] medicaid -- no cuts for medicaid -- no cuts for medicaid -- -- uts for medicaid -- uts for medicaid -- uts for medicaid no cuts for medicaid -- -- uts for medicaid no cutsfor medicaid -- for medicaid -- no cuts for medicaid, save our liberty no cuts for medicaid, save our liberty. no cuts for medicaid, save our liberty. no cuts for medicaid, save our liberty. no cuts for medicaid, save our liberty. no cuts for medicaid, save our liberty! no cuts for medicaid, save our liberty! no cuts for medicaid, save our liberty! cuts for medicaid, save our liberty! no cuts for medicaid, save our liberty! no cuts for medicaid, save our liberty! no cuts for medicaid, save our liberty! medicaid, save our liberty! no cuts to medicaid, save our liberty! no cuts to medicaid, save our liberty! no cuts to medicaid, save our liberty! no cuts to medicaid, save our liberty! medicaid, save our liberty! no cuts to medicaid, save our liberty! no cuts to medicaid, save our liberty! to medicaid, save our liberty! to medicaid, save our liberty! >> you guys better get in position. pounds] >> committee will be in

what's medicaid? well, just happens to be the program where 40 million children -- or i should say 40% of all children get their health care. 60% of all children with disabilities get their health care. about two-thirds of nursin nurse care is paid for by medicaid. ask a family member that has a loved one with a disability what medicaid means that family -- means to that family. it is life or death, medicaid is. the so i know we have debates here where people talk about medicaid as if it is just another program, just another budget matter, just another health care talking point, right? well, one of the reasoning why these -- well, one of the reasoning why these bills have -- well, one of the reasons why these bills have not passed is that democrats and republicans out there far a way from washington realize what would have happened if we passed some of these bills, what would happen if we -- no one here would lose their health care, by the way. no senator, no house member, or their families would lose

you have every state putting the bulk of their medicaid program, the vast majority of their medicaid program, the elderly, disabled, children, pregnant women under a cap. so that when cancer treatments come out and they are more expensive, the states will not be able to afford them at least without cutting something else. so that if there is another hurricane, they cannot afford to address that emergency unless they cut something else. that is not how the financing of the medicaid program works now to read it is important to understand the basic structural changes to financing for the vast majority of medicaid beneficiaries. >> thank you mr. chairman. again obviously, we believe that arkansas would be better off, or i would not be here today. and a number of other governors feel the same way. we feel there is great value in this, in terms of the level of funding that is sustainable for both the states and the federal government, these dollars continue to grow over time as i mentioned previously, the i plus one is higher than the capital basis for elderly and disabled enrollees, it is

no cuts to medicaid, save our liberty. no cuts the medicaid. save our liberty. no cuts to medicaid. save our liberty. no cuts to medicaid. save our liberty. no cuts to medicaid. >> save our liberty. >> no cuts to medicaid. >> save our liberty. >> no cuts to medicaid. >> save our liberty. >> let's have order and show some respect here. a lot of us are on your side. let's have some order. if you cannot be in order, then get the heck out of here. the committee will come to order. i would like to welcome everyone to this afternoon's hearing where we will discuss and examined the graham-cassidy-johnson-heller health care proposal. given the relatively unique circumstance we are facing with regard to health care generally particular, a hearing has been asked for on this proposal so we can all get a better sense of how it is intended to work. toward that end, we had two distinguished panels of witnesses before us today. the first panel will feature ourements from two of senate colleagues. if the police would please remove that person, we would appreciate it. and keep the door shut. ok, the

medicaid? now maybe it's because if you said that, you would directly counter a promise that the president made, i'm not going to cut medicaid. maybe there's a concern about we're taking $1.2 billion out of medicaid and we're about to come up with a big tax proposal that might be tax breaks for the wealthiest. we don't want to take money away from a program that is for poor, elderly, disabled, or children and then immediately turn right around and increase the deficit by a tax cut. but i find this to be the bigamies try of this entire debate that every proposal that's on the floor makes massive cuts to the core medicaid program even though that has nothing to do with the affordable care act and nobody ever acknowledges it. nobody ever explains it. i'm here to both say it's real and to challenge it. who are medicaid recipients? who are medicaid recipients? i think there tends to be a little bit of a misconception about who gets medicaid in this country. in virginia, 50% of medicaid recipients ar

