- 6/27/2025
Rep. Victoria Spartz (R-IN) talks to Brittany Lewis on "Forbes Newsroom" to discuss the medical cuts in the Big Beautiful Bill.
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00:00Hi, everybody. I'm Brittany Lewis, a breaking news reporter here at Forbes. Joining me now
00:07is Congresswoman Victoria Sparks. Congresswoman, thank you so much for joining me.
00:11Thank you for having me, Brittany.
00:13We have a wide-ranging, very important conversation today. I do want to start
00:17with President Trump's one big, beautiful bill act. It holds his hallmark tax and immigration
00:24policies of his second term, and it was delivered a potentially big blow today by the Senate
00:30parliamentarian. She is blocking on Thursday key Medicaid and student loan repayment provisions
00:35in the bill. What's your reaction to her move? Well, unfortunately, you know, this bill is getting
00:42less and less beautiful, but there are some good parts of it, and I hope it's going to be fixed in
00:47the Senate. So I think it's oversight of the senators, you know, because I just do not believe
00:53you cannot write provisions that directly affect federal budget. The actual reconciliation process
00:59was designed, never actually designed to increase spending or do tax cuts. It was designed to deal
01:05with spending reductions. So how can that not be in order? It means that it either wasn't written
01:11correctly or it was done intentionally. There is some other reason. So I hope senators will make it
01:16work that we actually can pass this bill and have some growth of the economy, bring some stability and
01:22predictability, but also at least incrementally dealing with all of the fraud and abuse in our
01:27spending because we're going on the path of fiscal calamity. We have to deal with some of that stuff,
01:33and I think that has to be fixed for that bill to be able for them to pass it in the House.
01:38I do want to talk about who exactly the Senate parliamentarian is. She's someone most Americans
01:43haven't heard of. The role's nonpartisan in nature. Her name is Elizabeth McDonough. Her role is to
01:50interpret the Senate chamber rules, especially as they pertain to the reconciliation process.
01:55She says this violated the Byrd rule, meaning that they aren't policy rules. They don't pertain
02:01to the budget. So you're disagreeing with her characterization. Talk to us about that.
02:07Well, how can something that has hundreds of billions of reduction in spending don't affect our budget?
02:16This is hypocritical. You know, it's like when we wanted to skirt the rules, the House say day is not
02:21a day in our rules so that we don't have to vote. It's something that Congress required to vote on. So
02:27it's really, you know, very, you know, dishonest to say that. You know, if there are some little words in
02:34there, you know, I'm surprised as, you know, sometimes what, you know, I work with parliamentarians
02:38a lot and usually when I work on legislation amendment, I run it by them. And if they have
02:43some words or concerns, you know, sometimes it's just very simple items to usually address it. So
02:48I wouldn't, I'm surprised that comedians wouldn't address it because in concept is this items that
02:54directly affect federal budget, not just a little bit, hundreds, billions of dollars, you know,
02:59of fraud, you know, and overspending. So I think they need to work on fixing it and find a way how
03:06to make it work right. But if you look at her rule, it was very interesting. Her rule seems very political
03:11because when Democrats ran a lot of spending on discretionary reconciliation, which didn't even
03:18make sense, it never happened before, you know, that it's actually some of the spending they passed,
03:24you know, that she ruled they were in order, you know, and that is actually never when reconciliation
03:30was designed for it. But it seems like every time Republicans are touching something, especially on
03:35health care, you know, she rules always that it's not in order because it seems like that may be her
03:41personal views. And he wants, you know, government controlled health care, which is go bankrupt in the
03:47country right now. So because that seems very strange. And if you look at her views and how she was
03:52appointed and how she rules on Democrat reconciliation versus Republican, I'm not surprised that some of
03:59my colleagues in the House and the Senate calling maybe she should be fired because she's doing
04:03political. She's not nonpartisan, I can tell you based on her rulings. So they need to either figure
04:08out to address it if there is some voting something, you know, or really get rid of her and find someone
04:14who's actually just looking at the latter of the law and rules, not doing political opinions.
04:19I hear how frustrated you are. Democrats were frustrated with her back in 2021 during a debate
04:26on the American rescue plan. She said that raising the federal minimum wage did not comply with the
04:32Byrd rule then. Vice President Harris decided not to overrule her, so the minimum wage bump was taken
04:38out. And Senate Majority Leader John Thune said he's not going to overrule her then, or now rather. So how do
04:46you think that the Republicans fix what is happening with Medicaid right now? Because that is one of the
04:52biggest points of contention when it comes to this bill. But there is a big difference when you try to
04:56regulate businesses through federal budget and reconciliation in mandates, you know, versus where
05:03you actually say we are going to limit some of this overspend and fraud and abuse in direct government
05:10spending that goes through our mandatory spending. So there is a huge difference when she ruling items.
