Floor Statements

Mr. President, I rise today to urge my colleagues, my Republican colleagues, to reverse course on their proposal that would take affordable healthcare away from the many patients across the United States who will suffer, I believe, financial strain and the financial strain will be put on the rest of us in our healthcare system.

Despite the talking points that you hear from our colleagues, they do propose on Medicaid to really make cuts that will hurt us. This isn't about waste, fraud, and abuse. Their plan is to allow enhanced premium tax credits to expire. That has really nothing to do with lowering costs on average Americans. And this whole idea, in my mind, is a veiled attempt to repeal the expanded coverage that we saw for Medicaid under the Affordable Care Act. Why is that important?

Well, it is critically important because Medicaid has been the cornerstone of, in the Affordable Care Act, expanding care to working families that could not find an affordable insurance policy. Medicaid gave them that coverage.

And now, with the proposal by our Republican colleagues, they are going to cut Medicaid and thus cut families who need the assistance to cover insurance to get the coverage they deserve. The result will be that Medicaid is stripped away. Coverage in the ACA marketplace will become more unaffordable, and premiums for even employer-based insurance will go up. But that is what happens when you take dollars out of the system. In fact, we are already seeing some of these prices start to go up.

Our healthcare system relies on people being insured so that they can pay for care, and when you dismantle that, the medical costs for everybody goes up. It only makes sense. Uncompensated care gets cost into the system that is passed on to the rest of us.

Earlier this month, the Congressional Budget Office confirmed that the House's reconciliation bill, if enacted, would cause 16 million people to become uninsured--so that is the Congressional Budget Office--so again, 16 million people currently insured. Now, all of a sudden, uninsured, means cost to the system, to say nothing of the cost to these individuals. Just as eye-popping is the projection that this proposal will drive up premiums and out-of-pocket spending for millions of people struggling to afford private insurance plans through the ACA marketplace or those with employer provided coverage.

A new analysis by the Center for American Progress proves that working-class families and people with all types of insurance will have to foot the bill for these harmful policies. For Medicaid, a family of four making $33,000 per year could see additional costs and copayments up to $1,600 in annual out-of-pocket spending. I guarantee you, these are people that already have had a tough time finding affordable insurance.

For an ACA market plan, a 60-year-old couple making $85,000 a year who want to keep the same plan could see their annual premiums increase--and these are numbers according to the Center for American Progress--and you could even see the cost of an annual premium increase by as much as $15,000 a year. So these are all costs that we don't need to see increased. But if you are taking people who have affordable insurance and displacing them, according to CBO, 16 million of them, I guarantee you that cost will be absorbed by the rest of us. For Medicare, which President Trump pledged not to cut, low-income seniors who qualify for both Medicare and Medicaid will see their out-of-pocket expenses rise.

For example, an older couple on Medicare, living on an annual income of $21,000 could face an additional $8,340 in annual healthcare costs. So this just shows that cutting almost $1 trillion in healthcare from funding and making millions of people be uninsured does not save the money. It basically gets into the system, and other people are paying the cost. The Affordable Care Act lowered the individual uninsured rate from 17.8 percent in 2010 to a historic low of 9.5 percent in 2024. So we significantly decreased the number of uninsured. This drop in uninsured Americans improved people's health. Saved money for individuals, saved money for families. It helped States. It even helped our State government.

According to the Kaiser Family Foundation, thanks to improved access to general health services, cancer screenings, and other forms of preventative care, Medicaid expansion alone lowered health-related mortality rates by 3.6 percent. So funding available insurance under the Affordable Care Act drove down the mortality rate and helped substantially save money. By contributing to a more robust economy, better societal well-being, lower mortality rates, it also helps States generate more than $20 billion in increased tax revenue and welfare savings.

So covering people--I like the best example of this, is the former Vice President of the United States. As a Congressman, Mike Pence didn't vote for the Affordable Care Act, but when he became Governor of Indiana, everybody in Indiana, the healthcare providers and others convinced him--oh, it is a good idea, you should get people covered in your State. And they did. So this is about a smart way of providing healthcare, and we have done it.

So States who were smart about this realized that their economy was better, their access to affordable insurance was better, that revenue stimulating the economy was better. They knew that the Medicaid expansion literally kept people alive. We should not reverse that. We have made great progress in the past 15 years to keep Americans healthier and financially secure. Allowing 16 million people, including 306,000 people from the State of Washington, to become uninsured is a bad idea.

Without any alternatives, this will be a shock to our healthcare system. It will bring it to the breaking point and threaten the very lives of our constituents. I would like to take a moment to read a letter from my constituent highlighting the concerns and fears about the impacts of the budget reconciliation bill.

Britton Winterrose from Richland, WA, is father to a joyful 5-year- old girl named Leda. He said he wrote to me because ``Without Medicaid, my daughter's next nap could be her last.''

So now I want to read a letter from the Winterrose family:

Leda entered the world at the height of the pandemic and

spent the first 45 days of her life in the NICU. Doctors

finally identified a rare form of congenital central sleep

apnea.

If she falls asleep without oxygen, she simply stops

breathing, and will die.

The only path out of the hospital was a Medicaid waiver

that paid for in-home nursing and life-support equipment.

Medicaid gave us the opportunity to bring her home,

surrounded by her siblings, surrounded by the normalcy and

safety of parents that love her.