, medicaid. medicare is about 15%. most, the majority of people who get health care coverage in this country get it through their large group plan. we have maybe 6% or 7% who get their coverage through the exchanges. as a veteran, a navy veteran, ohio state and navy guy all those years ago, retired navy captain, i know that not every veteran actually gets their health care coverage from the v.a. numbers of them aren't eligible for doing that. as it turns out, among the people who receive coverage under medicaid today, a lot of them are old. a lot of them are like our parents, our grandparents, aunts, uncles. the reason why they are eligible for medicaid is because they spent down their resources, their assets, they're old. a bunch of them have dementia. maybe their family is unable or unwilling to take care of them. they end up in a nursing home. medicare picks up the tab. this is like -- i described it yesterday in our finance committee. like a tsunami. the baby boomers are moving toward their r

no cuts to medicaid, save our liberty no cuts to medicaid, civil liberties no cuts to medicaid save ouriberty. no cuts to medicaid save our liberty. no cuts to medicaid save our liberty. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] no cuts to medicaid, save our liberty. no cuts to medicaid, save our liberty. no cuts to medicaid save our liberty. no cuts to medicaid, save our liberty. no cuts to medicaid, save our liberty. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] no cuts to medicaid, save our liberty. [inaudible conversations] [inaudible conversations] >> let's have order and show some respect. a lot of us are on your side. let's have some order. if you can't be in order, get the heck out of here. the committee will come to order. i would like to welcome everyone to this afternoon's hearing where we will discuss and examine the bill. given the challenges we are facing to healthcare and this proposal, the senate republican leadership, as well as members of the committe

let's talk about medicaid.edicare, social security and interest on the debt is going to consume all the money you send in the future in taxes. do you care about the debt? do you care about her? can we do both? so here is what i would say about medicaid. medicaid is growing twice as fast as health care in other areas. i want to make sure that medicaid is sustainable and affordable. what do we do to save a trillion dollars? we lower the inflation rate eight years from now. so your state of new hampshire is going to have the money to design programs that would help your family. they're going to get money that a bur accurate would have gotten in d.c., their share of the 1.2 trillion and they can take 20 pearls of that to spend on the medicaid that they want to. they can take money in the second block grant and go well beyond where medicaid would let them go. they're going to have more money to help people like you. and here is what i bet. they'll do a better job than the guy or the gal running obamacare. so if you

coverage for children is integrated in the chip, some in medicaid, 45 million kids are in medicaid. 36 or 37 million in medicaid and chip.er 8 million or so in the rules that aplay are different for the program. rules.id tis medicaid separate chip program tis a separate chip. covers very generous, it drugs, physician services, hospital services, number of at very low cost to recipients more generous than in that based coverage sense. i think the program is pretty generous to those people who are income and kids are elatively inexpensive it cover thankfully because the vast majority of them are healthy. pediatricians accept chip? guest: it depends on the state reimbursement. that state, surveys have found both family physicians and internists will limit the theyr of medicaid patients see. i think in general coverage is state basis. by host: port orange, florida, this is shane. morning, c-span. i just love this program. 've been watching c-span for decades now. i think this is one of the most important issues in any society know, i work in health care and one thing i've noticed, walk int

we pay a big medicaid bill. i want to put medicaid people into managed care. i want them to have some ownership over their health care. if you smoke, then that's something that ought to be considered in terms of costs. i like co-payments. i want to treat people who are low income and poor fair, but all of us need to be responsible for our health care. rather than having a medicaid program that just writes checks no matter what the outcomes are, we're going to in year eight, again to slow the growth of medicaid down. it grows faster than medical inflation. medical inflation is what it calls for in your family. medicaid is way beyond that. why? it's insufficient. we have proven at the state level you can get a better bang for your buck from medicaid. the bottom line is the first block grant begins to slow the growth of medicaid to make it affordable for the rest of us and incentivize innovation in year eight, and if we don't do that, here's what happens to the country. by 2038, all the money you spend sending taxes to washington goes to pay the interest on the d

