you'll not lose your medicaid. if you're on medicaid, you are grandfathered in. the future of medicaid .nrollment is as access to places like i mentioned before. places that have already said we have to take a look at how many medicaid recipients we are and weg because the cost .an only take so many brooklyn park, minnesota. were -- michelle's wedding. so wonderful're and logical. caller: he talks about medicaid and excited well and the changes. i think the government has to of drugs for cost medicare and medicaid. the insurance companies and pharmaceutical companies keep on saying if they do, that will hurt development. c-spans a gentleman on saying pharmaceutical companies are spending more on marketing. -- more than the jug. guest: it is unfair that american soldiers -- americans put the entire bill for these drugs. cause.talking about it happens to be very close to my heart. these are adding almost $50 billion for adapting all. in fact, the numbers higher because in every state, the doctors don't put hospital infection on the death certificate. they are not r

in medicaid, that is quite widespread. is the captain medicaid like managed care? >> i will jump in and answer that. i'm sure, it's very unlike managed care. they use managed care for the chip program and medicaid programs. they set rates at a regular time and adjust rates based on the acuity and the needs of the populations that are served. they take into account policy changes, healthcare changes and they are constantly re-examining their rate. in the bill, it's set based on spending from years back, suggested by a national trend rate that is not related to the actual needs and cost of serving people in that state, and it doesn't adjust based on acuity. >> what is going to happen to benefits and provider revenue? >> states have three major levers to do significant reductions in the medicaid program. enrollment, provider payment rates and benefits. i think likely with the kinds of changes that are proposed, all three will be relied on by states. if you think about going to provider rates which is maybe the first place they will turn, we worry a lot about access. i

range of medicaid beneficiaries. in contrast, they offer greater flexibility to design programs in which families retain a measure of responsibility for the cost of the child's care. most families pay an annual enrollment fee, and all families make copayments for office visits, prescription medication, inpatient hospital care, and nonemergent care provided in an emergency room setting. it's a critical part of the healthcare safety net in texas offering a healthcare benefit to children who do not qualify for the medicaid program. texas overall experience is that ship chip simply works. it provides reliable and medical benefits to the population at a rate of $156. member. month which is $67 less on a. member basis than the cost of coverage for the state's medicaid population. the states quality data also offers evidence of the efficacy of the program, indicating a 21% increase in children age 3 - 6 accessing well-child visits and a 90% increase in children receiving recommended vaccines in the first two years of life f

chip stands on the shoulders of a strong medicaid program and in fiscal year 2016, medicaid provided more than 40% of the community health centers funding. they are tied together as three legs on a stool that help children get health care they need. no child should be left off course because the congress actions. with that i would like to yield one minute to my colleague from massachusetts, joe kennedy, and after congressman kennedy i yield the remainder of my time. >> thank you. ladies and john, anyone who has welcome the child into this world knows that moment when you lock eyes with your son or daughter the first time. the promise that you make to protect them under any circumstance. you learn quickly that the matter how hard you try, nature will test the strength of the promise. children are not immune to unexpected accident or life-threatening diagnosis. we as a country in a community invest in their care through chip, medicaid and a ban on lifetime caps and a strong community health care center. it is our recognition that society are the precious resource that brings us togethe

who uses medicaid? america uses medicaid. children, the elderly, hard-working families, people with disabilities, people struggling with addiction. at any given moment in thisvery country, one in every five americans is counting on medicaid to help pay the bills. so what are these people supposed to do when the medicaid expansion goes away? when this bills additional massive medicaid cuts go into affect? what are they supposed to do? what are their families supposed to do? opioid one issue around this, digging on opioid induced. this is a problem that is growing around the country. last year we lost 2000 people in massachusetts alone.ts i hear from parents who have lost children from brothers and assisters who have watched a loved one disappear. i get from people who are desperate because their child or sister or brother can't get into a treatment facility. i hear from dedicated doctors and nurses and counselors who need more resources so they can expand treatment programs. rep and now the republicans propose a bill that is l

