next, a look at the future of medicaid with a representative from the national association of medicaid directors. this was part of the recent health care policy conference in washington, d.c. it is 45 minutes. >> thank you so much. all right. good morning. >> good morning. >> thank you, cathy, thank you, don, thank you, everybody, for having me here. i'm mat salo with the national soaks of medicaid directors. we just finished our only annual meeting and eye comparedded by today is veterans day and means all of my kid are off from school in daycare and i had to make arrange.s to get here but this is an important opportunity and i was thrilled to put the pieces together to make this work. honestly, anytime i can talk about medicaid and people actually listen for more than three minutes is great, and especially when i get to talk to a group of folks for whom this really does matter and who can make a very important difference in the things we're talking about. so, i guess the question or the title of the session was, medicaid, did it survive repeal and replace? is that what we are going w

-- at least 50% medicaid. if you think about how much money according to the cbo, if we still trust them, how much money the affordable care act spent over a 10 year window, it is about $1 trillion. literally half of that was in medicaid. so that was a big component of the debate. the other big component was the wholly unrelated discussion around entitlement reform and medicaid financial reform, including whether or not we should take the open ended nature of the medicaid program, the open-ended federal financing partnership that we have had for 50 years and convert that to a per capita cap. saw how thate all played out. we came within a hair's breadth or a dramatic john mccain thumbs down on the floor at 1:30 in the morning from doing -- from that passing. but that certainly doesn't mean any of these discussions are over. certainly, congress is going to turn and is turning out to tax reform. we will see how that plays out. but i think the impetus in the political and fiscal desires in congress and the adminis

is medicaid. said about 40% of medicaid spending is on the medicare beneficiaries the additional 20% is on younger adults and kids with a variety of disabilitieses developmental they are not onf medicare they require services and long-term care. 20 percent of talk about is kids keep in mind in addition to being the long-term care c program medicate also covers almost 50 percent of all births in the country. if you're a fan of "west side story." but go back to those numbers 35 percent, another 20% 20%, another 20% that is over 75 percent of medicaid spendingil on those who will never be in the workforce. think about big ticket items and major changes, '' lydia understand where the g actual dollars go because it is untrue that people will understandd that so we try to educate and it has made a difference we had a session ever annual conference a couple days ago where we had some health journalists talking from recapping 2017 and they were remarking we really didn't expect medicaid advocates and bene

but, look, when you've seen one medicaid program, you've seen one medicaid program, right? there's actually a lot of variation. and so, look, i think that there is an argument to be made that medicaid is consuming a -- i mean, it's not an argument, it's just the truth. medicaid is consuming a greater and greater percentage of the federal budget. the question is, is that a useful expansion of federal spending or not? i think most progressives would argue it is, and some conservatives would argue that it isn't because there are better and more effective ways to get at that population. >> chris, is that double talk? [laughter] >> i mean, i, i feel sorry for lanhee. [laughter] >> you and me both. >> i feel sorry for myself some days. [laughter] >> no, i mean, i feel like i, i'm double teaming. but i will just say a few things. one, i think the medicaid debate exposed a couple important points. one is, yes, there's some republicans in the senate who are liking it, but also the stakeholders, the providers, the health plans, they've now become, oh, this isn't as bad as i thought i

then there's those who expanded medicaid. but if you ask most people in washington was the most effective opponent of the repeal and replace, it would be republican governors. they have more of an impact than probably anyone else. the second issue on medicaid is that when you look at the media coverage and the legitimate policy problems raised specially been focused around the exchanges. the medicaid expansion has been expanded in a significant where little negative reaction. the repeal and replace rather than focusing on the exchanges was a political mistake in the end. as a concer consequence medicais become stronger than it ever has been. bradley, the republicans need an offset to do some policies they want. i'm please they strategically made snares but one not just to repeal the expansion that the cap growth of the medicaid program. it was a one-two punch. that brought in different people into the argument. for these reasons i think it was a huge mistake. lastly, you often hear medicaid costs and growth are out of control