the one thing about medicaid i don't like is with had a big medicaid bill. i want to put medicaid people into managed care. i want them to have some ownership over this. i like copayments, i want to treat people heart -- who are poor. rather than having a medicaid program that just rights checks for my what the outcomes are. eight, again to slow the growth of medicaid down. it grows faster than medical inflation. medical inflation is what it calls for in your family. medicaid is way beyond that. why? it's insufficient. we have proven at the state level you can get a better bang for your buck from medicaid. the bottom line is the first block grant begins to slow the growth of medicaid to make it affordable for the rest of us and incentivize innovation in year eight, and if we don't do that, here's what happens to the country. by 2038, all the money you spend sending taxes to washington goes to pay the interest on the debt, medicare and medicaid and social security. there won't be one penny for the department of education, the department of defense. that's how

we deal with medicaid, a reasonable fashion, more flexibility more control, slowing the growth of medicaid down. nothing, in 2027, medicaid will be over $650 billion in spending -- spending 549 billion today on the military. what me say that again. to do nothing means that we will spend the more -- more next decade on medicaid then we can to defend our country. this bill changes that. 40% of the money under obamacare goes to four states. out here spending 10 everyfrom now, 2020, state and its basically the same contributions. -- and the the risk tol is by 2026, to make sure see a contribution from a federal government. most americans believe that there. build levels out in an equity and funding, it allows flexibility that obamacare would never embrace. give patients a place in health care -- that they would never happen single-payer health care system. in my view, it's the best and last hope for the republican party to show that we have ideas, and that our ideas are better than our friends on the other side. will fight, liberals like tigers to the bitter end to get what they want. republic

the growth of medicaid down. if we do nothing by 2027, a decayed will be over $650 billion in spending. we are spending 549 billion today on the military. let me say that again. to do nothing means we'll be spending more in the next decade on medicaid than we do to defend our country. this bill changes that. 40% of the money under obamacare , where's that chart? 40% of the money under obamacare goes to for states. we level out spending 10 years from now, 2026. every state gets basically the same contribution from the federal government that will allow you to adjust for risk if you have an older population, sicker population you can get more money. the goal is by 2026 to make sure that every patient no matter where you live is basically the same contribution from the federal government. a i both think most americans believe that's fair. our bill levels out and inequity in funding that allows flexibility that obamacare would never embrace. he gives patients a voice in the health care they will never have their sing

you may still be eligible for coverage and medicaid but perhaps your provider isn't a medicaid provider. >> and i think we heard from senator scott, making sure that child, kaleb, goes to school healthy and being prepared makes him a better student -- >> and hopefully you look at the long road and long picture. and does it make sense where we have programs where families could potentially bounce back and forth from almost month to month. >> talk to me a little bit about the outreach and particularly rural outreach. many families may not feel comfortable going online or going to a library and putting very personal data into a computer without an outreach worker. >> certainly. as you know very well the state, we employ a few outreach workers. and we do try to position them around the commonwealth. but another thing we do in virginia is we use some of our chip admin dollars to help support a foundation of which you're the chairman. and of that program you also get to do the same. and their reach is expensive in trying to help families. and even in this day and age we still get a healthy po

you may still be eligible for coverage and medicaid, but perhaps your provider isn't a medicaid provider. >> i think we've heard from senator scott and others that in terms of plain old business, making sure that child, making sure caleb goes to school healthy and it's going to make him a better student. >> i think that's what -- hopefully you look at the long road, the long picture and does it make sense that we have programs where families could potentially bounce back and forth almost month to month. >> talk to me a little bit about the importance of out reach and particularly rural outreach since there are so many communities. i know we've got online sign-ups. but the truth is, many families may not feel comfortable doing on-line or going to a library and putting very important data into a computer without an outreach worker. talk about outreach and more specific lie rural outreach. >> certainly. as you know very well, we -- the state -- we employed a few outreach workers and we do try to position them around the commonwealth, but another thing that we do in virginia is we use some o