Since that day Medicaid has kept up with Leda's needs as

she has grown. A toddler who once needed a walker now sprints

across the yard because the program funded the therapy and

walker that strengthened her legs.

It's provided her with a bed, that keeps her secure so her

equipment stays connected and we can sleep at night.

Each stage of development adds new hardware, new supplies,

and new specialists. Feeding supplies, feeding pumps, G-

tubes, sensors, diapers, respite care, and an AEC device to

help my non-verbal autistic daughter communicate.

Private insurance, even the platinum plan that comes with

my job, rarely covers it.

There is not a private health insurance on the planet that

covers the edge cases of human existence for somebody with

medical complexities like Leda.

Tonight, like every night, my wife and I will hook our

daughter to an oxygen concentrator and a pulse oximeter, then

we will lie down and ``say no to death.''

The only reason we can sleep at all is because Medicaid has

provided the durable medical equipment and supplies needed to

support her.

From the days at the NICU until now, one thing has become

obvious: the last question on anybody's mind when they are

trying to keep their child or loved one from dying should be,

How can we afford these things?

I do not speak only for Leda. The bill before Congress

would strike thousands of Washingtonians from the rolls, and

when that happens clinics and long-term-care facilities

collapse.

That blow lands on veterans, on cancer patients, and on

newborns in rural counties as surely as it lands on my

family.

No one wakes up and decides, ``Oh, I want to be disabled

today.'' Everyone's health is a roll of the dice; Medicaid is

how we make sure the roll is not fatal.

I still lose sleep over what will happen when I am gone. As

a tired Dad, help me rest.

Please defend and strengthen Medicaid so that Leda, and

every child like her and those who are rightfully dependent

on this system can live and thrive.

That is the end of the letter from my constituent from Richland, WA. What an incredible story of how a family has depended on Medicaid.

Today, I met with an organization and individuals from it, MomsRising, where families from Washington State and all over the country came to protest the cuts to Medicaid and SNAP. I heard myself countless examples of how these programs are critical to families, to their well-being, and how this program, if cut, would be devastating.

There is a common theme on all these stories; these families are scared they will not be able to afford or get the care that their family really relies on. They are also concerned that there is nowhere to turn, even if the coverage is taken away. Does this mean these patients will no longer need care, or their illnesses will just magically go away? We all know that doesn't happen. This means that uninsured patients will wait to see a doctor until they are so sick they have to go to the ER, which costs more. This will lead to increased costs across the board.

Specifically, it is estimated that 5.4 million Americans will incur medical debt because they will become uninsured, and the total medical debt that Americans owe will increase by $50 billion. I think this is numbers from The Third Way. Hospital providers will have to shoulder an additional $36 billion in uncompensated care costs, and a portion of the costs will be recouped by increased premiums on employment-based insurance coverage. As a result, people with employment-based insurance will also see an additional anywhere from $182 to $485 in annual cost increases.

That is what happens when you increase the cost of uncompensated care, and the system has to make up for it somewhere; you increase everyone's cost.

This is particularly damaging in the area of certified community behavioral health. I am sure the President knows that behavioral health--very tough challenge, particularly with the fentanyl epidemic in our country.

I met with representatives of Peninsula Behavioral Health in Port Angeles, WA, and Sound Health in King County, who told me that clinics are already operating on narrow margins and have already sustained a 1- percent budget cut this year at the State level. If Congress passes the budget reconciliation bill and enacts policies like the suggestion on the State Directed Payment Caps, they will have to reduce their budget by 20 percent, meaning they will have to cut staff and lay off people.

As a result, patients who rely on them for substance abuse treatment will be left out in the cold. We literally will see an increase in overdose deaths, law enforcement run-ins, and incarceration rates. Where do you think these people go when they don't have behavioral health treatment for fentanyl?

All this costs taxpayers more, actually, a lot more, a lot more than just covering Medicaid. It would be better if we just kept the Medicaid Program and funded patients so they could get the

care when they needed it. My Republican colleagues know that this bill will cause harm; hospitals and physicians and various leaders across the industry are at their doorsteps, telling them not to hollow out our healthcare system.

But I beg my colleagues to drill down and listen to the fact that the revenue that rural hospitals particularly live on are huge Medicaid, Medicare budgets. That means there is no margin to have a 20-percent decrease in funds. Spending money to fix a problem caused by not spending money doesn't seem the smart thing to do; the logic doesn't make sense. In fact, it sounds to me like waste and fraud to say to people that you are going to somehow make this a better system, when in reality, you are going to cut care and increase costs on all of us.

Passing this bill and enacting these policies will only hurt working- class and middle-class Americans. Americans are still reeling from the effects of inflation, to say nothing about the tariffs. This is not the time to be taking away healthcare coverage or increasing premiums on anyone. We have already seen enough inflation. For most families, any extra money from a tax cut will be swallowed up by these higher healthcare costs. And every time a new report or analysis is done on this bill, the outlook gets more challenging for people at home.

If we really had this serious of a waste, fraud, and abuse problem in Medicaid, why haven't we had hearings on it? Why haven't we had legislation trying to fix it? Why haven't we had communication that this is a real issue? Because it is not a real issue. What is a real issue is Congress has been trying to fix the uninsured problem by passing the Affordable Care Act. It has worked successfully, and now our colleagues on the other side of the aisle want to try to repeal it.