this bill takes a machete to medicaid. it abandons people with preexisting conditions, punishes grandma and grandpa who live in a nursing home including 25,000 seniors, nursing homes who are on medicaid. it causes the single greatest rollback of civil rights for people with disability in a generation, by taking away the funding for those with disabilities. it creates an age test for those over the age of 50. it shreds a critical healthcare program for the disabled, working families, children, just to bestow billions in tax breaks for the wealthiest. this is an amazing number. the richest 400 billionaires in the united states, a tax break of more than $33 billion which is roughly equivalent to the cuts for ending medicaid expansion in four states. there are 700,000 people in just those four states that can be kicked off of their health insurance coverage to benefit just 400 billionaires in america who do not have to worry about their healthcare or family's welfare. for those who are going to lose the coverage, people with c

they did not expand medicaid. you do not qualify for the subsidy and your state not expand medicaid -- an. that is one thing about the plan that would drop the subsidies down. to 400% of poverty, which is around $48,000. the republican plan would take it down to zero. it is one benefit that people have pointed to. guest: the cbo said even if they got help playing their premiums, they would be responsible for their own health expenses, it would not help them that much. host: you can find more on kaiser health news. these guests and the staff at kaiser health news have been writing about it for years. kerry is in wisconsin, insured through medicaid. because --m calling for one, it infuriates me that they talk about the health care bill. it is not about health care. it is about health insurance -- who gets paid, how they get paid . it has nothing to do with health care other than access to it. to be able to get it, you have to afford it. the problem as i see it right now, a lot of people i know are on medicare. they

we have to reform medicaid. and secondly, if you need help with hospital infections, if you're going into the hospital and want to protect yourself from this terrible risk, please come to hospitalinfection.org. we only have one goal at hospitalinfection.org, and that's to save lives. >> betsy mccaughey, appreciate your time as always. come back again. >> thank you. >>> c-span's "washington journal," live every day with news and policy issues that impact you. coming up friday morning, role call's neal brzezinski and gabby mor morengelo debate health care, and also usa today contributor and ethics expert alicia shepherd discuss the rising tension between the media and the trump white house. be sure to watch c-span's "washington journal" live on friday at 7:00 a.m. eastern. join the discussion. >> next, former acting medicare and medicaid administrator andy slavitt on the potential impact of the senate's health care bill. from the "washington journal," this is 40 minutes.

>> these are not cuts to medicaid. this slows the rate for the future and allows governors more flexibility with medicaid dollars. they're closest to the people in need. medicaid imperate, its founng was m to he the poor, sick, needy, disabled. children, some elderly. women, particularly pregnant women. we're trying to get medicaid back to its original moorings. >> i don't know how you can say the more than $800 billion in savings is not cuts. you don't have to take my word for it. it's the republican senators you're facing right now who have that problem. led by senator dean heller. he said he's voting no. here's what they said. >> first, it doesn't protect nevadans on medicaid. second, the cuts to medicaid threatens critical services in nevada. services that a lot of nevadans depend on. >> i cannot support a bill that's going to make such deep cuts in medicaid that it's going to ship billions of dollars of costs to our state governments. >> so these senators are the ones saying these are medicaid cuts. is the preside

a strong medicaid program. you can't reach out with one hand in the guise of reauthorizing chip while cutting a trillion dollars from medicaid with the other. you just can't have it both ways. i yield back. >> the gentleman from new jersey goes back to the chair makes a technical observation of s-chip until the fiscal year 2019 as to whether accomplished in the affordable character funded through fiscal year 2015 that this is the second funding bridge that is how to occur because of the fiscal cliff villas built into the aca. we now stand adjourned until immediately -- in recess untilco immediately after the last vote. [applause] found not -- [inaudible conversations]