there are two steps, and deal with medicaid. slowly the growth of medicaid down in year eight. if we do nothing, by 2027 over $650ill be billion and spending. we are spending $459 billion today on the military. let me say that again. to do nothing means we will be spending more than a decade on medicaid than we do to defend our country. this bill changes that. 44% of the money under obamacare goes to four states. we level out spending 10 years from now, 2026 and every state gets basically the same contribution from the federal government that will allow you to adjust if you have an older or sicker population. you can get more money. the goal is by 2026 to make sure every patient no matter where they live gets basically the same contribution from the federal government. most americans believe that is there. an inequityels out in finding. it allows flexibility that obamacare would never embrace. it gives patients a boy in the health care that they would never have in the single-payer system and in my point of view, it is the last and best hope for the republican party to show our

are in the medicaid system. quite frankly, their coverage has never been enough and the medicaid system has helped fill the gap. that's going to cause a problem for our seniors. i'll just give you one example. we pride ourselves on federalism and federalism to me is very important. i served for several years in the state legislature, former speaker. maryland general assembly. and i pride the fact that maryland has been an innovator in health care. they have been able to do that because of the partnership between the federal government and the states. that's federalism. it's worked. if this bill, amendment were to become law -- the cassidy bill -- it will prevent the states from innovating. it's not giving them more flexibility. when you don't give them the resources and tools to deal with issues, you can't. example, maryland. we have what's known as an all payer rate structure for hospital costs in maryland. regardless of who covers your insurance, whether you're medicare, medicaid, or private insurance, or you

well, it ends the medicaid expansion, and it establishes a per capita cap and reduction of medicaid. by ending medicaid as we know it, after over 50 years of this program, by suddenly capping it and ultimately giving block grants to states, we know that it will affect dramatically the people that this program and these expansions have covered. and who gets covered by medicaid? who will be affected? well, in america right now, over half of all low-income families rely on medicaid. two out of three of our seniors living in nursing homes rely on medicaid. half -- half of all the births in the united states of america are children -- of america, our children, our future, our greatest natural resource, half are covered by medicaid. here is our reality. we are getting a program that benefits us all: our seniors, our children, as well as the disabled. the cruel medicaid cuts proposed in this bill, the cuts and the caps in this version, will still put those who have the most to lose in the most serious jeopardy -- those seniors in nursing homes, working families, communities of color, women,

medicaid down.he medical in inflation. leve we proven at the state level you can get a utter bang for your buck from medicaid. make so the first block grant begins to slow the growth of medicare to make it affordable and incentivize innovation in your eight. if we don't do that here's what happens.ay by 2038 all the money you spend, in texas goes to pay the interest on the debt, medicare medicaid and social security. there will be 1 penny. that's how quickly those programs are going. a the sustainable path and without to get better outcomes for the taxpayer and patient.n the second block grant is money that would've been spent by bureaucrat in washington. under the first proposal you get a refundable tax credit will give insurance companies money so claps on the exchanges. produ what we've decided to do is instead of given a refundabled f tax credit about a product that will go away because obama careg won't work and to give them a bunch of money to prop them up will take that money and give it back

the bill would also cut and cap the medicaid program. cut and cap are code words for drastic cuts, massive cuts to the funding that states receive to help people like bodie. new hampshire would lose hundreds of millions of dollars by 2026. i know as a former governor what that means, you get less money so you have to decide between slashing benefits or reducing the number of people who get care orb. it would lead people at risk like seniors in nursing homes, seniors who need homecare or get people with disabilities. even if you get good health insurance it would cut the medicaid that so many people need in addition to that private insurance to live at home and live independently. graham cassidy trump care also cut medicaid expansion, which in my state is getting critical medical care to about 50000. i thank you all for being here today and i have to tell you that i have been so moved in impressed by the degree to which people who experience chronic medical conditions or disabilities are willing to come forward and tell their personal sto

jeff: program if you decimate medicaid. the two are that directly, for the idea that somehow this bill is going to be good for chip is just absurd. this is a bargain basement block grant. we are going to pull out all the stops. people power be trumpcare before. we will use people power to beat it again. >> senator's death in us talking about rain gauge meant. >> people are really, a week ago no one saw, this hadn't even raised its ugly head but now the groups are really localized. you will find the hospitals, the aarp, the nurses, cancer care and all the societies that represent are all mobilized. they realize this is worse than the last one so i think over the weekend you will see huge mobilization. go ahead. >> how tough would this be for senators from missouri and obviously senator mccaskill another's? are you confident that this bill would not get any democratic votes and secondly. >> there are people in every state. you can be deprived of insurance if you have a pre-existing condition in every state. there are dramatic