05:16Of course, that makes sense. You know, the Democrats, a lot of things that actually, they were able to
05:21pass reconciliation where they were able to move discretion into mandatory spend. It never happened
05:27before. They ruled that it was in order, which was really never meant to be. I understand they went so
05:32farthest that regulated businesses through reconciliation. So that was not a direct budgetary
05:38impact. That was a true policy change. You know, here is we dealing with where we are funding Medicaid,
05:47where states have to be our partners and they have skin in the game. They are defrauding the federal
05:54government, cooking the book, providing Medicaid to ineligible people, you know, not doing the match,
06:01do a scam that Biden call a scam through provider taxes. So the federal government now pretty much
06:07paying most of it versus, you know, being a party. So they're not the partners. And then they overcharge
06:13the people and Medicaid cut services, but get payments at the level of private insurance. What
06:19hospitals and insurance get like a private insurance rate and split the profits, but people don't get the
06:25benefits and now we'll go bankrupt. So this is a direct budgetary item that was actually we are paying
06:32through our mandatory automatic spending. So there is a huge difference. If there is something in the
06:38warding, sometimes where they brought something like this is applicable to this section and all other
06:44sections. So if there is something in the warding like that, you can delete that warding sometimes,
06:48but that something should have been worked out with parliamentarian. I had some amendments and language.
06:53I work in the house version, you know, that we fix it. And it was interesting to me because when we
06:59sent the bill to the Senate, actually kind of informally was told us, so all our language was fine.
07:06The language would meet parliamentarian requirements. So this other was dishonesty.
07:10Who told you that? Who said, you know, that was kind of, that was kind of said to us and informally
07:16through the Senate. So like some of the provision I work, I even ran by that. So it's either that was
07:21dishonestly said, either something was changing the Senate, you know, or, you know, for whatever
07:28reason, maybe on purpose, not on purpose, or this is just a politics and no one wants to do it. And
07:33it's a good excuse to take some key provisions. And unfortunately, you know, that's not going to
07:39work because we have, it's not going to pass in the house for them. You know, that's not going to work.
07:43As we sit here right now, Senate Majority Leader John Thune, as I said, it seems like he's not
07:49overruling this. So there's two options. It's either tinker with the wording, change the wording,
07:54or strike out these Medicaid cuts completely. Is there any indication of where Republicans are
08:00going to go in the Senate right now? Well, I know that some senators that I talk to,
08:04they're working to fix it. And you know, but if they strike out this big offsets on fraud and
08:10defrauding the federal government and the people in Medicaid, by large cartels making a lot of money
08:16on it, I mean, truly, we create healthcare cartels now, you know, then if they're going to do it, it's not
08:21going to pass in the house, they are not going to get the vote in the house, because we're going to
08:26increase significantly spending, and we're going to be increasing, you know, our decrease in revenues,
08:33and gross is not going to upset it. So then they will have to go to plan B or C or D, whatever,
08:38I don't know at this point, you know, have a more narrow pass, you know, legislation, which I know
08:43that a lot of people don't. And we'll deal with some of the extensions of tax cuts later, because
08:49ultimately they cannot increase so much, decrease revenue, increase spending at the same time,
08:56and deal with spending offsets. I mean, something has to happen there. And if they take Medicaid out,
09:02it's not going to be enough even to break even, not to add to deficit.
09:07Democrats say this is blocking more than $250 million worth of cuts to Medicaid. And those cuts,
09:13in part, were meant to pay for President Trump's promises here when it comes to expanding the 2017
09:19tax cuts and border security. So without these Medicaid cuts, how are you going to pay for those
09:24promises? I want to make sure that we don't misrepresent what it is. There is no cuts we're
09:30doing to Medicaid. I want to just explain what really the House doing right now. So the state's
09:36original, it was supposed to be partners to do our match. They do the match, and depending on the,
09:43you know, the poverty level states, some of them have higher federal matches, some lower.
09:48So the states that cooking the books, defrauding the federal government, create fake taxes.