medicaid is their ticket to health insurance. and the republicans have decided to put a cap on the amount of money that will be given to states and republican governors like the governor of nevada.the governor of ohio. the governor of illinois said this is a disaster for the state if we do it. >> so nowhere in the comments to hear and answer the question of, is not medicaid expanding at an unsustainable rate? and does not something has to be done for budgetary reasons long term and short to curb the growth of this program and others like it? >> let me tell you what is expanding at an unsustainable rate.that is the notion of people would not have health insurance under this republican approach. let's face the reality. even if you do not have medicaid, even if the republicans are successful in cutting back. people get sick and go to the hospital.a stately kentucky, one of the largest expenses of medicaid, if they eliminate the medicaid funding, it will be 165 percent increase in kentucky in uncompensated care. it will be medical ca

cracks -- >> i hope they will change the medicaid. enrollment is so large and the cost is so great that it is threatening the existence of the safety net and access to care who should be guaranteed health care under medicaid. democrat --ink the is that something they will negotiate on? >> unfortunately, the rhetoric suggests that the democrats are willing to discuss this issue. i'm shocked when i hear someone ore senator bernie sanders chuck schumer in mean bill. hillary clinton labeling death policy.the on many people should not be medicaid? -- let me point out that right now one out of every two women who give birth has medicaid pays for an half. 75 million people are currently enrolled and according to the congressional budget office, unless these forms are number is not a safety net. it is really endangering medicaid for people who needed the most. the hospitals for example are able to keep the doors opened because they shift the costs over two people who have -- what isinsurance happening is medicated is isting so big that the co

who uses medicaid? america uses medicaid. children, the elderly, hard-workingfamilies, people with disabilities, people struggling with addiction. at any given moment in this country , one in every five americans is counting on medicaid to help pay the bills. so what are these people supposed to do when the medicaid expansion goes away? when this bills additional minutes massive medicaid cuts go into effect? what are they supposed to do? what are their families to post to do? it depends on one issue on this, dated on opioid abuse. this is aproblem growing around the country. last year we lost 2000 people in massachusetts alone . i hear from parents who have lost children, from brothers and sisters who watched a loved one disappear. i hear from people who are desperate because their child or sister or brother can't get into a treatment facility. i hear from dedicated doctors and nurses and counselors who need more resources so they can expand treatment programs. and now, the republicans propose a bill that is like throwing gas

number three, medicaid cuts. helperd is a lifetime for families across our country. ,ore than 70 million americans nearly half of which are children, depend upon it. it is clear that trumpcare's cuts to the program, that republicans want medicaid to flatline. for a program that covers more than 1/5 of the nation's population including the sickest, the oldest, and the poor amongst us, medicaid is especially irreplaceable. have an ancient animosity towards medicaid. restructureneed to medicaid's financing to help control the program's spending and make it more efficient. that is another way of saying to americans most vulnerable, that you are not just as important as those who donate to our campaigns. rating the medicaid coffers achieves two goals for republicans and president trump. it tears holes in a critical social safety net for more than 70 million low income and working-class americans. second it provides the gop with an open checkbook to pay back their donors with huge tax breaks. to referns might want to t

the medicaid expansion is gone. ripped up and flushed down the toilet. the rest of the medicaid progr program, for senate republicans it wasn't enough the hospital was going to toss grandparents at a nursing homes or/funding for people with disabilities, or pull the plug on healthcare's on babies weren't in soon. republicans wanted to go bigger. the republican bill claims to protect kids with disabilities by leaving them out of the calculations that decide how big the medicaid cuts will be in each state.ng i don't know if the republicans were expecting a round ofding applause for pitting kids with the breathing tubes against vulnerable seniors or someone needing treatment for addiction, but i know this exemption won't do a thing to help these kids. for the republican cut still/hundreds of billions of dollars from medicaid leaving states with no choice but to cut services that kids with disabilities desperately need. medicaid is the program that provides health insurance to one in five americans. are 230 million kids, to nearly two out of every three peop