it cuts back on medicaid. we know what that means. half the children in illinois are brought into this world because of medicaid. .isabled people so many people count on one program to make sure they have quality health care, and that program is medicaid. when it comes to school by state, half of the school districts get assistance for children who need special education, counselors, assistants, feeding tubes, from -- >> medicaid! seniorsbin: and helping who need medical care later in life, there is one program they turned to. >> medicaid! we are fighting for justice when it comes to health care, which this senator happens to believe is a right, not a privilege. [cheers and applause] sen. durbin: now i am calling you, let's get ready to win again. fight to make sure we protect health care for all americans. thank you, everybody. [cheers] >> all right, let's give it up for senator durbin! [cheers] we are as a moral crisis in this country. people should not have to die due to a lack of access to care. that is currently happening, and it

half o in this country are paid for b the medicaid program. when you're a state legislator, you have to do i go after grandma? do i go after the babies? disabled people? this is -- this is a lose/lose for states. soledad: money for medicaid expansion will be zero the date. sabrina: right this is essentially taking obamacare's coverage expansion and to be clear, we 20 plus million people who gai coverage under the affordable ce act. it just reverts back to before the a.a.passed. it eliminates all that coverage gai many elected officials know that cutting medicaid and medicare is the third rail of politics, right? those wol never come out of their mouths because they recogniz it's very, very challenging. are they lying if they say we're not going to cut medicaid? sabrina: this is a massive cut to not just medicaid expansion but to the core traditional m. soledad: where do you think it goes? sabrina: well, i've been working in hea25 years and i have never, ever seen anything like this where senators are rushingten something they don't understand

this is a built-in and medicaid as we know. why -- that is why 10 governors from the date of colorado, ohio, alaska, montana, pennsylvania, virginia, massachusetts and vermont -- five democrats, five republicans have said don't do trumpcare to. don't do graham cassidy. our budget and policy priorities will result in about $700 billion in cuts to health care by 2027. it would cause millions to lose coverage. millions. medicaid, it cut would bring us back to the days where insurance companies could discriminate against people with pre-existing conditions. it would get rid of the consumer protection that gives americans access to maternity care, substance abuse prescription drugs. we would throw the individual markets into chaos, resulting in 15 million people losing coverage. if they let the cbo do its work, if it were not pressured to put out something that was just a few lines -- this would all be told by cbo. how do we know? similar bills in the past have been explored by cbo with similar provisions. they are afraid. that the

medicaid matters. it pays for the health care of our most vulnerable and serves as a safety net for those who might not think they're ever going to need it. it covers nursing home care for older people who spend down hard-earned savings. it pays for critically needed addiction treatment services for those who struggle with opioids. we know that that's what millions of americans are facing now. and it helps americans with disabilities and kids with special needs live a healthier, more productive life in their communities rather than in an institution. and that is just a little bit of the good medicaid does for folks from portland, oregon, to portland, maine. under the graham-cassidy-heller proposal, that's gone, simply gone. the plan ends medicaid coverage that 11 million americans count on right now. it guts medicaid and guts hundreds of millions of dollars of support from the federal government. so in effect what it's like is telling the states good luck. it's telling them, well, you can make the hard

that approved her for medicaid and that's why your tax dollars might have paid for her medicaid even though she really might not have qualified for it. they calls this entire experience frustrating. >> i've called. i've gone in person. i've, you know, done everything that i'm supposed to do. >> your wheel is catching on the battery. >> i built my life here based on these services that i continue to receive and now you cut them off in the middle of the year. >> reporter: the judge has until early october to decide what will happen to andrea. meanwhile she's left to navigate a complicated system on her own. >> without a caregiver what are you giving is supposed to stand on? >> reporter: we have again working on this story for months and there's still a -- again working on this story for months and there's still a lot we don't know. for example, the state can't say how often cases like andrea's happen because they say cases differ and offer defy accurate comparison. we also don't know exactly how much the state paid out for her medicaid benefits over the years. if it turns out the state