i want to focus a little bit on medicaid. what is the republican think behind that >> i think there are a couple of reasons why. the notion of putting medicaid on a fixed federal medication has been around for along time. that's probably motivated by two things. one is a sincere sense that the federal obligation for medicaid isgrowing. relatedly, there's a sense the program has gotten tobreak and that has to do with the expansion of medicaid through the aca be abroad and it's good. whether it's a fiscalissue, those are the people policy motivations. the other side is an argument that if republicans want to undermine the aca the core of what the aca did is the medicaid expansion. whether you think it's a good idea or not we can agree that medicaid expansion explains some of the coverage increases in the aca. the other part is the politics. if you want to strike about theaca, getting at the medicaid expansion would be a big part. you can make the argument that you've done something because you have the aca. but there are some w

we also hear from the head of medicaid directors. californiat of the association of physician groups. >> good morning. i hope you enjoyed the dinner last night are bright eyed and bushy tailed this morning. i have a couple of panels in the wings by chance. rumor had it that i did. i see them coming. there is a handwaving. very good appeared it's good to see you. i was going to have to do a monologue for an hour. that would've been something. how are you? grab a chair. we are now going to have a debate. we are going to have a classical republican versus democrat debate. it seems to be the time to do such a thing. we've got repeal and replace in the wind and a very polarized nation. this is impacting ocelot. we thought it would make sense to invite a couple of representatives from the left and right. in terms of format, let me provide introductions to these gentlemen. we will out each of you to make a statement, maybe three or four minutes to provide your perspective on where we are in health care and then we will talk. been a guests h

then the importance of medicaid. after that a senate hearing on military caregivers. >> policies advisors discuss the future of healthcare policy in u.s. hosted by the california association of physician groups. this is one hour and 15 minutes. >> of money. p enjoyed the dinner last night and are ready this morning. to have a few panelist in the wings by chance? rumor had it that i did. i see them coming. chris, lonnie, good to see you. i was afraid i was going to have to do a monologue for an hour. that been something. >> grab a chair. we are now going to have a debate. we'll have a classical republican versus democratic debate. seems to be the time to do that. we have repeal and replace in the wind. apologize congress and nation. this is impacting us so we thought we would invite some representatives. in terms of format leme provide introductions. then we will allow each of you to make a statement, few minutes to provide your perspective of where we are in the we'll talk. christian is here to my left he is made his

the medicaid and that means massive reductions in help, not only for lowering cuts for americans, not only for children, but for people in nursing homes. they have already voted in the budget over a ten-year period to cut medicare by $470 billion in the halls they are working ways to cut social security and the republicans will also make massive cuts to education, the nutrition, to environmental protection. the other day, i sent a letter to senate majority leader mitch mcconnell into the speaker of the house paul ryan. and what i asked of them was to be honest with the american people. and this is what i said to the and i ask that this letter be put into the congressional record. >> without objection. >> thank you. >> this is what i asked. i said that, quote, i am very concerned that if you succeed in passing tax legislation, that significantly adds to our national debt, you will then move aggressively to balance the budget on the backs of working families come in the elderly, the children come in the second of four. in other words, in order to pay for tax rates for the rich and large

medicaid dish funding represents an important component of many state medicaid programs and is particularly relied upon by many states to help provide additional resources to key safety net providers. now, while this relief is only temporary, and does not address the larger structural challenges under obamacare, it woulgive congress time to explore what budget-neutral approaches ere might be delegate existing dish dollars on a morequitable and fair basis. in my state alone of oregon, hospitals have told me this relief in this bill just for them represents $6.8 mllion over the ne two years that they can use to helpow-income people get access to hospital care. in paying for this package,nd this is the area where we have most disagreement with the democrats, we have take an fiscally responsible approach. like using existingunding streams for prevention and public health efforts, for prevention and public health efforts. and ensung high-dollar lottery winners a removed from the medicaid program so its limited resources can be prioritized for the most vulnerable. and stopping individuals on the