your administration continues to talk down, criticized medicaid expansion and suggests medicaid.e went on to say clicking away medicaid would make this bike more difficult. i don't want to imagine the number of overdose deaths we would've had in ohio if a republican governor, and i'm proud of what he did. he's gotten criticism from president trump and your party, if he had not expended medicaid . the budget proposal you're putting together cuts medicaid by $600 billion. in addition to the house aca repeal which cuts medicaid by 100 billion. medicaid covers a third of all substance abuse treatment and communities across ohio. in ohio, it covers 50 percent of all assistance treatment. you sit in front of us, you have taxpayer funded insurance. we have taxpayer-funded health insurance. the 200 republican plus members of the house who have taxpayer subsidized health insurance are all willing to take it away from these 200,000 ohioans getting opioid treatment. your policy proposals, you say you are interested in fighting opioid epidemics. your policy proposals tell a different story.

and that's what medicaid is all about. medicaid is called a lifeline. but for people like my son, medicaid is a life. through a medicaid waiver, we are enabled to keep mike at home and to care for him by a family who loves him and who knows his needs best. if you take away medicaid from individuals like my son -- and my son in particular -- there would be no place for him. in the state of florida, there are no facilities for individuals who cannot be weaned from a vent, which is how mike breathes. he would be forced into an institution not even here in the state of florida but somewhere else in the country. his other option -- and we have seen other individuals with vents who have been in hospitals and had nowhere for them to go. and this is at an extreme cost. my son doesn't want to live at our local hospital. he doesn't want to be out of state in an institution. he wants to stay at home, and we want him to be at home. it's amazing that after all these years, i would have to fight to spend less money. >> so, karen, you're saying that the way this works

veterans, medicaid is the only source of coverage. many of them are eligible for va care only for the injuries they sustained in the military, but not for any of the other health needs. remind i shouldn't have to run my colleagues that veterans are at a high risk for serious health issues because of the sacrifices they made for our nation. yet, if trumpcare becomes law, many of them will lose their coverage that they gain from medicaid expansion under the aca. s right now 13 republican senators are sitting behind closed doors in some secret room on capitol hill gambling with the lives of millions of americans, people have honorably served their country. one of those lies along stew robert schmidt, a veteran on the north side of chicago. robin served during desert storm in army military intelligence robin loved her job in the military because it has always been her dream to serve her country pick as a 13-year-old girl, robbins to stood at the vietnam veterans memorial wall right here in washington, d.c., and she knew that serving her c

the ahca death with medicaid. medicaid is a program that is growing rapidly and could implode in so what we decided to do when we very carefully sat down and walked through the ahca is how to move forward.n this principle way of moving fur -- there's a block grant option the bill but the principal way was on a approach to medicaid that in the 1990s was bipartisan. matter of fact every sitting member of the senate who was in the senate in the 1990s on the dem crack site, signed a letter to president clinton supporting an option of going to per capita allotment, some being key ranking members and leadership on the other side. medicaid over the next ten years under the proposal will grow, not cut, will grow by 20%. so i want to make sure the record reflects more than some of the rhetoric we have heard. first, miss snyder in addition to basic medical benefits texas chain program includes behavioral health services,wi vision examples and corrective lensing, hearing examples and hearing aids, physical occupational and s

in medicaid. he went on to say taking away medicaid would make this fight more difficult. i don't even want to imagine the number of overdose deaths we would've had in ohio if our republican governor, i'm proud of what he did and he's gotten a lot of criticism from president trump and a lot of criticism from your party if he had not expanded medicaid to those 700,000 families. the budget proposal, thasz that's in addition to the house -- medicaid covers a third of all substance abuse treatments and communities across ohio and ohio it covers 50% of all medication assisted therapy or treatment. you sit in front of us. you have taxpayer funded health insurance. we have taxpayer funded health insurance. the 200 republican plus republican members of the house who have taxpayer subsidized health insurance are all willing to take it away from these 200,000 ohioens getting only poid treatment. your policy proposals, you say you -- your interested in fighting the epidemic, your policies opioid treatment. y