we pay a big medicaid bill. i want to put medicaid people into managed care. i want them to have some ownership over their health care. if you smoke, then that's something that ought to be considered in terms of costs. i like co-payments. i want to treat people who are low income and poor fair, but all of us need to be responsible for our health care. rather than having a medicaid program that just writes checks no matter what the outcomes are, we're going to in year eight, again to slow the growth of medicaid down. it grows faster than medical inflation. medical inflation is what it calls for in your family. medicaid is way beyond that. why? it's insufficient. we have proven at the state level you can get a better bang for your buck from medicaid. the bottom line is the first block grant begins to slow the growth of medicaid to make it affordable for the rest of us and incentivize innovation in year eight, and if we don't do that, here's what happens to the country. by 2038, all the money you spend sending taxes to washington goes to pay the interest on the d

pay a big medicaid bill. i want to put medicaid people into care. the smoke some --, that's something that should be considered. i want to treat people who are low income, all of us need to be responsible for our health care. we have a medicaid program the just rights check no matter what the outcomes are. in your eight, to slow the growth of medicaid down. it grows faster than medical inflation. medical inflation is way beyond it, why? because it's inefficient. we've proven at the state level that if you can get it better bank for your buck for your medicaid. incentivize innovation. in year eight, if we don't do that, here's what happens to the country. by 2038, all of the money you spend in texas to washington goes to pay the interest on the debt, medicare and medicaid and social security. there will be one penny for the department of education, department of the senate. that's how quickly they are growing. with the medicaid on a more sustainable fashion path because it's an important program. because it's

the bill does especially serious damage to medicaid this year's debate over health care is as medicaid matters.are those that think they will not needed. treatme it pays for criticallyit needed services in that is what millions of americans are facing now. to live a healthier and more productive life in their communities. that is the good they do for portland oregon under the gramm cassidy proposal to speeded medicaid coverage it caps medicaid with hundreds of billions of dollars with the federal government. in to tell that you can make the hard decisions which which will get adequate health care or who will be the unfortunate souls to go without? this is for those older americans who count on medicaid for nursing-home care.tates also a massive transferic dollars history tells us the most vulnerable americans so i have heard my colleagues m claim this bill is modeled on the children's health insurance plan so that means all supporters of chip, and that they could be further from the truth. the children's health insurance program has been extraordinarily successful for more than 20 year

the lingering question, would she get her medicaid back. special assignment reporter whitney wild has the answer for us. >> andraea lavant needs home nursing every day without exception. the price is high and for years medicaid handled the bill. now what she desperately needs is gone. andrea la haven't's morning -- andraea lavant's morning routine starts with someone else. >> i don't get out of bed without the services. >> reporter: she lives with muscular dystrophy and needs home nursing every day. according to an invoice she showed us, the cost can run about $2,250 every month. it's so expensive that when we met her for the first time, her friend josie gilliland was filling in. >> she can't reach ac counter to get toothpaste or, you know, f of a shelf. >> reporter: from 2007 through june medicaid paid the bill. those payments stopped over the summer. >> can you hear me now? i'm trying to reach martin smith, a medical care program specialist. you transferred me to peter smith. i'm looking for martin smith. >> reporter: but after wusa9's sp

, immediately ending medicaid expansion and establishing a per capita cap on medicaid spending. that jeopardizes coverage for 11 million americans and puts at great risk the coverage and affordable care act of insurance for the 12 million who buy >> >> and block grant to the states for imposing a massive cut on funding that helps so many americans the term block grant may sound harmless but in practice there anything but. right now the health care system reimburses states for the cost for what they actually nereus but they are fixed amount of money given to each state foresee people who need health care to fight for who gets the dollars.n people with parents in nursing homes or fighting with those with pre-existing conditions or with those who need to see a doctor. and in a heartless scheme to hurt so many block grants are not so clever way to hide a massive cuts to health care. hur cutting back care or raising premiums for millions and millions of average americans if that is the case with trump care the budget found the block grants in the bill would deprive hundreds of millio

