Thune Debunks Democrats’ Medicaid Falsehoods

“By refocusing available Medicaid dollars on those this program was originally intended to serve, we will make vulnerable Americans more secure - and ensure that this program will continue to be available to Americans in need long into the future.”

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WASHINGTON — U.S. Senate Majority Leader John Thune (R-S.D.) today delivered the following remarks on the Senate floor:

Thune’s remarks below (as delivered):

“Mr. President, the Democrat hysteria over Republicans’ One Big Beautiful Bill is in full swing.

“And Democrats seem to have fixated on the bill’s Medicaid provisions as a useful tool – they hope – to attack Republicans.

“And they’ve decided that a good talking point is to blame rural hospital closures – including current rural hospital closures – on our bill’s Medicaid provisions.

“Well, there’s only one little problem, Mr. President.

“The provisions of our bill that Democrats would like you to believe threaten rural hospitals – those provisions don’t even go into effect until 2028.

“Two and a half years from now.

“Suggesting that those provisions are responsible for rural hospitals closing this month is the height of absurdity.

“Mr. President, I said there was one little problem with Democrats’ argument.

“But in fact there are a whole lot of problems with Democrats’ argument, starting with the fact that rural hospital closures are a longstanding problem – not something that is suddenly being triggered by our bill.

“Under President Biden, Medicaid spending soared, and yet rural hospitals still closed.

“Why?

“Because rural hospitals have to deal with a lot of challenges that hospitals in major metropolitan areas don’t have to deal with.

“Despite those challenges, many rural hospitals are finding ways to adjust to keep their doors open and to serve their communities.

“And we have taken steps with our bill to ensure that they can continue to do so, with a $50 billion fund for vulnerable providers like rural hospitals – a fund that goes into effect this year.

“Our goal with this fund is to give rural hospitals and other vulnerable providers the time and resources to find solutions to some of the challenges they’re facing – and to give state governments the time to look at their budgets and develop ways of assisting rural hospitals that don’t involve pushing state responsibilities onto federal taxpayers.

“Now, Mr. President, hopefully what I’ve said so far brings some much-needed clarity – and accuracy – to this discussion.

“But I want to step back for a minute and discuss the overall scope of what we’re doing with the Medicaid provisions in our bill.

“We are restoring Medicaid to what it was originally intended to be – a federal-state partnership to support the most vulnerable Americans.

“Let me just repeat that, Mr. President.

“We are restoring Medicaid to what it was originally intended to be – a federal-state partnership to support the most vulnerable Americans.

“There’s been drift on both of those in the past few years, Mr. President.

“We’ve drifted from a federal-state partnership to a situation where the federal government picks up more and more – sometimes close to all – of the tab.

“And we’ve drifted from a focus on the most vulnerable Americans.

“Medicaid was created to serve the most vulnerable populations – the elderly poor, the disabled, pregnant women, and children in need.

“But in 2010, President Obama and Democrats allowed states to expand Medicaid to include able-bodied adults earning up to 138 percent of the federal poverty level.

“And they gave states an incentive to do so by promising that the federal government would pick up almost all of the tab.

Now, combine that with the Biden administration’s Medicaid rules and waivers, and both the Medicaid population and federal spending on Medicaid have exploded.

“Medicaid spending has grown by more than 50 percent since 2019.

“50 percent.

“Since 2019.

“That’s utterly unsustainable, Mr. President.

“And it threatens the stability of the program for the most vulnerable populations.

“And so Republicans implemented several commonsense measures to slow the rate of Medicaid growth and to refocus the program on Americans most in need.

“Note what I said: ‘slow the rate of Medicaid growth,’ Mr. President.

“We are not cutting Medicaid; we are simply slowing the rate of growth.

“And as Senate Finance Committee Chairman Crapo noted, ‘Only in Washington’ – only in Washington – ‘is a smaller increase in spending considered a cut.’

“So what did we do in our bill, Mr. President?

[…]

“We implemented measures to remove noncitizens from the Medicaid rolls.

“We implemented an extremely mild work requirement – just 20 hours per week – for able-bodied, working-age adults without young children.

“We overturned Biden-era regulations that made it difficult to remove individuals who don’t qualify for Medicaid.

“And we took aim at rampant abuse of the provider tax loophole.

“Now use of this loophole, which sees states inflate Medicaid service prices in order to garner a larger reimbursement from the federal government, has been a problem for quite a while now.

“In fact, President Obama proposed multiple budgets featuring measures to rein in abuse of the provider tax.

“But states continued to take advantage of the gimmick, and, thanks to waivers that the Biden administration issued to California and other blue states last year allowing them to further exploit a similar loophole, taxpayers were on the hook for tens of billions of dollars in new spending.

“And so we took action to rein things in.

“We are not eliminating states’ ability to use the provider tax loophole, but we are instituting limits – the identical limits, in fact, that President Obama proposed imposing.

“And we’re making states take responsibility for their Medicaid decisions.

“States like California – which chooses to spend state funds to have its Medicaid program cover illegal immigrants – they should not be able to, in effect, have the … federal government bail them out for their reckless spending decisions.

“Resources are not unlimited, Mr. President.

“And states need to shoulder their share of the federal-state Medicaid partnership, rather than pushing off their costs onto federal taxpayers.

“Now, Mr. President, the net effect of all these measures – like removing ineligible individuals and individuals who refuse to work from the Medicaid rolls, and restraining state abuse of the provider tax loophole – will be able to put Medicaid on a more sustainable fiscal footing going forward and put a renewed emphasis on the vulnerable individuals this program was actually created to serve.

“Vulnerable individuals will also be helped by the major investment our bill makes in expanding home and community-based services for individuals with developmental disabilities.

“This will reduce multi-year waiting lists for services and allow individuals with disabilities to access the care that they need at home or in their communities.

“Mr. President, the One Big Beautiful Bill was developed to make hardworking Americans safer, stronger, and more secure.

“And the Medicaid provisions of the bill fit right in with that mandate.

“By refocusing available Medicaid dollars on those this program was originally intended to serve, we will make vulnerable Americans more secure – and ensure that this program will continue to be available to Americans in need long into the future.

“That sounds like a good day’s work, Mr. President.”