also through medicaid. are they would be impacted in veterans with his care. our children who are seen at hospitals like children's hospital seattle, 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. all of the senate proposal does is basically move that steeper gap at a point in time thates makes and exacerbates this problem of cutting people off with access to care. if the house bill is me this is doubling down on mean. there is nothing about importa distracting the safety net that is so important to americans that goes hand-in-hand with the philosophy of how to drive down cost of healthcare. think about it, if we came out here and had a discussion with a hundred senators and said thell great way to drive down cost of healthcare is to cut people offa of healthcare, most of my colleagues with a that's not a smart idea. when people are cut off fro healthcare we know on compensated care, exacerbate

is to cap and reduce medicaid. so these stories are all over the country, and people are wondering why would you take this level of investment in medicaid out of our entire economic system. why would you impact our school districts, our regional hospitals, our veterans, our medicaid population? why would you affect a community that has a large medicaid base and that is the way they serve them? our hospitals have told them we have stabilized the increase in health care costs because more of the population was covered and had access to medicaid. you rip that back and we will be back to skyrocketing costs with people in the emergency room, no access to care other than that facility with impacts to everybody on private insurance and on medicaid. so it's just not a good idea. so i ask my colleagues, come out here, don't say you won a patient-centered health care deliver system because we're all for that. and we actually put things in the affordable care act that did that and are working. so if you want to make that clai

insurance because of medicaid. yet your administration talks down and criticize medicaid expansion. and he said taking away medicaid would make this fight more difficult. i don't want to imagine the number of overdose deaths we would have had in ohio. he has gotten criticism from. the budget proposal your team put together cuts medicaid by $600 billion in addition to the house a.c.a. repeal. medicaid covers a third of all substance abuse treatments. and ohio it covers 50% of all medication assisted treatment. plans to address the opioid risis. what you are not telling to your readers, donald trump's second best state. you aren't telling them what ou are doing and i'm sorry for this, how do you plan to increase access to treatment when you cut the single biggest ource by $600 billion? how does that add up in the rump-price math in 2017? secretary price: i visited your state, southwest corner of your state to visit with victims of opioid addiction and parents of kids who died -- one mom told me about her son who died

medicaid population. we need to have a way that's compassionate and sustainable. under current law, federal rules prevents states from focusing on their most vulnerable communities and testing new ideas to improve health outcomes and care. this budget changes that. h.h.s.'s mission of protecting the health of the american people involves far more than overseeing the nation's health care and insurance programs. h.h.s. is the world's leader in helping the health care sector prepare for cyberthreats and responding to and protecting against public health emergencies. recently i witnessed this important work firsthand visiting ebola survivors in liberia and representing the united states at the g-20 minute steerial assembly in berlin and also in geneva. to support h.h.s.'s unique federal role, preparedness and response, the president's budget provides $4.3 billion for disaster services coordination and response planning, biodefense and emerging infectious disease research and development and stockpiling of cri

who uses medicaid? america uses medicaid. children, the elderly, hardworking families, people with disabilities, people struggling with addiction. at any given moment in this country, one in every five americans is counting on medicaid to help pay the bills. so what are these people supposed to do when the medicaid expansion goes away, when this bill's additional massive medicaid cuts go into effect? what are they supposed to do? what are their families supposed to do? dig in on one issue around this. dig in on opioid abuse. this is a problem that is growing around the country. last year we lost 2,000 people in massachusetts alone. i hear from parents who have lost children, from brothers and sisters who have watched a loved one disappear. i hear from people who are desperate because their child or sister or brother can't get into a treatment facility. i hear from dedicated doctors and nurses and counselors who need more resources so they can expand treatment programs. and now the republicans propose a bill that is like growi