medicaid dish funding represents an important component of many state medicaid programs and is particularly relied upon by many states to help provide additional resources to key safety net providers. now, while this relief is only temporary, and does not address the larger structural challenges under obamacare, it woulgive congress time to explore what budget-neutral approaches ere might be delegate existing dish dollars on a morequitable and fair basis. in my state alone of oregon, hospitals have told me this relief in this bill just for them represents $6.8 mllion over the ne two years that they can use to helpow-income people get access to hospital care. in paying for this package,nd this is the area where we have most disagreement with the democrats, we have take an fiscally responsible approach. like using existingunding streams for prevention and public health efforts, for prevention and public health efforts. and ensung high-dollar lottery winners a removed from the medicaid program so its limited resources can be prioritized for the most vulnerable. and stopping individuals on the

they are expanded medicaid. mr. chairman and colleagues, the amendment that is before us what a chore that veterans can see a reduction in access to their health care as a result of this bill. let me say that again. nos memo would ensure that veterans for their families would see a reduction in access to their health care as a result of this bill. i must have heard what hundred days last week on veterans -- i must have heard people thinking one another for this service. thanks for my service i have think a lot of veterans. how do we make real those words? how do we know for sure we mean that read i think one of the way we can do is dedicating this stipulation that no veteran or their families will see a reduction in access to health care as a result of this bill. i think everybody in this committee in this room, has a obligation to honor our nation's veterans to not increase costs and take away the care and benefits of they deserve. >> your time is up. >> recognizing our veterans -- i am one of the 14 people who wer

covered under medicaid will not covered. let me remind my colleagues in medicaid includes mental health and addiction coverage. that would carry will be lost, but that is half of the story. in addition when hundred $80 billion approximately is saved for subsidies that will not be provided under the affordable care act. then again is spent, spent by tax expenditures chairman's mark now, that $180 billion of savings that is spent in the chairman's mark and added to the deficit means there will be 13 million people needing medicaid and your portable care act that will not be covered by health insurance that will lose their mental health and addiction coverage under their health insurance policy and as was pointed out by the american psychological association many people because of that 10% increase in insurance premiums under the individual marketplace will be priced out of coverage and not be able to get mental health and addiction coverage, so for all those reasons we need to make sure we have the capacity to deal with the op

covered under medicaid will not be covered. let me remind my colleagues that medicaid includes mental health and addiction coverage. that could very well be lost. but that's half the story. in addition, $180 billion approximately is saved for subsidies that will not be provided under the affordable care act. now, that's, again, spent. spent by tax expenditures in the chairman's mark. now, that $180 billion of savings that is spent in the chairman's mark and added to the deficit means that there will be 13 million people with medicaid and the affordable care act that will not be covered by health insurance that will lose their mental health and addiction coverage under their health insurance policies. and as is pointed out by the american psychological association, many people, because of the 10% increase in insurance premiums under the individual marketplace, will be priced out of coverage and will not be able to get mental health and addiction coverage. so for all those reasons, we need to make sure that we have the capacity t

many get it through medicaid. medicaid accounts for about 2 million veterans. it's about one in 10. as it turns out, since the affordable care act went into effect, the number of working age veterans uninsured has decreased. not by a couple of percentage points, but 42%. no small part to the affordable care act establishing health insurance marketplaces, and expanding medicaid. colleagues, and remember that what is before us that no veterans or their families see a reduction in access to their health-care as a result of this bill. again: this memo would ensure that no veterans are other families see reduction in access to their health care as a result of this bill. i must have heard 100 times last , friday on veterans day or saturday -- and must have heard hundreds of times, people thinking one another for their service. i have been think for mind, and think a lot of people for theirs. words?we make real those how do we know for sure that we really mean it? one of the ways we can do that is to dedicate this legislation -- moving forward with the stipulation, that no veterans or thei

through medicaid that doesn't -- that didn't before the aca thanks to the medicaid expansion. unfortunately, americans fighting addiction like live in states that refuse to expand their medicaid programs like texas are left out in the cold. for those in the individual markets all plans must include services for substance abuse disorders and mental health and consumers cannot be denied coverage because of a history of substance abuse all thanks to the aca. this is not a small feat. prior to the aca, roughly a third of all individual market policies didn't cover substance abuse treatment. repealing the substance use disorder coverage will remove at least 5.5 billion annually from the treatment of low income with abuse disorders. going even further is the gut the medicaid expansion in states that took the money would be absolutely devastating to our fight against prescription drug and heroin addiction crisis. we're in the midst of the largest public health crisis in our country has known and this is not time to cut health care safety nets that serve those in recovery. i'm pleased