I hope that my colleagues will realize the only thing that you can know for sure about this proposal that cuts Medicaid--the only thing we know for sure is that thousands of Americans will become sicker and will become poorer because, without the access to care, that is exactly what is going to happen.

I urge my colleagues to really understand the harmful effects of this legislation, understand the harmful health effects on the citizens of our country, and I ask them to reject these Medicaid cuts.

I yield the floor.

Mr. President, I rise to express my concerns about reports that President Trump is going to again extend the deadline for getting TikTok out of the control of ByteDance and the Chinese Government--concern because that means that, again, we are going to allow this national security issue to fester and to continue on, maybe for several more months.

What we know now, though, in the middle of a global conflict, during which we know our enemies can weaponize TikTok to spread their propaganda and turn the world against the United States, we need to take action. While I know there are legitimate uses of TikTok, it is also used by governments, in particular the Chinese, to spread lies and indoctrinate people about what China, Iran, and Russia want Americans to believe about our own country, about our own government. This is alarming when an app is the top news source of Americans under the age of 30. Let me give some examples of these practices.

In December 2023, Rutgers University found that TikTok's algorithm disproportionately amplified anti-Israel and, by extension, anti- Semitic content compared with other social media platforms. This amplification observed in the context of a major geopolitical events, such as the portrayal of the Israel-Hamas conflict, and such hashtags ``I stand with Israel'' or ``Pray for Israel'' were unrepresented. That means they weren't represented at a ratio of six to one.

According to the Jewish Federation of North America, individuals on TikTok for over 30 minutes a day were

17 percent more likely to be anti-Semitic. And last year, anti-Semitic comments on TikTok rose 912 percent.

My fear is that a similar study would show that in between the issues that we do think are legitimate businesses on TikTok, that there is a bias and anti-American content being pushed about even the current hostilities now in Iran. That is why I would like to submit for the Record a report by Rutgers University entitled ``A Tik-Tok-ing Timebomb: How TikTok's Global Platform Anomalies Align with the Chinese Communist Party's Geostrategic Objectives,'' which can be found online at https://networkcontagion.us/wp-content/uploads/A-Tik-Tok-ing- Timebomb__12.21.23.pdf.

On the flip side of another example is the current topics that China doesn't like to talk about--they are sensitive to. You are never going to see any information on TikTok about Tiananmen Square and what happened.

And now, we are in a trade war. In a new report last month, Rutgers University found that following President Trump's decision to put new tariffs on China, TikTok drove content pushing Americans to buy directly from Chinese manufacturers, as well as content denigrating U.S. companies. The research pointed it out--and it resulted in tens of millions of views on Chinese products, suggesting the platform influenced the user and drove behavior that changed at a massive scale. That is to say, now, TikTok is being used against us in a trade war.

I am also concerned that despite this clear and present danger, these extensions just continue to give China an ability to unduly influence American citizens. The President needs to implement the law that Congress gave him, that the Supreme Court has upheld, and protect our military and our citizens against this foreign misinformation that is taking place. Last week, I asked Secretary Bessent from the Treasury whether he had been discussing TikTok at meetings with Chinese officials in London. He said they had not.

I am concerned that these extensions of the TikTok deal are illegal. Note that Congress passed this law, and the President extending the deadline to allow them to continue to operate in the United States under the control of ByteDance and the Chinese Government is not what Congress intended.

Congress said in the law that any deal on the sale of TikTok must include a transfer of the ownership of TikTok's source code, training data, and recommendation algorithms. This may be, for some people, not really clear, but we would not let the Chinese Government own ABC or NBC, and we shouldn't let them broadcast their content into the United States on ABC or NBC, and we shouldn't allow them to do the same with TikTok.

The Supreme Court, as I said, unanimously upheld this law that Congress passed. I am concerned that each extension, though, of not getting a deal, puts America and some of our leading tech companies at great financial risk.

Under the law, app stores that distribute and support TikTok are subject to severe penalties: up to $5,000 per user and that could amount to billions of dollars in damages. And while the current administration has signaled that they won't enforce the law, the statute of limitations for that liability is 5 years, meaning future administrations could apply those penalties retroactively.

So simply put, we cannot continue to allow foreign adversaries to control technology that can fuel domestic and political polarization and civil unrest. We need the President to follow the law that Congress passed and bring TikTok under U.S. ownership.

I yield the floor.

Mr. President, I thank my colleagues for coming to the floor to remember this horrific shooting in their State and to remember those and the family ones who were affected by this. I very much appreciate this resolution.

I yield the floor.

Mr. President, I am here too to focus on some history and a resolution. Today is the 95th anniversary of one of the worst economic policies our country ever made: the Smoot-Hawley tariffs.

Don't just take my word for it. The Senate Historical Office has characterized it as ``among the most catastrophic acts in congressional history.''

So today I am introducing a resolution that commemorates this anniversary as a moment to reflect on the devastating impact and the consequences. It shows you what we can learn from history, and at its peak, the Smoot-Hawley Tariff Act placed an average rate of 20 percent tariffs on goods imported into the United States--just 20 percent. So we have had this big discussion about many other things, definitely well above 20 percent.

The goal then was to bolster U.S. farmers and manufacturers by protecting them from foreign competition. But that goal, as we all know, if you study history, was not met. What it did instead was widen and deepen the Great Depression.

