00:00Mr. President, on another topic, school may be out for the summer, but I have a pop quiz for the American people following this at home.
00:08The following statements are about President Trump's so-called Big Beautiful Bill.
00:13Try to guess whether a Senate Democrat or a Senate Republican made the following statement.
00:18Statement number one, if we don't watch out, people are going to get hurt.
00:22People are going to be upset.
00:24It's going to be the number one thing on the nightly news all over the place.
00:28Statement two, reference to the Big Beautiful Bill, I'm concerned if there are cutbacks in some of the Medicaid programs, it could have an adverse effect on our rural hospitals.
00:39Many of them are barely making it now financially.
00:42Statement number three, on the subject of slashing Medicaid payments, this is a whole new system that is going to defund rural hospitals.
00:50If you guessed that all three statements were made by Senate Republicans about the Republican Reconciliation Bill, you're right.
00:59Even my Republican colleagues know that under Trump's plan, billionaires will win and American families will lose.
01:07The more we learn about this bill, the worse it looks.
01:11Perhaps that's why the Senate Republican leader is anxious to pass the bill before the arbitrary Fourth of July deadline.
01:17It is expensive.
01:19Yesterday, the Joint Committee on Taxation estimated that the Republican proposal will add $4.2 trillion to our national debt.
01:28In Trump's first term, in that four-year period of time, he added more debt, money to the debt of the United States, than any president in four years in history.
01:39Now, he's going to top that number with this new big, beautiful bill, adding to our national debt.
01:45And does the proposal borrow against the future in order to lift millions of children out of poverty or invest in clean energy jobs for the future that will grow the economy?
01:55Think again.
01:56This bill provides tax breaks to the ultra-wealthy.
02:00One of my colleagues did a calculation here.
02:03If you make a cutoff point of an income of $400,000 a year and say that we won't give any of the new Trump tax breaks to people making more than $400,000 a year,
02:17you eliminate 60% of this tax proposal.
02:2160% of it goes to people making over $400,000 a year.
02:26What about at the highest levels, 0.1% income?
02:29The tax break, permanent tax cut, annually is nearly $350,000.
02:36Come on.
02:37Do you really believe Elon Musk is waiting to see this, whether this goes through, so he can take this tax break and spend it on something worthwhile?
02:45Not at all.
02:46The richest people in the United States, God bless them, don't need this tax cut.
02:51Working families do.
02:53And it's unpopular.
02:54A recent Fox News poll.
02:56Did I say Fox?
02:57Fox News poll found that 38% of registered voters supported the House-passed bill.
03:0359% opposed it.
03:05And it's downright mean.
03:08This measure would be the most significant health care cut in American history.
03:1216 million Americans would lose their health insurance.
03:15I heard one Republican senator on the news say,
03:18well, that's just health insurance that we're providing for illegal aliens.
03:22He's wrong.
03:23The Medicaid doesn't cover them.
03:25Medicaid people who would be denied coverage, 16 million of them are American citizens.
03:31Medicaid cuts will lead to higher co-pays, longer emergency room wait times, and skyrocketing nursing home expenses.
03:38So many of our senior citizens in my state and other places are in places to take care of them.
03:45They need a helping hand, nursing facility and the like.
03:48The majority of that is being paid for by Medicaid, and the Republicans want to cut that Medicaid reimbursement.
03:53What's that going to do when you're trying to take care of your mom and your grandmother if you can't afford to keep them in a good place?
04:02In an extreme situation, they may have to move in with you and change your own lifestyle and your own relationship within your family.
04:10One provision in particular in the Republican bill will cripple the funding mechanism used to keep hospitals afloat.
04:17According to Children's Hospital Association, this provision in the Republican bill will cut funding for most children's hospitals by 42%.
04:28So do you have a children's hospital in your town, in your state?
04:3242% ask them what that will mean in terms of services for kids in your home.
04:37Take Children's Mercy.
04:39It's the children's hospital in Kansas City, serving kids in Missouri and Kansas.
04:4535% of its revenue is from Medicaid, and the hospital operates with a 5% margin.
04:50If you take a chainsaw to Medicaid, families with six kids who trust Children's Mercy will have another worry on their minds.
04:59And in red and blue states, rural hospitals will be in jeopardy of closing.
05:03For what?
05:04For a tax cut for the wealthiest people in America?
05:07Really.
05:08Don't take it from me.
05:10I recently spoke with the CEO of BJC Health, the largest hospital system in Missouri, and a third of their patients are from Illinois, I might add.