so this is just above medicaid. people who are above 150% of 0%, maybe 100, the poverty line, people whose jobs are in the service industry, people who maybe both the service work in industry, really not employer provided health insurance, meant to stay above medicaid, similar programs,d, state-run given allotted amounts of money, a granting system and they set up their own programs. 13.5 total cost yearly billion, 9 million children or covered in the chip program. we're talking about it in "your segment," should note special line for chip your family is on the chip program. 202-748-2003. independents, 202-748-8002. alex ruoff, for the nine million children covered, how much does up, how have to pick much do they pay out of pocket and what sort of services are they getting? chip is dependent on the states, states really define a are, some have y been pretty innovative with the wrapped ome have around, make sure kids get a big robust more ices, han medicaid, medicaid does -- array of services -- i wouldn't say some,

we ensure high-dollar lottery winners are removed from medicaid so that medicaid resources can go to medicaid eligible low-income people in our districts. our bill directs funding from the prevention and public health fund to finance important prevention and public health needs. like funding the national health service corps, teaching health graduate center medical education and family-to-family health centers, community health centers. if these are not important programs for prevention and wellness and public health, i don't know what are. that's why, mr. speaker, the house is not in order. the speaker pro tempore: the gentleman is correct. please take all conversations off the house floor. the house will come toured. until it comes to order, the gentleman will not continue. the gentleman will continue. mr. walden: thank you, mr. speaker. our bill before us today, which i predict will have bipartisan support, directs funds from the prevention fund for important public health priorities that have long had bipartisan support. so we're using a bipartisan fund to pay for bipartisan heal

budget -- it ransacks the budget of medicare and medicaid .5 trillion -- $1 trillion from medicaid. half a trillion to medicare. take a trillion and a half out of medicare and medicaid. we are joined today by men and women and children who speak to the consequences of the ryan-mcconnell act. they are speaking for the families and communities they didn't want you to listen to, hardworking americans who will bear the pain while corporate america gets the tax giveaways. they are just the tip of the iceberg when it comes to the suffering under the g.o.p. bill. we thank them for making time to share their stories. and we have with us today susan flashman, a retired union electricity with medical expenses which of course the deduction will be eliminated. captain john nepick, professional firefighter, local 2068. kendrick, a health care worker and mother of three. two here. plus a friend. [laughter] bar are a altman, retired grandmother, who has a grandson with microcephaly who relies on medicaid. and michael smith, nabisco worker, laid off from a chicago plant. in addition to hearing from

medicaid has been his lifeline, and mine. medicaid allowed him to have a normal round of life. they programs during the week and activities on the weekend. sometimes it even comes home. cutting taxes for millionaires and corporations while cutting medicaid and medicare is simply immoral. don't take from my son for people who don't need it. >> thank you so much, barbara. a big thing you said applies, we've heard from the veterans and veterans defend very heavily on medicaid, food stamps, some of the initiatives that kendra mentioned as well. and why? and why? just to have an unfair tax policy at the expense of the middle class, to the benefit of billionaires in our country, and corporations with advantages to send jobs overseas. with that we welcome michael smith to the podium. thank you, michael. >> thank you, madam leader. my name is michael smith, and i'm here to tell you why we believe that the tax bill is a job killer. up until march of 2016 i was employed at the nabisco bakery in chicago. i worked there nearly five years, and i am unemployed today because nabisco sent my j