My resolution recounts our major trading partners, including Canada and countries in Europe, responded to those tariffs placed on by the United States by raising tariffs on the United States' exported goods. So yes, let's say a trade war. And anti-United States sentiment rapidly intensified in foreign countries, leading to a consumer boycott of American products in Canada, France, Spain, Italy, and many other countries.

The retaliatory tariffs and consumer boycotts caused farm and manufacturing exports from the United States to plunge from 68 percent, basically $5.24 billion, in 1929, to basically $1.6 billion--so from $5 billion to basically $1 billion in 1933, so a big drop in what the United States was able to do.

The U.S. gross domestic product fell nearly in half, from $104 billion in 1929 to just $57 billion in 1932. And the unemployment rate rose from 3.2 percent to a peak of around 23 percent in 1932. So the Great Depression had arrived.

In my State, the State of Washington, we have always been dependent on trade. Back then, lumber was our main export, and the trade war essentially destroyed that industry. Production dropped 70 percent, and the board feet dropped down to just 2 billion board feet in 1932--more than cutting in half what we had done before. More than half of our State's loggers lost their jobs. The unemployment rate in my State was 33 percent much higher than the national average. And where do we stand 95 years later? Do we want to take a moment and understand the lessons of Smoot-Hawley?

The administration is running a very high tariff playbook. The world's economy is much more interconnected now than it was in the 1930s. Uncertainty is the enemy of continued economic growth. And at least the Smoot-Hawley tariffs were set at an established rate. American businesses knew what they were standing up against and could make forecasts and plans accordingly.

These tariffs in the Trump administration change at the discretion of the President, creating huge uncertainty. Small business owners in my State tell me that while the tariffs are a challenge, the uncertainty is what keeps them up at night. The administration's tariffs are on par with Smoot-Hawley era tariffs. On that, the economic historians agree: That was a prolonged and deepened global depression. Last week, the President said the tariffs on China would be set at 55 percent.

So what have we learned from this historical date? Before President Hoover signed the Smoot-Hawley Act, he got a signed letter from more than 1,000 economists--1,000 economists sent a letter. The economists warned that raising tariffs would cause the cost to rise on consumers; farmers and manufacturers would suffer; and retaliatory tariffs would make exports dry up. And they said that starting a trade war would damage our foreign relations.

As early as 1934, Congress tried to right the ship. That year, we passed the Reciprocal Tariff Act directing Presidents to reduce us and world tariff rates. This year, my colleague Senator Grassley and I are trying to stop the administration by introducing the Trade Review Act of 2025 that establishes limits on the President's ability to impose tariffs. Why? Because this is the constitutional power given to Congress, not to the President. The courts have already said at certain levels that this President, as it relates to the International Emergency Economic Powers Act, does not have this authority.

So out of the ashes of World War Two, the U.S. led in a way of creating an open and rules-based international trading system. Tariffs were lowered in the U.S. and abroad--falling in the U.S.--from a trade weighted average of 20 percent in '33 to 7 percent in 1950 and continuing to fall afterward with trade agreements.

So it means we established rules. That is what trade needs. We don't need a President whose authority isn't in this particular area to start trade wars with no end in sight. The rules-based trading system provided the stability we needed to drive investment and to drive growth.

So the resolution I am introducing today asked the Senate to affirm the importance of a rules-based trade policy that reduces production costs for American farmers, for manufacturers, and one that opens markets to US exports.

It is time for us to commit to encouraging trade policies, particularly when so many other countries are getting their products on the shelves in foreign markets, leaving our products at home.

Let's avoid the repetition of this historical policy mistake and instead do something that reaffirms this institution's oversight of this issue and recognize the problems that tariffs are causing.

Mr. President, I come to the floor to join my colleagues to express outrage over the actions taking place in Los Angeles when our dear colleague Alex Padilla, Senator Padilla, was thrown out of an event where he was just simply trying to express his opinion on behalf of the millions of Californians that he represents.

It is so interesting to me that this situation happened because not that long ago in the State of Washington, in Olympia, we had a bill signing, and it is no secret in the State of Washington that a guy named Tim Eyman is probably the antithesis of what our Governor Bob Ferguson believes.

He fights him on all sorts of initiatives to the people about policies that Mr. Eyman wants to express. So he is a noted individual in our State.

So Mr. Eyman shows up at a press conference to basically protest a bill that the Governor is going to sign.

And he gets into the Governor's office, and he stands right behind our Governor. One of our legislators, who basically wants the Governor to know that this individual, who he disagrees with--doesn't support this bill--has now snuck into the Governor's press conference.

So what does our Governor do? He turns around, and he looks at Mr. Eyman, and he says, ``Oh, why are you here?''

And he said, ``I'm here to protest this.''

And the Governor turns around and delivers his remarks. Because, you know why? Because our Governor was not afraid what Tim Eyman said. Our Governor didn't think, You throw him out of the building, and he is just a constituent.

It is not like he is a State rep. It is not like he got elected by people. Our Governor was not afraid to let this voice be heard. But somehow, ICE and Homeland Security are afraid of the voice of Alex Padilla. They are afraid of Alex Padilla's presence in a room.

Now, how can that be in the United States of America that a Senator elected by the people of his State, who simply wants to go to a public meeting and have his voice heard on behalf of his constituents, is handcuffed and thrown to the ground?

It is not acceptable. Our colleagues on the other side of the aisle need to say, ``This is not acceptable.''