the cut to medicaid to pay for people at the top so we are going to cut the medicaid budget where 64 cents on the dollar goes to nursing home care for middle class people. so we can again pay for a tax cut and remember you have to change the baseline ticket to the tax cut they want to undertake. when the american people's office for what it was, their health care is going to be curtailed. they are going to pay for the tax cuts for those people, so they shed light on this and the magnifying glass and with that i want to introduce our friend from the education workforce. it's the public, the doctors, the hospitals. they would cover smaller percentages of the actual bill. it would return and cut you off after they spend a certain amount. their voices were heard. the colleague from new york and others pointed out that this may not be the end. the house bill was withdrawn and then a few days later came back and was passed and we have to remain vigilant. they need to make improvements. so long as they are trying to go backwards we are not going to help them and we are not going to take a b

llen in knightstown, pennsylvania, you were on medicaid, ellen, tell us how you and do medicaid and why you continuing is a good program? caller: well, i have this comment about it. enough money, so i until my for medicare x-husband died and then my enemy went up and i no longer was on medicaid, just medicare i realized that during all those years i was on medicaid, in the officed me at least once a month, sometimes put me through every kind of test and colon colonscopy, everything you could imagine. had no idea what it was costing and once i had to start paying for it myself at least of it because now i still realized that i should be taking supplements and money on staying healthy and so i think if people medicaid, if it was reduced to where they at least had to little bit of it, maybe the doctors wouldn't put them through everything that they that, is my -- host: yeah, ellen, the new york times this morning in the piece reading, points that advocates for the structural to inefficiency in the current program, there is some evidence medicaid programs enroll people not eligible and some

of medicaid. medicaid is much broader than people tend to deal with in their discussions. do violence to medicaid, you do violence to senior citizens living in nursing homes. the second thing, community health sentence. in the affordable care act, we expanded community health centers. that gets us to around 40% of what we really need to build a safety net that needs to be built. in our medicare or medical delivery system -- health delivery system. 30,uld hope that september for community's help -- health centers, we will reach the cliff on september 30. i think the leader, leader mcconnell, for taking another look at this and i would hope we will come back with something that will fix the cliff for community health centers and greatly expand them. with that, i am pleased to yield to the chair of our caucus. >> thank you, gentlemen. one thing we know, what this congress -- what we think they have done, they have actually not. we know they are not done yet on the assault on the affordable care act.

medicaid does more than cover the nursing home care. v 37 million kids are enrolled in medicaid. a vital source of support for kids and adults withus disabilities. medicaid is the only lifeline of thousands and thousands of americans fighting opioid addiction have two be able to put their lives back together. no community anywhere in theded country since the kid was expanded under the affordablet care act leading the fight against the opioid epidemic by improving access for millions of people for treatment, mental health and substance abuse orders. but with the republican plan, enormous cuts, thousands ofir people could lose their shops to recover from addiction and lead a healthy life. finally, what is especially unfortunate about this legislation is the process for writing this bill. it's being written behind closed doors. no input from across the aisle and particularly the american people. s madam president i serve as the ranking member on the senateomme finance committee and i can tell you our committee has authority over hundreds of billions of dollars in payments for medica

we want a seamless transition for those moving from even medicaid to the individual market or medicaid to the employer sponsored market. so individuals are able to maintain the type of coverage they want for themselves. >> brit: the senate bill is similar in many respects to the house bill. it was scored by the cbo is leaving 27 million on short over the a time. what is your response to that? of leading people out? >> two major points of the budget office is a pretty good job of saying when something is going to cost. they've been woefully inadequate and being able to predict what kind of coverage. for example, they said that right now obamacare would cover about 23-24 million people, and fact it's about 10 million people. they are off a significant factor. we believe they are off by a huge factor here as well because they don't get any credit for individuals purchasing some type of insurance. the cbo says it is incredible insurance. second point is the entrance of the entire plan, the failure of the entire plan that we are doing at the department of health and human services is to mak