05:18I asked about their concern with people losing insurance under this Republican bill.
05:24This is BJC out of St. Louis, Missouri.
05:27BJC Health Care cares for more Medicaid patients than any other health organization in the region.
05:34More than a third of their patients are covered by Medicaid, paying one million visits a year.
05:40It's the same story for SSM Health, headquartered in St. Louis, operating nine hospitals in Missouri,
05:45including the famous hospital Cardinal Glennon Children's Hospital.
05:50SSM's CEO expressed her, quote, deep concerns about the proposed Medicaid changes in the Republican bill,
05:57stating that the Republican bill, quote, threatens coverage for millions of people
06:01and jeopardizes financial stability of safety net providers like SSM Health.
06:07For what?
06:08For a tax cut for the wealthiest people in America, 60% of this tax cut goes to people making over $400,000 a year.
06:17And at the highest levels, $346,000 annual cut in taxes for the richest people in America,
06:24so that we can cut back on these hospitals.
06:27In Missouri, 250,000 individuals are expected to lose coverage under the Republican plan,
06:33resulting in Missouri hospitals facing an increase of $430 million in uncompensated care costs in a single year.
06:41I know these numbers are numbing.
06:43There's so many of them, and they're so big.
06:45But let's get down to the basic message.
06:48Hospitals that are hanging on, rural hospitals, hospitals in the inner city,
06:52children's hospitals, are the ones that are making it barely each and every year.
06:57They're the ones who will lose replacement of funds by Medicaid under the Republican plan.
07:05What would the cuts mean for rural hospitals in Missouri?
07:09Already 10 rural hospitals are in jeopardy of closing.
07:13This Republican bill could be the final straw,
07:15and I hear exactly the same message across the river in Illinois.
07:20I heard this message from UnityPoint Health,
07:22which has hospitals in Illinois and in Iowa.
07:25They told me that Medicaid covers nearly 40% of the children born at their hospital,
07:30and they rely on provider taxes to offer maternal, emergency, and behavioral health services.
07:36If Republicans have their way, these critical services are in jeopardy, and some will go away.
07:41Todd Patterson, the CEO of Washington County Hospital in Iowa, said,
07:46quote,
07:47Medicaid is not a line item.
07:49It is a cornerstone.
07:50When policymakers in Washington slash Medicaid funding,
07:54they're turning off the oxygen for rural health care.
07:58I will tell you, I've grown up in downstate Illinois,
08:00and I've represented it in Congress and the Senate.
08:03These hospitals are critical to the economy of these communities.
08:06You take the hospital out of a community,
08:08you've taken the major employer and a major economic factor.
08:12Try to attract a new business and explain the hospital is two hours away.
08:16Try to keep a new business in town when the hospital is going down.
08:21Currently, 107,000 people in Iowa are projected to lose health insurance under this plan.
08:27It would increase annual uncompensated care costs for hospitals by nearly $190 million.
08:33Republicans in Iowa and Missouri get sick and rely on their hospital just like Democrats.
08:39My colleagues know these Medicaid cuts would be devastating.
08:42And no Band-Aid hospital grant fund that Republicans are frantically trying to create will make up for this seismic hole.
08:49While President Trump said he would protect Medicaid,
08:52he is now pressuring Republicans to make deep cuts in the program.
08:56He's asking Republicans to choose billionaires over hardworking American families.
09:02Now is the real test for Senate Republicans.
09:05Mr. President, I can remember when it occurred during Trump's first term.
09:08Another tax bill, another massive increase in the national debt.
09:13How were they ever going to pay for it?
09:14Well, there was a proposal, a cutback on the Affordable Care Act, Obamacare.
09:20And that cutback was hanging by one vote in the balance.
09:24I was sitting here at this chair and watched as John McCain came through that set of doors at 2 o'clock in the morning.
09:30He was the deciding vote.
09:32John McCain walked to the well and gave a no and saved the Affordable Care Act from Trump's first term.
09:38Now we're going through this scenario again.
09:40Again.
09:41Another Trump tax cut, more cuts when it comes to medical care, particularly for families who are the most vulnerable.
09:49Will anyone rise to the occasion as John McCain did?
09:52We need four Republicans to stand up and say, enough.
09:55Stop penalizing the families of America and the rural hospitals of America and the small town hospitals of America for a tax break for wealthy people.
10:05We're better than that in America.
10:07It's time we need four Republicans with good sense to step up before it's too late.