Are we trying to freeze the voice of dissent? Are we trying to say that we cannot understand what true public policy discourse is about? I think we

showed in Olympia, WA, that we are big enough to take it, that we know that if somebody disagrees with us, we are not going to get them thrown out.

And in this case, to have a U.S. Senator handcuffed and thrown to the ground is disrespectful. It is an atrocity. We need to understand how this is happening and if this administration or this side of the aisle thinks that is the way you treat the voice of a U.S. Senator expressing dissent.

I yield the floor.

I ask for the yeas and nays.

Mr. President, I ask unanimous consent to complete my remarks before the vote starts.

Mr. President, I come to the floor to talk about the action that we are seeing in the House of Representatives today that will lead to action here in the Senate and asking our colleagues to reverse course on this reconciliation bill that I think is going to have unbelievable economic consequences to our economy.

Trillions in red ink that are alarming credit agencies and bond markets, spiking billions in energy project costs, and driving up prices and burdening States with billions of dollars of new healthcare that they can't afford.

Instead, they should be focusing on protecting healthcare coverage, lowering costs for American families, and

giving working families the breathing room they need to prosper.

Even now, 5 years later out of COVID, we can still see the effects of the pandemic. That time changed the way we live and took a toll on our economy. The U.S. economy lost 23 million jobs at the start of the pandemic, leading to a recession in early 2020, and thanks in no small part to well-designed, bipartisan fiscal policies by both Congress and the Biden administration, the recession that started was the shortest in history, lasting only 2 months.

Coming out of it though, the combined effects and impacts on our supply chains and durable goods caused inflation to spike to 9 percent by June of 2022. Again, well-designed fiscal policies by the Fed helped get that inflation back down in just 1 year to 3 percent by June of `23 and continue to lower and hover just above 2 percent.

We need, though, to continue to make progress on inflation and costs--costs that impact everything from clothes, cars, food, computers, you name it, and costs may be getting even more expensive because of the impacts of the tariffs, and they are making their way onto our shelves.

The last thing American families need is to be saddled with even more financial restraint, particularly as it relates to Medicaid and the policies in the reconciliation bill. More than 72 million Americans are enrolled in Medicaid, making it the single largest insurer in the United States.

It is critical that it remain a critical part of our healthcare system. Depending on the State, the Federal Government covers somewhere between 50 and 70 percent of the cost of insuring people with Medicaid. While Medicaid is administered jointly by the Federal Government and, in most States, about two-thirds of the funding for the State Medicaid program is Federal support. So make no mistake about it, cutting Medicaid at the Federal level is going to have a dramatic economic impact on States. It is the largest source of Federal funding for States.

It is the largest component expenditure across all States--more than K-12, more than higher education, more than transportation--and somehow, in an economy with great inflation, you think the idea is to make it more expensive for Americans to get health insurance and cover their costs and impact the economy?

The bill that is now being cobbled together is a serious attack on Medicaid. As an assault, they will continue to have ripple impacts on the economy. It undermines the Medicaid program, shifting the burdens to the State, and it makes the entire healthcare system more expensive for everyone.

Medicaid provides financial support to the healthcare sector, stimulates local economies--spending that does have a multiplier effect. Every dollar spent generates more than $1 worth of economic activity. Medicaid drives employment in the healthcare sector, it generates State and local revenue, and it saves money for the enrollees to spend on more items--not healthcare.

But reductions in the Medicaid funding, especially as large as $715 billion, will take a toll on States, on jobs, on revenue, and it will increase the financial burden on individuals and families.

So it is important to remember that direct recipients of Medicaid are not just individuals with coverage. They are a payment system. They are the benefits of a healthcare system, hospitals, doctors' offices, pharmacies, nursing homes. And so when you cut that funding, you are cutting those businesses and those opportunities. The impact on the State economy would be greater than the loss of Federal Medicaid funding because of the ripple effects of the costs across the State.

The Commonwealth Fund estimated that, collectively, States' gross domestic product could be cut $95 billion smaller than the total economic output lost, and that could be even deeper.

So imagine every State now having $2 billion more costs because of Medicaid. The additional loss in individual income would mean that State and local revenues would decline by $7 billion. This would make it harder for States and localities to balance the burden of Medicaid.

And our constituents would also see more far reaching impacts as they struggle to provide healthcare. Today, 49 States, plus the District of Columbia, are all part of the system and counting on these providers and the funds. But this bill even eliminates the ability for States to adjust the revenue in any way that would be helpful for them to deal with this crisis. So this is an extreme approach to cutting American citizens off of the healthcare.

But think a bit about it for a second on the work requirement--also almost like a surveillance of U.S. citizens, trying to make them prove that they are eligible. Let's be honest; the provisions are not designed to cut down on waste. Rather, their primary objective is to prevent people from signing up for Medicaid coverage. In Arkansas, the casework requirement led to disenrollment of 18,000 people in just 4 months. And in New Hampshire, the complexity and administrative burden of the work requirement caused 17,000 beneficiaries to receive coverage termination in just 1 month.

Today, Georgia is the only State that has a work requirement for Medicaid. And instead of expanding Medicaid through the Affordable Care Act, it allows individuals and households that have income up to 100 percent of the Federal work poverty to get coverage if they work for 80 hours a month. The results are not good. A report found that Georgia's model cost taxpayers--taxpayers, not these individuals--cost the taxpayers $87 million and enrolled only 6,000 people, about 75 percent fewer than had been projected. So I ask again, what policy is this that saves money?