billion in reduced medicaid subsidies. coming $364 billion directly out of subsidies and medicaid. that is where you are getting your $320 billion. that is why this debate is relevant. those numbers are cbo numbers. that is why it is important to have a debate because what will happen is that those people will get sick and they will still so -- show up at hospitals and all of our constituents will pay bill through higher premiums. >> we are trying to get this government under control. it is not under control. one reason is not because of this continual plethora of spending. senator toomey? >> the operative part of this amendment asks for the joint committee on taxation, the congressional budget office to certify the bill will not reduce the number of middle-class americans with health insurance coverage. today,testified earlier there is not a word in this bill that causes anyone to lose their coverage. we do not change any rules about medicare, medicaid, nothing of the sort. what we are doing is repealing a tax on people who cannot afford obamacare policies. 83% of the state, peopl

don't claim you are not cutting don't claim you are not cutting medicaid when you are decreasing medicaid spending of $179 $185 billion in decreased $185 billion in decreased aca subsidies. don't claim you are not doing this, then you are spending these dollars. i think there are a lot of comments we have heard from both sides that want us to slow down the movement of american businesses abroad. sides that want usi'm still tryh all the new minimum tax procedures. i claim to have a little background in math and tax policy. -- i find the complexity will grant the majority -- maybe they wanted to do the right thing, but i believe what you have created is a perverse incentive to send more jobs abroad. the ability of a company to make an investment, a capital investment in a relatively high taxed nation like germany, and still move their intellectual property to a tax haven like bermuda. frankly, this bill does nothing to remove any of that bias towards tax havens. -- i don'tnding think you had a chance to work that you canhis -- take what are called normal return deduction amounts, and then i

how his life has changed because of the coverage of medicaid. well, that could be said of someone who's receiving their health insurance, not through medicaid through a disability, but through the exchanges. nothing in this bill and we ought to be able to guarantee an certify that if you are an american with a disability and you have coverage, health insurance coverage through the insurance marketplace, nothing in this tax bill will do anything to rip back coverage away from you. this should be a simple yes a bow by everyone. making sure individuals with disabilities will have insurance today, will have it tomorrow and have a next month and next year or as long as they needed is a mission worthy of a great country. we call ourselves a great country. we can guarantee that or we should try like hell to guarantee. i would hope you have an affirmative yes vote on this amendment. >> mr. grassley. [roll call vote] [roll call vote] [roll call vote] [roll call vote] [roll call vote] [roll call vote] [roll call vote] [roll call vote] [roll call vote] [ro

we have got to cut social security, medicare, and medicaid. now, i happen to see my friend from pennsylvania here on the floor dish say to him and i say to the leader of the senate, mr. mcconnell, i will floor this amendment if you can assure the american people tonight that you are not going to cut back -- come back to the senate and cut social security, medicare, and medicaid. can i have that assurance? i would yield time. good. i would yield time to my friend pennsylvania to assure -- now, i see senator rubio down here as well. he just the other day, correct me if i'm wrong, senator rubio -- i know you just walked in and i got you into this debate. but correct me if i am wrong, if you did not say yesterday that the senate would now proceed to a, quote-unquote, entitlement reform which will mean cuts to social security, medicare, and medicaid. i would yield to my friend from florida to tell me whether or not i am accurately portraying what he said just the other day. mr. rubio: mr. president? the presiding officer: the senator from florida.

you didn't say a word about medicaid nor mention medicaid at all. >> the reason i don't mention medicaid is not a lack of commitment to medicaid. it's really that medicaid does not have the same kind of payment rules that medicare has at the national level. and that was my focus, i'm not a-- >> i'm a governor and i ran a medicaid program and an ex-governor. it's interesting, wouldn't you also agree that we can focus to paying for procedures and shift that focus and pay for health and outcomes. the medicaid program can be part of that as well. >> certainly could. and the governors, if governors are willing partners to try to drive that, absolutely, medicare, the secretary has more levers in his or her control and-- >> would you try to do the same thing in medicaid. >> absolutely, could have,. >> if we could make medicaid better let us serve more people. >> thank you. >> thank you, senator. senator murphy. >> thank you, mr. chairman, thank you for your nomination, mr. azar. i enjoyed our conversation and open to your nomination. i'm very, very concerned about your answer to senator casey's