09:54I just want to interrupt you for one second, just so we're on the same page. When you're saying
09:58cooking the books, I mean, name names, who are you accusing? All of the majority of the state cooking
10:03the books, including my state, the state of Indiana is one of the abusers. So majority of the states
10:08that have provided taxes. Are these no name, are these no name government officials? I mean,
10:13who specifically are you talking about? No, this is the states, the state legislature,
10:17the state's governors, the one who run in the state. So they would be the states that been using and
10:23abusing the system to get money from the federal government. And some of them doing to the point
10:29of insanity, like New York, now they start even giving Medicaid to illegals, which never, you know,
10:36you know, allowed to do that. So what there are three things that states are doing, since when they
10:40don't have a fair share, fair skin in the game and pay fair share of the match, they have a perverse
10:46incentive then to enroll a lot of people. They have a lot of stakeholders in the states that making
10:52money, lobbying state legislature, and state legislatures give them perks left and right because
10:59they can create the tax, new tax, which will allow, by using federal match, will allow them to make
11:07money. The states will make money, the provider like hospital will make money, and the federal government
11:12is going to lose money. So they're not really, they're using it defrauding as a scam. So that's
11:18how they get larger federal reimbursements. So the federal government keep increasing the amount of
11:23spending, but they don't really go even for the benefits. It's really make profits between insurance
11:28and hospitals in the states, and legislatures heavily lobbied to do that. So they don't have to use their
11:34budget, you know, to complement, to do their fair share of payment. That's why the states are not
11:41dealing with Medicaid. That's why they have where seniors in nursing homes don't get the care,
11:47but they allow hospitals to use Medicaid dollars to build Taj Mahals that they're supposed to go to
11:53nursing homes. Billions of dollars, the state of Indiana, actually one of the abusers, my state,
11:58a lot of states are abusing. So the provider tax has really been so widespread and it's become really
12:05defrauding, a scam. Biden used to say it's a scam, so we need to stop that. Then we have another thing
12:10that Biden invented. That's true insanity. They use a loophole and the Obamacare to allow now
12:18that automatically for the states to bill federal government and private insurance rate for Medicaid.
12:28So they're cutting the benefits, but on top insurance and hospitals billing at private insurance rate,
12:36you know, through the state-directed payments. So we try at least to limit that to Medicare rate.
12:44Even they shouldn't be getting them at all. So that's what we're trying to do. That's a true fraud.
12:49And then, you know, try to put some requirements so ineligible people are not on Medicaid and also the
12:56people that don't work, that should be working, that not using Medicaid because it meant for people,
13:02for poor people, people with disability, for children, poor children. So that's what was intended,
13:07where the state should be a part of the federal government. But when they don't have to pay their
13:12part, they're not. Some of the expenses, administrative expenses, pay 100% at the federal level. So they
13:19have this luxury computer conference with some of the lobbyists over there. The state, they pay enormous
13:24amount of money. So this needs to stop. So we try to make sure that the states start doing a better job
13:30and pay their part into Medicaid. So there is no one there cutting anything. I want to make sure we
13:35try to clean up and save Medicaid for the people who that actually should be getting it and better Medicaid.
13:42Congresswoman, I feel really lucky in my conversations with Republicans and Democrats
13:46in the House and Senate alike. I've talked a lot about Medicaid and that is the most contentious issue
13:52by far in my conversations regarding the One Big Beautiful Bill Act. And both sides of the aisle
13:58agree that there could be waste, fraud and abuse when it comes to some people using Medicaid. But
14:06the CBO, which is nonpartisan, says that the Big Beautiful Bill that was passed in the House
14:11will leave more than 7 million Americans uninsured over the next decade based on the cuts of how they
14:18were passed. I mean, are 7 million Americans, more than 7 million Americans who were using Medicaid,
14:24is that all waste, fraud and abuse? Is that more than 7 million examples of that?
14:29So we need to decide what part of insurance is for what. So Medicaid is meant for people with
14:36disability. That's what we need to be Medicaid, right? We have to decide where part of insurance
14:41it needs to be, right? So in which scope. Then we have a different conversation. You know,
14:47what is the people, how people can get affordable insurance and why we don't have affordable insurance.
14:52Actually, moving people from Medicaid, from Obamacare, Medicaid became so expensive,
14:57would save us probably half a trillion dollars, you know, to the federal budget. That's how bad it is
15:02because states don't even control it because they don't have to. Right now, federal government
15:07are writing a blank check and states are running wild. So we're trying to say like, okay, this is people
15:13who are not eligible. We are not, we cannot provide Medicaid for people who are here illegally.
15:19We need to make sure that people who get this Medicaid, you know, that, you know, they meet
15:24their work requirements. So try to get jobs. So make sure that these people move up in life,
15:30not stay and use it in Medicaid. You know, so this is the things where the CBO is looking.
15:35But the big ticket items right now is that is really big and why they're important to look,
15:41it's where stakeholders, you know, insurance in hospital overbilling Medicaid at rapid rates.
