cut Medicaid, a lifeline for the patients who depend on it and for our entire health care system,
53:58that they want to cut that, that the people most in need depend on, again, we're talking
54:05about the elderly, people with disabilities, pregnant women, children. To think that they
54:13would cut care for them in order to pay for gigantic tax cuts for billionaires,
54:22it's a backwards transfer of money. It is Robin Hood in reverse. It is just plain wrong. And I've
54:31explained now, in addition to being morally bankrupt, it is also fiscally reckless. It's
54:40irresponsible. And I just don't understand how this is the plan that my colleagues came up with.
54:49Their constituents are going to hurt every bit as much as mine. And statistically,
54:55with more rural areas and more vulnerable, already vulnerable rural hospitals,
55:01chances are their constituents are going to get hurt even more. I sure hope that people out there
55:08are paying attention. Call the people who represent you. Tell them what your fears are. I
55:15know people are calling me and I am standing up here, appealing, appealing to my Republican
55:22colleagues, letting the American people know what is going on right now, why they should be concerned.
55:29This is a democracy. Call the people who represent you. Tell them what you think. Tell them what it
55:35would mean for you, for your family, for your neighbor. Again, it's one out of three in Washington
55:41State. What would it mean if these largest ever cuts to Medicaid transpired? Here's what's going
55:51to happen tonight. At one o'clock in the morning, the rules committee is going to meet. They're
55:58going to craft the rules for this, well, Trump's so-called big beautiful bill, which would be a
56:07travesty for the people I represent. They're going to do this at one o'clock in the morning,
56:13when everybody else is asleep. They're not watching. They're not paying attention.
56:18They're not watching the nightly news. This is not prime time because I think they're embarrassed
56:23about what they're doing, but they're going to do it anyway. They're going to do it for the people
56:29who are in the front row at President Trump's inauguration. That's who they're going to do it
56:35for. This is not helping their constituents. It's not helping my constituents. America, it's not
56:41helping you. It is morally bankrupt. It is fiscally irresponsible, and it's just plain cruel.
56:50And so that is why I, along with the rest of the doctor's caucus, have spent this evening
56:58talking about what this means for our patients, for our healthcare system. We understand it
57:03on a visceral level because we have lived in and worked in this healthcare system. We have
57:09worked in crowded emergency departments, seeing people who, if they had health insurance,
57:14wouldn't need to be in the emergency department. We've taken care of patients who didn't have
57:20insurance like Medicaid, and so they delayed care, or they didn't pick up a medication because it
57:26was too expensive and they didn't have coverage. We've seen these things. Dr. Morrison and I have
57:34both seen complicated pregnancies, neonatal resuscitations. These are patients who rely
57:40on Medicaid, and we're here saying as doctors who swore an oath to our patients to protect them,
57:48to stand up for them, this is us standing up for our patients to plead with my Republican colleagues
57:55not to cut Medicaid. And I want to let them know, and I want to let my constituents and the American
58:02people know, that I will continue to fight every minute to make sure that these cuts don't happen
58:09and that we keep this oath to our patients. Thank you, Mr. Speaker. I yield back.
58:20Members are reminded to address the remarks to the chair and not to a