Cantwell Blasts Latest Trumpcare Bill to Strip Millions of Americans of Health Insurance

Cantwell: “This bill is just one more sneak attack by our colleagues at kicking people off of Medicaid”

WASHINGTON, D.C. – Today, U.S. Senator Maria Cantwell (D-WA) delivered a speech on the floor of the U.S. Senate opposing the latest version of Senate Republicans’ Trumpcare bill, known as the Graham-Cassidy bill.

“[Graham Cassidy] is just one more sneak attack by our colleagues at kicking people off of Medicaid,” said Cantwell in her remarks. “Our job here has to be about affordability, it has to be about driving down costs, it has to be about driving down costs in the individual market and in the system overall. There is nothing good about kicking 15 million people off of Medicaid and sunsetting it in this bill. My colleagues are advocating the privatization of Medicaid.”

The Graham-Cassidy Trumpcare bill has key components of previous legislation, including:

  • Establishing a per-capita cap on Medicaid.
  • Ending the Medicaid expansion and permanently undermines Medicaid.
  • Rolling back protections for Americans with pre-existing conditions.
  • Allowing states to impose burdensome work requirements as a condition of Medicaid coverage.
  • Tearing coverage away from millions of Americans.

However, the Graham-Cassidy Trumpcare bill goes even further than earlier Trumpcare bills, including:

  • Repealing the Medicaid expansion, premium tax credits, cost-sharing reduction payments, and Senator Cantwell’s Basic Health Program in favor of an inadequate block grant.
  • Establishing a block grant for states without any consumer safeguards.
  • Creating a funding cliff that eliminates the guarantee of coverage in 2026.

A transcript of the senator’s remarks can be found below:

Sen. Cantwell: Mr. President, my colleagues have been out here in the last few minutes, last night, this morning, and this afternoon to talk about our distress of people trying to push again the repeal of the Affordable Care Act without a successful strategy to move our nation forward on more affordability. We just received a letter from ten governors telling us to slow down and work on a bipartisan basis, basically telling us that the proposal that people are trying to rush through without regular order is not the kind of thing that is going to help us make the reforms that are necessary. So I think that these bipartisan governors’ [letter], from the governor of Colorado to the governor of Ohio to the governor of Alaska, is something that the people in the United States of America should listen to because it's important that we get it right because the affordability of health care is so important.

What I don't like about the proposal that is now being pushed by my colleagues, even though they want the states to have some flexibility and play a larger role, is that it basically ends the 52-year state partnership that we know as Medicaid today. That is, it changes the dynamic that says the state and federal government are in business together to take care of a population that is the most vulnerable of citizens in our country and that giving them affordable access to health care is a priority because it actually reduces everybody's health care costs.

When people think about the expense in health care, you can ask any provider, they will tell you 1 in 5 patients will drive the costs. If you leave people uninsured, it raises the costs for everybody. We have seen states that cover people on Medicaid actually raise people out of poverty and help their economies and reduce the costs at individual hospitals, thereby driving down the cost of private insurance. So why would we want to destroy that by authorizing in legislation the end of this 52-year relationship between the federal government and states on trying to make sure that our populations are covered, that if a state spends a dollar, they can count on the federal government to spend that dollar as well as to continue the partnership that works cost-effectively?

What I also don't like is that it sunsets Medicaid for 15 million people. Sunsetting Medicaid -- if you're going to sunset this 15 million people, when will you sunset Medicaid for the rest of the population? When will you try by legislative action to curtail the opportunities for millions of Americans who use Medicaid as a stabilizing force for health insurance in America? In our state, 600,000 people, most of whom were previously uninsured, would then be set for that sunset of Medicaid. The legislation that my colleagues are pushing basically would end the funding for this program in 2027. So that would leave states with an unfunded bill for those individuals of over more than $300 billion. So I doubt that states have the money. I doubt that the individual market is going to take care of those individuals as cost-effectively as we're taking care of them and states will then cost shift these resources back to the cost of the public in raising everybody's rates again.

Our job here has to be about affordability, it has to be about driving down costs, it has to be about driving down costs in the individual market and in the system overall. There is nothing good about kicking 15 million people off of Medicaid and sunsetting it in this bill. My colleagues are advocating the privatization of Medicaid.

They are advocating that what you do with this population is take them off the current program and shift them on to the exchange. Now, some people who are following this will say, ‘Wait, they can go to the private market.’ The legislation also says that you stop that support by 2027. So this is just one more sneak attack by our colleagues at kicking people off of Medicaid. To start the process and agree to privatize Medicaid, where is it going to end?

Now I'm the first to say that we can improve our delivery system, that we can save money. I've advocated what I think one of the most cost-effective aspects of Medicaid is to move those who need care later in life off of nursing home care into community-based care. Our state, the state of Washington, saved over $2 billion over a ten-year period of time. If other states did this we could save $100 billion or more by giving states opportunity to age at home and have a long-term care delivery system that works in our communities. It is one-third the cost. Now that is innovation, that is cost savings, that is improvement on our current delivery system and hopefully covering an aging baby boomer population that is going to reach retirement and a population of Americans that are going to live longer. But there is nothing innovative about privatizing Medicaid and kicking people off by shifting them over to an exchange and then cutting the resources for the exchange. So I hope our colleagues will stop the notion that somehow this is innovation—it's not innovation. It's sunsetting, it's privatization, it's cutting people off of care, and that is why we have heard from these governors and others about why this is so important not to take this bait.

We need to make sure that we're continuing our bipartisan discussions, continuing to work together about what will drive affordability into the market. Bundling up a population and giving them clout to negotiate on rates and giving a state the ability to negotiate on rates, either on drug costs or on insurance, yes, can save dollars. It is being done right now in New York and Minnesota and it can be done in other places.

But cost shifting to the states, this $300 billion, or then making states make the draconian decision of, “Wait, I already shifted that population on to the Exchange. Oh, my gosh. The federal government just cut the funds that we're going to get.” Next thing you know this population is left without care.

Privatizing Medicaid is not the way to go. I hope our colleagues will continue to discuss on a bipartisan basis the aspects of the Affordable Care Act that could be expanded to drive down costs and increase affordability. I hope that they will continue to make sure that things like basic health – the essential elements of what should be covered in a basic plan – are there for our consumers. That somehow we're not going to take the bait in thinking that by cutting essential services to people that somehow is the way to get a private insurance plan. We have the ability to work together.

My colleagues and I have been working and discussing these ideas. My colleagues Senator Murray and Senator Alexander are working on various ideas in the HELP Committee as well as the Finance Committee to make sure that we fund the insurance and their families under the CHIP program.

Let's not make this worse. Let us not end this 52-year relationship that has successfully covered a population of Americans, and let's not fall for the bait and think somehow this is going to save money for the American taxpayer. It is not. It is going to cost the individuals, raise the individual rates, and we can't afford it. Let's make it cost-effective.