15:49That is actually the biggest fraud and abuse in the system that we don't talk enough. They're
15:54building Taj Mahal, don't pay taxes, make a lot up to executives and allowed to overbill because they
16:01have the state directed automatic. It's like an open credit line where they can just draw the money and
16:08the Biden administration just ran it wild. I mean, they ran it wild, used COVID to enrich so many COOs
16:15of this cartels. That is unbelievable. Then they buy physician practices further and further. Then
16:22under law, physicians even cannot own, you know, hospitals, but hospitals can own physicians.
16:28They control rural areas, closing hospitals, and every time what we to do something,
16:33they threaten legislators and try to intimidate us. But then they don't want hospitals to be owned in
16:39rural areas by, you know, doctors. So that seems hypocritical. They don't want to do business
16:45and they don't allow anyone to do business. So it creates scarcity, no access to healthcare and
16:50ability for them to overbill. And that's why a lot of Americans are bankrupt and not getting the bad
16:55services on healthcare. And we don't have a competition on the market. So it creates a lot of
16:59perverse incentives. So we have to fix Medicaid and make it better for people that actually it's
17:05meant to be. We need to make nursing homes better. We need it, which actually not even dealt in this
17:11bill. It's not even dealt with this bill. Provided taxes on nursing homes were excluded, which one of
17:16the biggest abuses in the system. So we need to fix it. But then also we need to fix healthcare. And I
17:22hope it could be a bipartisan conversation because we either were going to have to go to Medicaid for
17:27all as Bernie wants, or we'll create more competition for value. We are one of the,
17:33we spend more than any developed country in the world per person. And we have way worse outcomes.
17:40That's just unacceptable. I think that's something that a lot of people want to talk about,
17:46fixing healthcare in this country. I don't think anyone is too happy with that. I think that can be
17:49a bipartisan agreement. I do just want to ask because I heard you say something that sparked my attention.
17:55When you said they're threatening legislators, who's the they and what exactly are they threatening?
18:00Lobbys, hospitals, lobbies to close rural hospitals. That's what they, we start moving some stuff.
18:05They pretty much bought hospital cartels, almost have every lobbying and legal firm here on their
18:12retainer, have army of lobbies. Actually, that was just reported, I think in one of the newspapers,
18:18maybe political or something. They spent eight and a half million just in the last quarter,
18:22lobbying here. They're running around and tried to intimidate my legislator. Oh, if you do something
18:28and take any money from cartels that have billions on Wall Street, invest billions in foreign countries,
18:33pay no taxes, pay millions to CEOs and their staff, that's where we have now 10 administrators per doctor.
18:40You know, they intimidate everyone. Oh, we're going to close rural hospitals. We're going to close rural
18:44hospitals. And everyone is afraid, right? They threaten us. And they said, okay, if they don't want to do
18:50business, why don't we try to allow physician-owned hospital that will prohibit it to provide Medicare
18:56and Medicaid in rural areas or near areas under Obamacare, why don't we let them do it? You don't
19:02want to do business, okay, then why don't you let doctors to do business? People have no access to
19:07health care in these areas, but they lobby not to allow to do that. So that's a total hypocrisy,
19:13and it's a total lobbying special interest to hold us hostage. They spend three times more
19:19money on lobbying here than defense lobby, and between healthcare, PBMs, hospitals, insurance,
19:25and, you know, this is, you know, it's almost impossible to move healthcare. This has became
19:30so corrupt, and, you know, my legislators need to grow the backbone to deal with that,
19:35and they spend so much money on running ads and lies, and unfortunately, it's been working.
19:41Congresswoman, I know one thing from certain based on this conversation is that this is a
19:46significant setback for the One Big Beautiful Bill Act, but President Trump is still, as you and I
19:52sit here right now, that could change, but as of now, it seems like the administration wants this
19:56still on his desk by the July 4th deadline. This barely passed through the House. It seems to even,
20:03as of right now, have a more delicate dance in the Senate, and you said it won't pass in the House
20:07if the Medicaid cuts aren't in there. I mean, what are the chances of this making that
20:13imposed July 4th deadline to President Trump's desk?
20:16They need to fix this Medicaid fraud. I mean, this is truly insanity. The countries go bankrupt,
20:22and at least need to bring to something to what we had, at least a break-even situation. You know,
20:27at least what we passed in the House, it was with assumption of gross and pretty, you know,
20:33significant assumptions, but I hope we'll have that gross, and we need gross. You know, at least
20:38that it did break even situation where we don't add to deficits, because it's extremely important
20:43within the current dire situation with our national debt not to add to deficit, and it's important for
20:49the market, and it's important for the economy, and really for our treasury bills and everything else,
20:54because it's becoming almost a debt spiral situation if we're going to continue on this path.