it would deeply cut medicaid. would bring us back to the days when companies could discriminate against people with pre-existing conditions. they could get rid of consumer protections that give americans access to maternity care and substance abuse drugs. intos her the markets chaos, resulting in 15 million people losing coverage. do its work,he cbo if it were not pressured to put out something that is just a few lines, this would all be told by cbo. how do we know? bills in the past have been scored by similar provisions. they are afraid the public will hate this bill so they are trying to rush it through in the dark of night. we want, above all, a bill that protects average americans, not slashes the health care they need, whether the governor or washington tries to do that. it is wrong. we want to work in a bipartisan process to make things better. we want the house, the president, republican leadership to stop pressuring those who want to come up with a to refrainsolution from doing so. we can make it work in

if we did that to obamacare and medicaid, you would see what it looks like. it is a pretty minor cut, the type of cut that many suggested under the penny plan, but that's what a real cut looks like. what graham-cassidy-heller-johnson does is not a cut, it's a slight reduction in the rate of growth and spending. now, again, oftentimes colleagues other side of the aisle are talking about drastic cuts. let me detail what i consider a possible drastic cut. let's say rather than 1% a year, we reduce spending by 5% a year or 10% a year. now, i would agree with folks on the other side, if we're proposing those cuts, that slashing cuts, that is a massive or draconian cut. again, that's not what we're doing. we're just slightly reducing spending over the next ten years. let's look at this differently. let's look at cumulative spending. if you just take cumulative spending year over year and just add it up, our current projection on obamacare and medicaid, we would spend $5.67 trillion. what graham-cassidy-heller-johnson proposes spending is the green line of $5.44 the

it puts caps on the medicaid program, the core medicaid program that existed before there was the affordableact and those caps would take about $120 million out of medicaid and the number would grow in future years. why are they so fixed on trying to attack medicaid? in virginia and most places, 55 to 60% of the recipients of medicaid are children. if you need a wheelchair to go to school, it's medicaid that's paying the wheelchair and it's usually medicaid reimbursing the school system for the services that they're providing you. but why are they going after medicaid? this whole thing, in my view, is a big smoke screen. they want to get rid of obamacare but what they really are fixated upon is going after medicaid. the medicaid program doesn't have anything to do -- the core program with obamacare, but that's what they're going after and they are probably doing it because they can take all of these savings and make it part of their big tax cut plan that they're going to bring up next month. >> all right. senator tim kaine, thank you. >> absolutely. >>> still to come, tom brokaw on what cons

, immediately ending medicaid expansion and establishing a per capita cap on medicaid spending. that jeopardizes coverage for 11 million americans and puts at great risk the coverage and affordable care act of insurance for the 12 million who buy insurance on the marketplaces. it would take the money used for medicaid expansion and block grant it to the states. but in proposing a massive cut on funding that helps so many americans well into the middle class, the term block grants may sound harmless, but in practice they're anything but. right now our health care system reimburses states for the costs of what their citizens actually need and use. block grants are a fixed amount of money given to each state. forcing people who need health care to fight among each other as to whoest goes those dollars -- as to who gets those dollars. people are parents in nursing homes will fight with those on opioid treatment who will fight with those who have kids with preexisting conditions, who will fight with those who simply need to go see a doctor. they'll all be pitted against one another i

medicaid matters. it pays for the healthcare of our most vulnerable, serves as a safety net to those who might not think they are ever going to need it, nursing home care for older people, hard-earned savings, it pays for critically needed addiction treatment services for those who struggle with opioids, millions of americans are facing that now. it helps the americans with disabilities and kids with special needs live a healthier more productive life in their communities rather than an institution. that is just a little bit of the good medicaid does for folks from portland, oregon and portland, maine. under the graham cassidy heller proposal, that is simply gone. it ended medicaid coverage, 11 million americans count on right now. it medicaid, hundreds of billions of dollars in support to the federal government. in effect, telling states good luck, telling them you can make hard decisions about which americans are going to get adequate healthcare and who will be the unfortunate souls who go with out.

it would deeply cut medicaid. would bring us back to the days when companies could discriminate against people with pre-existing conditions. they could get rid of consumer protections that give americans access to maternity care and substance abuse drugs. intos her the markets chaos, resulting in 15 million people losing coverage. do its work,he cbo if it were not pressured to put out something that is just a few lines, this would all be told by cbo. how do we know? bills in the past have been scored by similar provisions. they are afraid the public will hate this bill so they are trying to rush it through in the dark of night. we want, above all, a bill that protects average americans, not slashes the health care they need, whether the governor or washington tries to do that. it is wrong. we want to work in a bipartisan process to make things better. we want the house, the president, republican leadership to stop pressuring those who want to come up with a to refrainsolution from doing so. we can make it work in

