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John Thune Rails Against 'Democrat Hysteria' Over Cuts To Medicaid In Big, Beautiful Bill
Forbes Breaking News
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7/17/2025
During remarks on the Senate floor Thursday, Senate Majority Leader John Thune (R-SD) spoke about Medicaid spending.
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00:01
Thank you, Mr. President.
00:02
Mr. President, the Democrat hysteria over Republicans' one big, beautiful bill is in
00:09
full swing.
00:11
And Democrats seem to have fixated on the bill's Medicaid provisions as a useful tool,
00:19
they hope, to attack Republicans.
00:22
And they've decided that a good talking point is to blame rural hospital closures, including
00:26
current rural hospital closures, on our bill's Medicaid provisions.
00:31
Well, there's only one little problem, Mr. President.
00:35
The provisions of our bill, the Democrats would like you to believe, threaten rural hospital.
00:41
Those provisions don't even go into effect until 2028, two and a half years from now.
00:50
Suggesting that those provisions are responsible for rural hospitals closing this month is the
00:54
height of absurdity.
00:57
Mr. President, I said there was one little problem with Democrats' argument.
01:03
But in fact, there are a whole lot of problems with Democrats' argument, starting with the
01:07
fact that rural hospital closures are a longstanding problem, not something that is suddenly being
01:14
triggered by our bill.
01:16
Under President Biden, Medicaid spending soared.
01:20
And yet, rural hospitals still closed.
01:23
Why?
01:24
Because rural hospitals have to deal with a lot of challenges that hospitals in major metropolitan
01:29
areas don't have to deal with.
01:32
Despite those challenges, many rural hospitals are finding ways to adjust, to keep their doors
01:35
open, and to serve their communities.
01:38
And we have taken steps with our bill to ensure that they can continue to do so with a $50 billion
01:44
fund for vulnerable providers like rural hospitals, a fund that goes into effect this year.
01:54
Our goal with this fund is to give rural hospitals and other vulnerable providers the time and
01:58
resources to find solutions to some of the challenges they're facing.
02:03
And to give state governments the time to look at their budgets and develop ways of assisting
02:08
rural hospitals that don't involve pushing state responsibilities onto federal taxpayers.
02:14
Now, Mr. President, hopefully what I've said so far brings some much-needed clarity and accuracy
02:22
to this discussion.
02:24
But I want to step back for a minute and discuss the overall scope of what we're doing with the
02:28
Medicaid provisions in our bill.
02:31
We are restoring Medicaid to what it was originally intended to be, a federal-state partnership to
02:38
support the most vulnerable Americans.
02:42
Let me just repeat that, Mr. President.
02:44
We are restoring Medicaid to what it was originally intended to be, a federal-state partnership to
02:53
support the most vulnerable Americans.
02:57
There's been drift on both of those in the past few years, Mr. President.
03:02
We've drifted from a federal-state partnership to a situation where the federal government
03:07
picks up more and more, sometimes close to all, of the tab.
03:13
And we've drifted from a focus on the most vulnerable Americans.
03:17
Medicaid was created to serve the most vulnerable populations, the elderly poor, the disabled,
03:24
pregnant women, and children in need.
03:28
But in 2010, President Obama and the Democrats allowed states to expand Medicaid to include
03:35
able-bodied adults earning up to 138% of the federal poverty level.
03:40
And they gave states an incentive to do so by promising that the federal government would
03:45
pick up almost all of the tab.
03:47
Combine that with the Biden Administration's Medicaid rules and waivers, and both the Medicaid
03:53
population and federal spending on Medicaid have exploded.
03:59
Medicaid spending has grown by more than 50% since 2019, 50% since 2019.
04:10
That's utterly unsustainable, Mr. President.
04:12
And it threatens the stability of the program for the most vulnerable populations.
04:17
And so Republicans implemented several common-sense measures to slow the rate of Medicaid growth
04:22
and to refocus the program on Americans most in need.
04:27
Note what I said.
04:29
Slow the rate of Medicaid growth, Mr. President.
04:35
We are not cutting Medicaid.
04:37
We are simply slowing the rate of growth.
04:41
And Senate Finance Committee Chairman Crapo noted, only in Washington is a smaller increase
04:49
in spending considered a cut.
04:52
So what did we do in our bill, Mr. President?
04:56
We implemented measures to reverse non-citizens, or I should say we implemented measures to remove
05:03
non-citizens from the Medicaid rolls.
05:06
We implemented an extremely mild work requirement, just 20 hours per week for able-bodied, working-age
05:13
adults without young children.
05:17
We overturned Biden-era regulations that made it difficult to remove individuals who don't
05:22
qualify for Medicaid.
05:25
And we took aim at rampant abuse of the provider tax loophole.
05:29
Now use of this loophole, which sees states inflate Medicaid service prices in order to garner
05:35
a larger reimbursement from the federal government, has been a problem for quite a while now.
05:43
In fact, President Obama proposed multiple budgets featuring measures to rein in abuse
05:52
of the provider tax.
05:54
But states continued to take advantage of the gimmick.
05:57
And thanks to waivers that the Biden administration issued to California and other blue states
06:02
last year, allowing them to further exploit a similar loophole, taxpayers were on the hook
06:10
for tens of billions of dollars in new spending.
06:16
And so we took action to rein things in.
06:19
We are not eliminating states' ability to use the provider tax loophole, but we are instituting
06:24
limits.
06:26
The identical limits, in fact, that President Obama proposed imposing.
06:34
And we are making states take responsibility for their Medicaid decisions.
06:39
States like California, which chooses to spend state funds to have its Medicaid program cover
06:43
illegal immigrants.
06:45
They should not be able to, in effect, have the federal government bail them out for their
06:52
reckless spending decisions.
06:55
Resources are not unlimited, Mr. President.
06:59
States need to shoulder their share of the federal-state Medicaid partnership rather than pushing
07:04
off their costs onto federal taxpayers.
07:07
Now, Mr. President, the net effect of all these measures, like removing ineligible individuals
07:13
and individuals who refuse to work from the Medicaid rolls and restraining state abuse
07:19
of the provider tax loophole, will be able to put Medicaid on a more sustainable fiscal footing
07:28
going forward and put a renewed emphasis on the vulnerable individuals this program was
07:33
actually created to serve.
07:37
Vulnerable individuals will also be helped by the major investment our bill makes in expanding
07:41
home and community-based services for individuals with developmental disabilities.
07:47
This will reduce multi-year waiting lists for services and allow individuals with disabilities
07:52
to access the care that they need at home or in their communities.
07:59
Mr. President, the one big, beautiful bill was developed to make hardworking Americans safer,
08:09
stronger, and more secure.
08:12
When the Medicaid provisions of the bill fit right in with that mandate, by refocusing available
08:19
Medicaid dollars on those this program was originally intended to serve, we will make
08:27
vulnerable Americans more secure and ensure that this program will continue to be available
08:35
to Americans in need long into the future.
08:41
That sounds like a good day's work, Mr. President.
08:44
Mr. President, I yield the floor, and I suggest the absence of quorum.
08:47
Mr. President, Mr. President, I yield the floor.
08:51
Mr. President and Mr. President, I will have a good notice to ask a prayer.
08:52
Mr. President, I shall virtually in this program back now.
08:54
Mr. President, I yield the floor once a quarter for Forced of ٍ車, as we shall
08:55
be shown.
08:57
Mr. President, I yield the floor here above 4, 7 seconds tomara 1.
08:57
Mr. President, if I yield the floor for the reserve.
08:58
Mr. President, it is a tribute habr, and I F.
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