Cantwell Responds to Trumpcare on Senate Floor

Senator: Trumpcare is “a hoax and a scheme that is not cost-effective for the American people, that will literally cut people off of access to health care.”

“This is a continuation of the war on Medicaid."

WASHINGTON, D.C. – Today, shortly after Senate Republicans released their version of Trumpcare, U.S. Senator Maria Cantwell (D-WA) took the Senate floor to deliver a stern condemnation of the contents of the bill. Cantwell, who has been working for months to bring attention to the consequences of cutting and cost-shifting the Medicaid program in the House-passed version of the bill, noted with alarm the deep cuts made to Medicaid in the Senate legislation

A full transcript of Senator Cantwell’s remarks is below:

Senator Cantwell: Madam President, I thank my colleague from Maryland for articulating the issues in this discussion draft that's been released this morning, as I hear him talk about these complex kids and how the cap is going to work and when people are going to be affected. It reminds me of that book ‘The Smartest Guys In the Room,’ right? I mean, basically people cook up schemes they think other people can't understand or the broader public won't catch on to in the hopes that they can pass something.

That's exactly what's going on here: a hoax and a scheme that is not cost-effective for the American people, that will literally will cut people off of access to health care, and literally, if the house bill was mean, this is doubling down on mean. So I thank my colleague from Maryland for articulating this about the complex kid issue because these are concepts -- if this is a discussion draft, I would hope my colleagues would come to the floor and discuss it, discuss the concepts that are in this bill and debate them.

But that's not what's happening. In fact, we know very little detail at this point in time because people are assessing the information and then trying to read and assess in between the lines. Well, I can tell you what I know and have gleaned so far by the accounts, and that is this is a continuation on the war on Medicaid. I say that because this war on Medicaid, we didn't know where the Senate would go in their proposal. We know what the House decided to do.

The premise and structure of the House bill is to cut Medicaid by capping it and continually driving down the amount of federal obligation to this program.

Now, I will tell you, it is not even a smart idea. If you want to reform and deliver better health care at lower cost, there are many ways to do that and save dollars and give better patient care. But that's not what the House proposal is.

It was a budget mechanism, and I’m not saying that. I’m talking to my health care providers at home. I’m talking to university professors, people who know and understand health care and have studied it for a long time.

What the House did, and now the Senate, is doubling down on nothing but a budget mechanism to cut people off of health care. And as my colleague said, the most vulnerable of our population.

So it's a wrongheaded idea. It is not going to help us control cost. Actually, Medicaid reduces bankruptcy rates, helps people stay employed, and boosts our GDP. Why would we want a draconian idea like cutting Medicaid as the centerpiece of a budget proposal by our colleagues on the other side of the aisle? As people have said, because they want to take that revenue and give it away in tax breaks for the wealthy.

I guarantee you that's not what we should be doing. The access to Medicaid is so important. Our veterans access the health care system through Medicaid. Many of them through the VA but many services also through Medicaid. They would be impacted and veterans would lose care.

Our children who are seen at hospitals, like Children's Hospital in Seattle, the Medicaid populations, they would not have the resources to get access to care.

Our institutions that are covering individuals at Medicaid rates would take a hit. So all the Senate proposal does is basically move that cap, but a steeper cap, at a point in time that makes and exacerbates this problem of cutting people off to access to care.

So if the house bill was mean, this is just doubling down on mean. There is nothing about destructing the safety net that is so important to Americans that goes hand in hand with the philosophy about how to drive down costs to health care.

Think about it. If we came out here and had a discussion of 100 United States senators and we said, the great way to drive down the cost of health care is to cut people off of health care, most of my colleagues would say, that's not a smart idea. Because when people are cut off of health care, we know that uncompensated care exacerbates health needs, challenges with other parts of our system, delivering care to them makes it more expensive. And when we've had discussions and round tables about the proposal that the House had put out, providers in my state told me point-blank: covering the Medicaid population has helped drive down and control the rate of insurance in the private market.

So now all we're doing by saying we're going to cut Medicaid at a more drastic rate is you are going to just send a signal to the market that rates for the private insurers should go up. I don't think that's what my constituents want. They want us to innovate. They want us to drive quality care and managed care into parts of the United States where it doesn't exist. They want us to take care of our most vulnerable population, and they want to make sure that we're not delivering that off people who are going into the emergency room 50 times in a year because they don't have insurance.

We know that the Medicaid rate is critically important, that Medicaid costs up to one-quarter cost than what the private insurance. So it's a way to deliver care. We know that things that we've put into the Affordable Care Act, like moving people off of nursing home care to community-based care, has saved Medicaid dollars.

More states should do it. We know that plans like bundling up the individual market into larger programs so they can have clout, like others who work for a larger employer, has also driven down cost.

So those are the things that we should be accelerating, not this notion that we move forward as a country by cutting the most vulnerable off of health care. So I ask my colleagues to come out and discuss this concept, discuss this idea, how it will affect the health care providers in their states.

I plan to do that with my state. I hope they'll come out harder and tell us -- I hope they'll come out here and tell us why it is a smart trait -- and tell us why it is a smart strategy to cut people off. I know no state that has a strategy to make up for the people cut off of Medicaid that has been doubled down in this bill. So I do not want to see a war on Medicaid.

What I want to see is innovation. What I want to see is that covering people with some level of insurance basically helps save everybody on their insurance bills as well. So I hope my colleagues will take this discussion draft and be proud to come out here and discuss it, but we haven't heard very little of that thus far.

Let’s look at the real numbers, and I guarantee you that we will hear from governors, we will hear from states, we will hear from providers, we will hear from businesses, we will hear from people who do not think this is a good idea. I know that already the National Association of Area Agencies on Aging is quote, “this strategy will put consumers on a fiscally precarious path.”

We've heard from other people that the Medicaid cap is up to twice as worse for states. It will cause problems and also from children's health care groups, quote, converting Medicaid into a per capita cap would dismantle critical protections to care for all enrollees, end quote.

So these aren't just partisan. These are the facts. What my colleagues don't realize is that by taking a huge chunk out of Medicaid, you are taking a huge chunk out of the safety net that so many Americans depend on. It will not help us lower costs. It will exacerbate an escalation of rates for everyone in the market. I thank the president and I yield the floor.