and then they want to come rent and cut medicaid and medicare and education. and you know how we know that? they already told us come in the budget that passed the senate and the house, they called for cutting medicare almost $500 billion, 473 billion to be exact. cutting medicaid by $1 trillion. cutting cutting education investment very deeply. cutting our investment inve national infrastructure. so we know that once they blow up the debt by another $1.5 trillion, they are going to come right back and say the seniors on medicare or americans who rely on medicaid or kids, education what to invest, sorry, now we have that national we just created. let's come back and cut everything else. so i really hope, mr. president, that everyone will take a step back. we should not rush through something that will do great damage to the country and great damage to the middle class just because of someone's political imperative, to get something, anything done. because the reality is that while we do need tax reform, we don't want to mess things up even worse than they are

and then they will want to come around cut medicare medicaid and education, and you know how we know that?ol they were ready told us in the budget that passed the senate and the house, they called for cutting medicare by almost $500 billion, 470 billion to be exact, cutting medicaid by a trillion dollars, cutting education investments very deeply, cutting our investments in nationalri infrastructure so we know that once they blow up the debt byac another $1.5 trillion, there to come right back and say to the seniors on medicare or americans who rely on medicaid or kids who need an education investment, sorry now we have a national debt, let's go back and cut everything else. so, i really hope, mr. president that everyone will take a step back, we should not rush through something that will do great damage to the country and great damage to the middle class just because of someone's politicalag imperative , to get something, anything done because the reality is, while we do need tax reform, we don't want to mess things up even worse than they are today. i would welcome the t opportuni

so don't claim you're not cutting medicaid when you're spending the decrease in medicaid spending of $179 billion in increased subsidies. at least don't claim you're not doing this when you're then spending these dollars. i think there's a lot of comments we've heard from both sides that want us to slow down the movement of american businesses abroad. i'm still trying to work through all of the guilty, the new minimum tax procedures. and i absolutely do claim to have a little background in math and a little background in tax policy. but i fine the complexity of what i will grant the majority, maybe they wanted to do the right thing, but i believe what you have created is a per verse incentive to actually send more jobs abroad. because the ability of a company to make an investment, a capital investment in a relatively high tax nation like germany and still move their property to a tax haven like bermuda, and this bill does nothing to remove the biases towards tax havens. my understanding, and mr. barthold, i don't think you've had a chance to work through all this, that you can take

why didn't you mention medicaid? medicaid is a very important part of your portfolio. i found it interesting in read -- in reading that sentence, you didn't say a word about medicaid. >> the only reason i don't mention medicaid in that context, it's really that medicaid does not have the same kind of payment rules at the national level. that was my focus. >> say i'm a governor and i ran a program. it's interesting. wouldn't you also agree that we can focus to paying for procedures and sickness, shift that focus to paying for health and outcomes. the medicaid program can be part of that as well. >> it certainly could. if governors are willing partners to try to drive that, medically the secretary has more levers in his or her control to do would you try to do the same thing in medicaid? public school. if we can make medicaid better, it will let us solve that. >> i enjoyed our conversation. i was very open to your namtion. -- open to your nomination. i'm very concerned about your answer to senator casey's series of questions. i just want to state it to you one more time

scheming to use the debt they pile up today to obliterate medicare and medicaid tomorrow. this is a shell game. a ponzi scheme that corporate america will perpetrate on the american people. the republican bill written in secret, designed to be raced forward before it is truly understood, ransacks vital benefiters in middle class. but if you're the wealthiest 1%, republicans will give you the sun, the moon and the stars. all of that. at the expense of the great middle class. which is the back bone of our democracy. i'm pleased now to welcome back to the house side and yield to the distinguished democratic leader of the senate, chuck schumer. mr. schumer: thank you, nancy. when we were in the house we didn't have such a fancy -- fancy room here, wed that that little room on the third floor. which i iven habited regularly. ms. pe he see: camera shy. mr. schumer: we're still poring through the fine print of the republican tax plan. one thing is crystal clear. this plan is a tax burden that ought to be on the backs of the wealthy and the biggest corporations. but instead it dro