It makes healthcare more expensive for the rest of us. Nobody defers their healthcare costs. They are just going to show up at the emergency room. Just because we are cutting spending, it doesn't mean that the need magically disappears. States will have to find their way to make up for these shortfalls. A Kaiser analysis found that the House reconciliation bill--if it is enacted, the State of Washington would need to spend 30 percent more per Medicaid enrollee to make up the difference.

We don't have those resources. The same will be true of every State. For example, Louisiana would have to spend 50 percent more per Medicaid enrollee to make up the difference, translating into an 11 percent increase in the State taxes if they had to do that. Now is not the time to force our States to jump off of a cliff just because we won't live up to our Medicaid obligation.

I know the President used the f word, but what is real here on the Senate floor--I am not going to say it--but you are making a mess out of Medicaid, and we should stop them.

I yield the floor.

Vote on Motion

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I rise today to urge my colleagues to oppose any proposals to take healthcare coverage away from the American people who need it most.

Today, the House Energy and Commerce Committee is marking up a section of what is called their budget reconciliation bill, which would reduce spending by $912 billion over 10 years. That is a lot of money. Out of that, $715 billion would come from Medicaid and other healthcare programs that are essential to Americans, children, and our most vulnerable families.

House Republicans say that these cuts are about waste, fraud, and abuse--but the real fraud is telling the American people that by implementing these requirements, that somehow these policies are going to save money.

The truth is, it is just making it harder on Americans to stay on Medicaid. A Medicaid program that even the Seattle Times has said cutting it could hurt our State's poor and our children.

So is that what we are trying to do, give a tax break to corporations and billionaires by cutting the effects of Medicaid on poor people and children?

The proposed work requirements basically make Medicaid beneficiaries submit paperwork every month to prove that they are working at least 80 hours a month, but we already know that 64 percent of Medicaid beneficiaries are working. That is what the big fraud is. This chart right here shows that people who couldn't find other affordable health insurance and are working full-time is 44 percent of Medicaid adult recipients.

Some are not working because of their inabilities and due to retirement. So 8 percent of them are not doing that, 20 percent are working part time, 12 percent we basically said it is better for you to be a caregiver and provide the caregiving, and we will cover your health insurance costs so you can provide the caregiving because that way the families stay in the home instead of going to their nursing home, which would cost all of us a ton more amount of money. So they are working.

There are 10 percent not working due to illness or disability, and some are not working because we are smart enough to let people who go to school, but don't have the ability to get affordable insurance, allow some percentage, a small percentage of them to be on Medicaid too.

So what is it that the House is really trying to say? They are really trying to sneak in a massive cut to Medicaid that will shut down hospitals, kick people off of Medicaid, make them go to emergency rooms, cost us all more money, and do nothing but perpetrate a fraud. When in reality, people are working and those that aren't working, we are happy that they are not working because one--could be due to an illness, or they are a caregiver, or they are working part time.

So all of these issues show that the House isn't serious. In 2018, another State tried this, ``Oh, brilliant idea. We're going to make a work requirement.'' Now, if I hadn't been in the U.S. Senate at the same time the House of Representatives tried another canard--``Oh, we're going to block grant Medicaid. We're going to block grant it and it's going to be great, and then we're going to save money.''

No, no, the hospitals, the Republican county commissioners, the jails--everybody basically said, ``Don't do that. You're going to cut Medicaid--you're going to decimate the safety net that makes healthcare work in our communities. Don't do it.'' And because we had three Republicans join us, we were able to stop that ridiculous idea of block granting Medicaid.

But in 2018, Arkansas tried the same thing that the House of Representatives are now suggesting. They became the first State to establish a work requirement for certain Medicaid enrollees. It took just 4 months, and the new requirement got 18,000 people kicked off Medicaid.

Where do you think those people go? You think they don't have any healthcare needs? You don't think they go to the hospital and cost us all a bunch load more money? That is what they do. They cost all of us a bunch load more money.

A Federal court ruling stopped Arkansas from implementing that rule a year later because it disrupted so many people because of the work requirement.

And after that, a Harvard University study found that Arkansas' work requirement didn't lead to more people getting jobs. It actually took away their health insurance, and then they didn't have the ability to stay as healthy and get jobs. So is that what is going to happen across our country, to my State, all because the Republicans are putting this nonsensical idea on the table?

Still, the issue is that other States tried the same thing, and other States also stopped their ridiculous idea. So this isn't something that works, and according to the Center on Budget and Policy Priorities, more than 780,000 Washingtonians could be subject to a work requirement and are at risk of having their coverage taken away.

Now, I am already done fighting with the DOGE people who basically said, ``Oh, waste, fraud and abuse, and Social Security.'' Really? My constituent not only had his Social Security benefits cut; they said he was dead. He wasn't dead. And not only did he go there, wait in line, crummy service, and say that he wasn't dead--they still, after that-- after he notified Social Security and told him he wasn't dead, and I want my Social Security, they had the audacity to go back into his bank account and claw back money out of his bank account, still saying that he was dead.

Now, is that what really the House of Representatives wants us to do, harass the heck out of 780,000 Washingtonians to write a proposal every month, telling them they are somehow doing something? Or do we want to set up a program to cover those who can't get affordable insurance and cover them because we don't want to pay the extra costs at the emergency room?