of the medicaid services. the federal government is getting out of that, which or at least transferring substantial responsibility to the states. so we have to be vigilant about that and make sure we do everything we can to put the interests in the priority -- the from the of older americans and the priority of taking care of them at the front of the agenda. research also shows that medicaid dollars also plays a role in supporting a lot of good-paying jobs in a state like pennsylvania. we're told that over a quarter of a million jobs in the long-term care field -- meaning long-term supports and services -- are pennsylvania jobs right now. and so any change there could be an adverse job impact. the commonwealth fund and george washington's mill ken institute released a report projecting 942,000 fewer jobs in 2026, and that nearly every state would experience an economic downturn if the republican bill were to become law. based upon the house bill, as we know it and we were told most recently by a republican sen

let me get back to medicaid. if you're currently in medicaid, if you became a medicaid recipient through the obamacare expansion, you're grandfaurd in. we're talkinging about in the future. obamacare took medicaid, which was designed to help the poor, the needy, the elderly, sick, disabled. children, pregnant women. it took it and went way above the poverty line and opened it up to able-bodied americans. who should probably see if there are other options for them. if they're able-bodied and they want to work, they'll have employer sponsored >> hold on. there's though way you can say a 15-year-old on medicaid today is not going to be affected by the cuts in the future. you said everybody on medicaid now is grandfathered in and won't face cuts. that is not factual. >> you keep callinging them as cuts the. we don't see them as cuts. we're slowing the rate of growth. obamacare expanded the pool of medicaid recipients beyond medical intentions. you have to look at the whole health care bill in order to have a full con

what we'll do is we'll gut medicaid. for 50 years congress has had a pact with the american people that we will be your safety net if you need it. and that's going away. that's a huge change. so for a vocal minority about premiums in the marketplace, millions will lose their coverage. this bill is even worse than the house bill. if the house bill was mean, this bill is cruel and heartless. >> let me ask you this. >> if you have the exchanges in the individual markets, you have medicaid and how it's funded and you have tax cuts, you could do stuff about the individual markets. and just deep taxes to keep funding medicaid. right? they don't have to go together. this is an affirmative choice because majority ofs don't like people on medicaid. so by replacing the aca's medicaid and xiang, what are we do? it had state sanctioned monopolies to run programs in certain states. they won't have that. they'll have to compete with blue cross to compete for those customers who will get to choose which insurance plan they wanted. just

only do recommend specifically on the medicaid portion for ways to improve medicaid services and the cost as well? nothing that betsy said was correct and with all -- we had anr, election about these changes. but we ended up with is a bill that takes 26% out of the medicaid program and money to american families from hospitals and communities. break to ag a tax very small number of individuals. what we have to do this if we want to have a serious conversation about medicaid and making it more efficient and making it work better for the people it serves, that is great. we would have hearings and experts say it and come and talk about the medicaid program and how it works. funds just take care of people living with a disability or the nursing home and much of it takes care of come talk about the scare tactics and medicaid will take care of lazy people, these are people who don't know about the program. obviously, all parts of health care lead to the better, but if they want to do it right, they cash ands on the create a thoughtful process to get people to look at the medicaid system. i

furthermore, the rate at which standard medicaid is compressed -- medicaid before obamacare, that rate is increased to further diminish health care, just to add to the cruelty of this bill. so millions lose but we deliver billions of dollars to the richest americans. in my home state of oregon, just the elimination of the expansion of medicaid -- the oregon health plan, just that -- would eliminate 400,000 oregonians. imagine those individuals holding hands -- 400,000 orange orangians -- orange orangian oregonians. anyone who has given across oregon realizes it is 400 miles across oregon. it is seven hours of driving -- if you did that, you would pass a stream of people who would lose their health care just from an elimination of the expansion of medicaid. my colleagues across the aisle have crafted this so as to put it beyond the next presidential election -- beyond the 2018 election and beyond the 2020 election. why? they are to terrified about the impact of this on the election, they decided postpone it after 2018, after 2020, as if that makes it acceptable to rip health care from p