, immediately ending medicaid expansion and establishing a per capita cap on medicaid spending. that jeopardizes coverage for 11 million americans and puts at great risk the coverage and affordable care act of insurance for the 12 million who buy insurance on the marketplaces. it would take the money used for medicaid expansion and block grant it to the states. but in proposing a massive cut on funding that helps so many americans well into the middle class, the term block grants may sound harmless, but in practice they're anything but. right now our health care system reimburses states for the costs of what their citizens actually need and use. block grants are a fixed amount of money given to each state. forcing people who need health care to fight among each other as to whoest goes those dollars -- as to who gets those dollars. people are parents in nursing homes will fight with those on opioid treatment who will fight with those who have kids with preexisting conditions, who will fight with those who simply need to go see a doctor. they'll all be pitted against one another i

. >> we keep medicaid in place as it is today. we try to give more flexibility because indiana is a good example of what can happen if you give states flexibility to help poor people. one thing about medicaid, is you get a headache you run to the emergency room. i want them to have some ownership. if you smoke that's something that ought to be considered. i like copayments. i want to treat people low income and poor fair but all of us need to be responsible for our health care. rather than having a medicaid program that just wrilingts checks no matter what the outcomes are we're going to in year 8 again to slow the growth of medicaid down it grows faster than medical inflation. medical inflation is what it costs for you and your family. we have prove than the state level you can get a better bang for your buck. so the bottom line is the first block grant begins to sloy the growth of medicaid to make it affordable. and incentivize innovation. in year eight. if we don't do that here is what happens to the country. y 2038 all the mon

most people on medicaid are quite satisfied. it is a challenge for states and the federal government when we talk about how to make the system better is how to build a system that is affordable to taxpayers and that the same time pays physicians and hospitals a sufficient amount of money that they will agree to take these patients. this is a balancing act that we have been trying to strike for decades, and it continues to be a challenge. host: the u.s. census bureau has no numbers on health care. i want to get your perspective. in terms of who has health care, 91.2% of americans have health insurance. 37% have government coverage. numbers, willse perspective would you add? guest: it is worth noting that we don't appreciate often enough how remarkable coverage expansion has been since 2014. the affordable care act has helped 20 million previously uninsured americans get health insurance. the rate of uninsurance in this country has never been lower. that is a substantial change and accomplishment and one that is undervalued. there

medicaid. and breaking news, the hill is reporting that all medicaid directors from every state in the country, all 50 states, have now just come out against the republican bill to repeal obamacare. this is the national association of medicare directors, the directors from every state. they say that this bill would constitute the largest intergovernmental transfer of risk from the federal government to the states in the country's history. all 50 states. that does it for us tonight. we'll see you again tomorrow. now it's time for "the last word with lawrence o'donnell." good evening. >> good evening. the block granting is the republican dream for decades. this is the closest they have come. >> and the directors of medicaid, the largest insurance program and provider of any kind in the country are now screaming bloody murder about this, all 50 states. >> you find out how well medicare and medicaid actually work because you can talk about it either way depending on how much time you have. here's w

people in indiana today on medicaid have health savings accounts.hey're able to choose their own doctor. they are able to be in primary care. they are given incentives for engaging in wellness like quitting smoking and losing weight. people love it. the healthcare outcomes have been encouraging. people are moving from emergency rooms to primary care. and the graham-cassidy bill includes significantly more flexibility than we ever got in indiana. i mean, ultimately, i know that many in the national media want to focus on the politics of this and whether this gets done and what it means to people. can i tell what you president trump and i are focused on, what the authors of this bill are focused on is passing legislation that will improve healthcare and ultimately improve people's lives. and the kind of reforms that this will make possible in medicaid, i truly believe are going to improve the lives of our most vulnerable all across this country. steve: they are going to do something next week vote-wise in the senate regarding obamacare. another obamac