That is what we are trying to say. We don't want to pay the extra costs. So this proposal just doesn't make sense, and so I am not surprised that I got a copy of a letter passed on by health officials in my State that said, ``The undersigned here are writing to you to oppose any cuts to the Medicaid rates, any adjustments to the federal Medicaid assistance program, to our healthcare systems, or changes to the direct payment programs.''

Well, what is surprising about this is it is signed by the Republican county commissioners, the Republican State representatives. The people in that community who know what it takes to build a healthy community, they sent a letter basically saying, Don't do the very things that the House of Representatives just did.

My own constituents, bipartisan Republicans and Democrats, though, already said, Don't do this because you will cut the legs out from under us. We won't have rural hospitals. And just think about all the jails that are dealing with the opioid and fentanyl epidemic, and now, all of a sudden, you are taking Medicaid away from them. What are they going to do? You are going to make all those people go to an emergency room? Now, all of our emergency rooms, instead of these people being in a detention facility, are all going to be in an emergency room crowding us all out from getting healthcare?

So this idea is ridiculous, and people all across my State are already speaking out about the choices or lack thereof. I spoke to a Medicaid patient in eastern Washington who was worried that she wouldn't be able to be supported when she needed to go to a nursing home because where is all the money going to go?

We are trying to save enough money by putting people on Medicaid, so the people who do need to go to a facility can, but a resident told me that without Medicaid, her father wouldn't have been able to afford treatment or medication for his mental health issues.

So that is really what we want to do? Give a tax break to wealthy, wealthy people and to corporations, just so we can be kicking poor people off of Medicaid?

So I hope our colleagues will not allow this to happen. I hope that our Senate colleagues will be ready to show that the defeat of the fentanyl epidemic needs to be addressed, and helping Medicaid continue with substance abuse treatment is key.

Recent polls show that 77 percent of Americans have a favorable view of Medicaid, including 64 percent of Republicans. And as I said, last week, I

met with the healthcare providers, mostly from central Washington, who said, ``You literally will take away essential revenue that keeps our hospitals open, and our State could see five to seven hospitals close.''

That is not what we want to see out of a budget proposal to give a tax break to wealthy corporations and individuals. So I ask my colleagues to make sure that we are fighting these cuts to Medicaid. Our communities are demanding it. They are watching, and just like with the block granting of Medicaid, they are not going to believe another idea that has already been tried and failed and doesn't even meet the goals of being successful in making the most affordable healthcare possible and keeping the cost down on all of us.

I urge my colleagues to reject this House proposal on Medicaid.

I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I come here today to urge my colleagues to vote no on the nomination of Mark Meador to be the FTC Commissioner. But before I do that, I did want to take a moment and talk about today's actions that happened when the President created a 90-day pause on the tariffs, taking the temperature down a bit.

I definitely want to thank my House colleagues Representative Bacon and Gottheimer for introducing legislation similar to the Trade Review Act of 2025 that we have introduced here in the Senate.

And while we have seen America on a roller coaster the last couple of days, I think it also is a reminder that we need to continue to play this oversight role. If you want to have the ability not to have the roller coaster ride we have been on, the best way to do that is to make sure that Congress continues to play a role in this very important policy. So I appreciate all my colleagues, and I appreciate my House colleagues for their leadership.

Mr. President, I come to the floor with my colleagues today to echo concerns about the budget process that is pursuing here related to a proposal that we will be voting on that I am not sure I understand the math.

I certainly, when it comes to Medicaid, want to make sure that we are protecting Medicaid, that the House budget that proposed to have $880 billion come out of the Energy and Commerce portfolio--a portfolio that is basically Medicaid and Medicare. So I don't know how you would get the majority of that money if it didn't come out of Medicaid, I hope my colleagues are not considering any cuts to Medicaid, and I heard from people all over my State last week about what a devastating impact that would be in the central part of our State, where many of our hospitals rely on a huge Medicaid/Medicare population, hospitals wouldn't be able to deliver services or stay open.

So I want to see a promise that we are not going to touch Medicaid, no sleight of hand, no gimmickry, no budget where all of a sudden now somebody is going to go in a dark room after we pass this and then say, oh, oh, but I got a great idea. Here is how I am going to save X billions of dollars out of Medicaid. I am just not for it.

When we had this debate before, I heard from Republican county commissioners all over my State, when people wanted to block grant Medicaid, and they were basically saying, How am I supposed to run this jail? How am I supposed to take care of these issues in my county if you are going to block grant Medicaid? So again, I hope my colleagues won't do that.

I also hope my colleagues won't count revenue from the tariffs. I hope that they are not saying, Okay, well, we got a brilliant plan now. We are going to give a huge tax break to corporations and billionaires, but we are going to do it basically on the backs of American people who are paying higher tariff costs today, I don't think we don't need that in America. We certainly don't need these tariff costs. And what we are now seeing this morning is that China is imposing reciprocal tariffs. We are seeing a counterpunch from our other allies.

A tariff is a last resort, not a first step in a process. We need to have a rules-based trade regime where you are doing trade that is fair trade, based on rules and not using a disruption of the market that ends up costing all of us, trillions of dollars could be, and certainly impacting us. So my State obviously wants to see a more alliance-based approach. We believe in building alliances with like-minded countries.

It is very interesting how Europe successfully created a huge alliance. Europe, many years ago, said, You know, we are better off together. Let's create a European Union, and now they have something like a $20 trillion GDP because they work together in an alliance. Or if you look at the trade deals that we did as a nation in the Bush administration, we did a half a dozen or so trade deals that now represent a $47 billion surplus because we did those trade deals with those countries and we created an alliance.