if you are on medicaid and somebody you love is on medicaid this is a heat sinking missile right at medicaid. the kaiser family foundation, only 30% of americans know that this bill kts medicaid. it has an approval rating in another poll of 74%. they want to sneak the goods through customs with no hearings and they want to lie about it. i saw the tape you played earlier with kellyanne conway, saying there's no medicaid cuts. >> senator, i want you to respond to that but look at the promise and reality of president trump when talking about medicaid. he said there will be no cuts to social security, medicare, medicaid. then you look at this senate bill and it's an expansion that continues for three years but then cuts. he's not making good on a promise. >> here is what i would say about the, quote, cuts to medicaid. it says medicaid expansion will be treated like every other person on medicaid. if you're in expanded medicaid the federal government pay force roughly 100% of your cost. if you're in regular medicaid it pays, on average, 50%. what the senate bill does say is why are we differentia

of course medicaid does a lot more than cover nursing homeil care. 37 million kids are enrolled in medicaid, a vital source of support for kids and adults wite disabilities. medicaid is the only lifeline that thousands and thousands of americans fighting opioid addiction have to be able to put their lives back together. no community anywhere in this country has escaped the opioid epidemic. since medicaid was expanded under the affordable care act, it is beating the fight against the opioid epidemic by improving access for millions of people to treatment from mental health and substance abuse. but with republican plan, enormous cuts, thousands of people could lose their bestov shot to recover from addiction and lead healthy lives. finally white is especially, especially unfortunate about this legislation is a process for writing this bill. it's been written and close doors. no input from across the aisle,a and particularly from the. american people. madam president, i serve as the ranking member on the senate finance committee, and i can tell you our committee has authority over hundreds of

are any cuts to medicaid okay by democrats? >> it's not a good idea to cut medicaid. in fact, you have a lot of republican colleagues making a point that even today it's hard to get some providers, especially doctors, to provide services to people on medicaid. and then they turn around and say, well, let's cut it even further. we're happy to discuss potential reforms, but the reality is that medicaid is already one of the most flexible programs there is. we have lots of waivers for different states to allow them to pursue their own creative ideas with respect to medicaid. and as you and andy were just discussing, most of the money in medicaid goes to folks who are in nursing homes, 2 out of 3 people in nursing homes are funded in some way with medicaid. and then people with disabilities. >> so medicaid, if medicaid is off the table for you for these negotiations, where are you willing to discuss those reforms? >> i should point out also, during the campaign, donald trump said he was not going to cut medicaid, and as the two of you were just talking, the reality is the

, 772 billion in medicaid cuts. we know that we thought it was heartless, and now we see the numbers that say cutting that many people off of medicaid is, in my opinion, as my colleagues have also said, not something that we should be pursuing as a nation. and it leaves us to ask about not just the impact of this on individuals, as i just mentioned, because i believe there's a much better way to go with innovation. but what it also does for the individual market, a lot of this debate started because people thought the individual market hadn't seen some of the benefits. why not talk about the individual market? why if 7% of health care delivery, the individual market was having a problem, why not talk about ideas to improve the individual market? instead we have a bill from the house and senate that beats up on the medicaid population as if they are the culprit. if you want to improve medicaid and delivery services and help decrease costs, let's do that. there are so many innovative ideas. but just cutting people off

get rid of medicaid.they only find out that a refundable tax credit may not be great when mom goes in a nursing home five or six years from now, but by then, mitch mcconnell will have passed his bill, right? >> i think there were a lot of factual deficiencies in the discussion with the congressman. it's important to understand that $882 billion in reductions in medicaid spending, 85% of that comes from the phase-out of obamacare's expansion of medicaid. it doesn't touch the traditional medicaid. there are reforms as well. we can get to that. but the vast majority of that dollar figure is the phase-out of the aca's expansion of medicaid which is replaced in this senate bill, with robust refundable advanceable tax credits that are structured similarly to the affordable care act's exchanges. pretty much the same kind of mechanism to deliver coverage to that same population. that was on the medicaid expansion before. so in texas where i live, there are going to be millions more with health insurance as a resu