many folks get their coverage through medicaid and medicaid covers about 2 million veterans, one in ten. since the affordable care act went into effect number working age veterans who are insured has decreased. , not by just a few percentage points, by 42%. that is due in no small part to the affordable care act establishing marketplaces and expanding medicaid. mr. sherman and colleagues, the amendment before's would ensure no veterans or the families see reduction or access to the healthcare as a result of the bill. it would ensure no veterans or their families see reduction and access to their healthcare as a result of the bill. i must heard 100 times last weekend on veterans day hundreds of times people thinking one another for their service. i have been thing for my service and i think a lot of people for theirs. had we make real those words? th the stipulation that no veterans or families receive reduction in healthcare as a result of this bill. everybody in this room believes we have an obligation to honor veterans and to not reduce their benefits. >> your time is up. >> i think s

they've already culled called for a $18 trillion cut in medicaid. so the beauty of the republican plan to give all of these huge tax breaks to the wealthiest in america is that it creates such a huge deficit that their elephant symbol is shedding crocodile tears about how big the deficit is going to become. that will be next year when they're shocked at how needed it is to cut medicare and medicaid but they have already given us the preview of coming attractions by putting it in their budget already this year. so this reconciliation game, this con job tries to separate the tax breaks from the wealthiest from their brutal, vicious cuts to programs for the poorest, the sickest, the elderliest, the neediest in our country. that is the game. that is the con game, the reconciliation game that they are playing with the american public. and by trying to divide this story line, they seek to have it sneak through without any full understanding of the ramifications for the american people of the implications for their family. but make no mistake about it, as

ut is a $1 trillion cut in medicaid part of the budget resolution? >> to be clear, a budget resolution just shows changes in numbers. ms. stabenow: i understand. >> so the implication is given how much they've cut out of those functions. ms. stabenow: they cut that function by $1 trillion. is the medicare function cut by almost $500 billion? $470-some billion? >> yes, that was our reading of the budget. ms. stabenow: so i just want to be clear. it's not -- this is more than one step in the process. just as during -- with the 2001, 2003 bush tax cut, that didn't have anything about privatizing social security in it. but when the deficit resulted, the big debt, as a result of the tax cuts, then the next step was trying to privatize social security. so this is the first step, the budget resolution has assumptions in it of lower spending. $1 trillion in medicaid, almost $500 billion in medicare. >> correct. ms. stabenow: in the budget resolution. >> correct. s. stabenow: thank you. >> clerk will call the roll. >> mr. grassley. no. mr. crapo. no. mr. robe

we saw it with medicaid in maine. congressman, do you think that -- what do you think republicans like ed gillespie should have done last night in order to win? should he have embraced the president more, as the president said? or should he have even distanced himself more, maybe run on a 2013/2012 version of ed gillespie other than the 2017 version we saw, which was talking about monuments, and as some might say, campaigning on race. >> yeah, i think lindsey graham actually had the right answer right off the top of his head. he said, we need to perform up here, right? our policy trumps state-level policy. state level, you can have a little bit of an impact, right? but the u.s. macro policy dwarfs any state's policies. and so when our senate failed to repeal obamacare, that was it, right? and tax -- we don't have tax through yet, so everybody's waiting to see if they get a tax cut. and we better get that piece right as well. and so ed ran a guide campaign on rational virginia policy, but the national indicators were d

and medicaid -- we have working families that qualify for medicaid. veterans qualify for medicaid. we know that. we had that debate on the floor of the united states senate. because these individuals right now don't come forward, because there's no mandate. and they lose those benefits. >> that's correct. there's reduction and outlays. >> so i just -- want -- middle income families are getting a lot of conversation here. but it seems like it's disingenuous to say that you're providing $43 billion of relief when you're taking away $360 billion of benefits. am i missing something? as far as the benefits to basically middle income families? >> the analysis that you've provided on the benefits that you provided seems accurate. >> let me use my last 45 seconds, mr. chairman, just make a plea here. i don't know what impact this is going to have on the state of maryland. but i do know that we have an all-payer rate structure, which is truly unique. and if we have a high increase in the uninsured, it's difficult to maintain that program of all payers. and these are the consequences of chan