20:59But I think there are a lot of good parts in the bills that are good, you know, and I think it's
21:05important for look at some of the stuff that needs to happen. So I think Senate, if they truly want
21:11this bill to pass, they need to fix some of this, you know, the provision that their parliamentarian,
21:18you know, told that it was not in order. They can be fixable because they have budgetary provisions,
21:23so if they cannot, if they cannot make something in order that directly affect hundreds, billions of
21:31dollars of spending, then why is this reconciliation even for? Then it means that they didn't work hard
21:36enough, so the Senate needs to work harder to do the right thing and not to be afraid to do the right
21:41thing. Congresswoman, I want to make a complete left turn just for a few minutes and pick your brain
21:47about recent activities regarding the situation in the Middle East. President Trump announced that Israel
21:52and Iran reached a ceasefire agreement after a really rocky two weeks in the region. The United
21:58States, over the weekend, dropped bunker-busting bombs on multiple Iranian nuclear sites. Iran
22:05responded with an attack that was symbolic in nature on a U.S. airbase in Qatar, and the ceasefire
22:12appears to be holding now. What we do know, though, is that your party seemed a little bit divided
22:18on the strikes. I know that you're supportive of them. Some members of your party, not so much.
22:23What do you make of what's unfolded in the last couple of days? Well, I think, you know, listen,
22:28I think President Trump understands that peace can be only achieved to strength. And America
22:33has been doing a lot of talk and a lot of other presidents and not really doing the work in dealing
22:39with Iran. It's very dangerous for countries that finances terrorists, has a very aggressive,
22:45offensive ideas, you know, about destruction of countries in their areas and really anti-American
22:51ideas, onto Muslim ideas, onto Jews ideas. And there are a lot of aggressive, you know, people
22:56there in the Middle East and with nuclear weapons. So I think that's something that Iran should have
23:01never been allowed to do, which was actually said all of the president, not just President Trump,
23:06President Bush, President Obama, President Biden had made the same statements, that Iran shouldn't
23:10have nuclear weapons. Well, President Trump understand that talk is cheap. And, you know,
23:16he needs to make sure that Iran is going to get to the table and stop doing what they're doing,
23:21because they're getting closer and closer to nuclear weapons. After all of these talks, no one
23:25achieved anything. So I think he needs to send the message that it's going to be serious. And if Iran
23:31is not going to do it voluntarily, that we're going to intervene in this situation. And I think that is,
23:37you know, that's something he had to do. So they understood that we're serious. So I hope that
23:43they got the memo and they're going to have a negotiations because Iran is really the most
23:49destabilizing country in that region. And really, they need to come to census and stop destroying so
23:55many lives. And I think a lot of countries, even in that regions, are tired of that. And their
24:01finances, so many bad people there, it's just not good.
24:04And what do you think an agreement looks like? What do you think diplomacy looks like when it
24:10comes to the United States and Iran? What's the next step forward?
24:13Well, I think, you know, the first thing, you know, that president needs to make sure
24:18that, you know, Iran is going to give up on the idea of having nuclear weapons. And we need to make
24:22sure that we, you know, Iran reassures us, not just reassures that we have a way to know that,
24:29because that's something that they're not being very honest. And there was very little access to the
24:34country. You know, and then, you know, it's very difficult to deal with governments that in that,
24:39you know, region or some other regions that really, you know, have not very good ideas how they want to
24:46treat their people and economy, you know, but we have to deal with them. And ultimately, people decide
24:51what government they elect, and people decide what the price they're going to be paid for this
24:56government. But then we'll need to have a discussion how Iran could, you know, be stopped
25:01destabilizing the Middle East and finance terrorist groups, and what things we can bring to the table.
25:07And I think President Trump is a good negotiator. And, you know, so I hope that Iran will want to
25:14understand that they can empower their people more, not fighting with everyone. They're very wealthy
25:21country with lots of resources and that people are suffering there because they have bad leaders.
25:26And ultimately, that's a choice to make. But for us, the most important thing that they stop
25:30financing terrorist group and destabilizing the region and try to initiate wars and try to have
25:36weapons. That's the most important thing, I think, for us and for our national interest, because we've been
25:42dealing with the Middle East for a while now. And it would be nice to not to deal with these wars in the Middle East.
25:48Congresswoman, I really appreciate your time today. Thank you so much for offering your perspective
25:54on these really important topics. I hope to have you back on again soon as each situation really
26:00develops. Thank you for the time. Thank you for having me. Always a pleasure.