do they not know or do they not care that over 1 million veterans are on medicaid? do they not know that this has a direct impact on the lives of america's veterans? do they not know? have a hearing, find out. but the veterans have come forward and they are telling their story about how this budget that predicates this tax bill and then will necessitate those cuts is unfair. but what's interesting about it, $1.5 trillion in tax breaks, a rate of $1.5 trillion in tax breaks for corporate america. $1.5 trillion for medicare and medicaid. what a terrible statement and what a very, a lack of values for the american people and for our veterans. any other questions? >> i think it's entirely reasonable that we've never had a chance to talk about, you need money to do tax reform. and now there's a chance to find out where it's going to come from. >> so i say once again, are distinguish ranking member on the ways and means committee. we look forward to his take on what they put forward, but again an act of desperation. and who knows if this is the last one? what a shame they

we should not cut medicaid to fund these two programs. you are taking money away from the poorest children to give to the less poor children. we need to support vaccination programs, infectious disease detection, prevention, and chronic disease prevention. we need to make sure this bill is bipartisan and it's not right now. thank you. the speaker pro tempore: the gentleman's time has expired. for what purpose does the the gentlewoman from florida seek recognition? >> mr. speaker, i ask unanimous consent to revise and extend. ddress the house for one minute. the speaker pro tempore: without objection, the gentlewoman is recognized for one minute. ms. ros-lehtinen: thank you so much, mr. speaker. there are less than 21 legislative days left this calendar year and the house has yet to vote for a permanent solution to protect dreamers from deportation. h.r. 3440, known as the dream act, introduced by congresswoman lucille roybal-allard, and me is an effort to put an end to the fear and to the uncertainty that surrounds over 800,000 young immi

do they not know or do they not care that over a million veterans are on medicaid? do they not know that this has a direct impact on the lives of american veterans? do they not know? have a hearing. find out. but the veterans have come forward and they're telling their story about how this budget that predicates this tax bill and then will necessitate those cuts is unfair. but what's interesting about it, $1.5 trillion in tax breaks, a rate of $1.5 trillion in tax breaks for corporate america, $1.5 trillion from medicare and medicaid. what a terrible statement and what a very lack of values for the american people and for our veterans. >> one other question if i can. i think it's entirely reasonable, that we've never had a chance to talk about. you need money to do tax reform. mr. neal: now there's a chance to find out where it's going to come from. ms. pelosi: i thank once again our distinguished ranking member on the ways and means committee. we look forward to his take on what they put forward. but again, an act of desperation. and who knows, this is the last one

we know what the republican budget looks like on medicaid and medicare. we know what martin feldstein said, president reagan's trickle-down economics guru. tax cuts don't pay for themselves. maybe only a quarter for themselves, let's raise the eligibility age for social security so the barber in garfield heights and a construction worker in war and and the woman that works at mansfield can't work until they're a 70 years old. maybe we can because of the jobs we hold but to ask others to wait until 74 social security for a tax cut, i wanted to ask and understand those that are. i guess your say we can do that tomorrow. i hope you will live up to that commitment so we can as those questions. >> thank you mr. chairman. colleagues, this major tax bill is now officially a moving target. a enormous departure from the way the finance committee has traditionally work. this now does not resemble .egular order it sets a precedent i guess, for letting practically anything fly to the shoot at any time. and say it's relevant to a tax bill if it amounts to an ideologic

on a brighter medicaid, medicare part d. i mean, that is the jurisdiction of this committee has over health care. are we really say because we were discussing some day which has been declared a tax, that we are now going to go and bring in medicaid in 340 b.? that just seems like a stretch. i got to admit this is a tax and is not medicaid. i don't quite get the connection between the whole scope of health care this committee has been that which is specifically -- >> if i can respond to my colleague, this is related to a host of other health care issues. this is partial repeal of the affordable care act and that is why the congressional budget office scored with such ominous consequences. people losing coverage, millions of people having their premiums go up. my college has been involved in health care. far fewer healthy people go into the risk full, which means that premiums are going to go up in this country. this is turning a tax bill into a health care bill with colleagues getting an hours worth. >> that does not address