So I just see this world view differently than what is being proposed today. I definitely think that building alliances, getting supply chains here in the United States, strengthening those alliances are the key to our success.

I believe in betting on the American worker. If you bet on the American worker, they will do the rest. And we do need to help upskill and train, and we should reward them for their upskilling. Right now, I think we need something like 500,000 electricians--that is what the AFL-CIO and Microsoft say. Hardly people that get up every day and get on the same page, but they are saying we need 500,000 electricians.

I met a young man in my State who said, You know, you helped us get the workforce training. And he said, You brought me out of poverty. I said, How did we bring you out of poverty? He said:

Well, I had some health challenges, and literally, I didn't

even have tires for my car. but [because of] a stipend that

went along with the program, I was able to then get tires,

drive myself to another town, and get the training to become

an electrician.

He said:

I accomplished that, and now I'm going to buy a house.

That's how you got me out of poverty.

So that is what we need to focus on. We need to focus on skilling and training the American worker for the opportunities of tomorrow that are here today, and that is why I feel so strongly that we can't ask the American people to pay for a bill that gives away tax breaks to billionaires and corporations by taking money from tariffs that are costing us. I know in my State, because I am already starting to hear this from people all over, that they are impacted from these tariffs. They could be the largest economic impact in the history of our country, the largest increase and very regressive, burdensome to households. But here is what I am hearing from my constituents.

A retired woman told me that her stock portfolio which, along with Social Security, she relies on to pay for her living and healthcare expenses, lost $40,000 yesterday. That was yesterday. I don't even know what is happening

today. But we have Americans who are like this individual counting on Social Security and that market income for her retirement, and it just got a big hole blown in it because of tariffs. So please do not put tariff revenue in this bill and say that you gave that revenue to corporations for a tax break.

I heard from the owner of Fernseed, a plant and flower shop in Tacoma. The owner said:

We work with the supplier of pretty much everyone and every

vase that you will ever see in any plant or flower shop.

She goes on to say:

We got notification two weeks ago that there's just going

to be a blanket 10% increase on prices, increased costs for

imported ceramics, going to cut into our margins that we are

going to have to pass on to consumers. And with margins of

just six to 8% there's not enough breathing room.

She continued to say:

Our employee review cycle is in April, and because of the

uncertainty about tariffs, I have to give my employees a

small, incremental raise instead of a real raise. That puts

me under the threat of losing those people that have been

with me for three to four years, which is a lot in a very

incredibly small business. And by the way, I don't expect to

be paying myself either.

That is what I am hearing from my State.

We know that small businesses are going to be hard hit by this. They are resilient, but this is asking a lot. I heard from the president of the Washington Distillers Guild and founder of broVo Spirits. They told me:

For lots of distilleries in my State, it's 20% of business

that's going away, whether that's from Canada or the EU, the

two primary markets. So exports aren't a big part of our

business, but it's 20% and that hurts enough.

I find this very real for my constituents.

I--oh my gosh--I am so proud to represent the State of Washington. They are a resilient group of people, but in our State, we evangelized becoming exporters a long time ago. We just told people, go, go, do it. You can grow your market. Go, take your product and get it sold overseas. And what we find is that a lot of these businesses, somewhere between 20 percent and 25 percent of their sales are in overseas markets. So it is a nice little boost to what just the domestic market is.

We certainly grow more apples than can be eaten in the United States of America, and we sure as heck want them to be reached to international markets. And I would say the same thing for these distillers. It is one thing to look at the U.S. as a geographic market. It is another thing to look at the whole world as a market. It is amazing. It is an amazing market, and they want to have entry into that market instead of having some aspect of their business being attacked. So people are now holding back on spending. They are not going out as much. They are staying home, and they are going to start cutting back on everything. The opportunity has been taken off the table for export growth, and at the same time, we are getting hammered on day-to-day operation expenses.

So they continue to say at this distillery they are ``concerned about bars and restaurants and surviving the tourism impact we're going to see during this summer.'' I am sure they are saying that because a lot of our tourism comes from Canada, and I know that they believe that that is going to be challenging, given what the Canadians are telling us.

I believe open markets and innovation are a better approach. I hope that we also don't see any cuts in these important programs on the other side of the aisle that I know have been proposed by DOGE. I can't believe that when it comes to agriculture, they are cutting the ARS programs and research that help our farmers be competitive in addressing issues to get markets open in the first place. We know that we have to continue to fight to make sure that we do get these markets open and, I believe, reverse these tariffs because I think that they are having a devastating impact.

When it comes to fair trade, we need a rules-based trading system. That is what the U.S. has led since World War II, creating bigger global opportunity, creating more prosperity, and certainly not leading with the tariff first approach. So I hope that we will hear in our budget discussions, think about these hard-working American families that are working so hard to produce these products. I hope that you will think about the fact that many of these people have taken the risk to become exporters, to grow jobs in our State. It was a risk. It is harder to do. No one wants the unknown of what is happening in an overseas market. That is why I also support the Export-Import Bank that made financing of those exports easier, and certainly it makes for the innovation that Americans pull off much easier.

I told a story yesterday about Cosmic Crisp. Cosmic Crisp--it took us 20 years, 20 years to figure out this apple and to get it produced for the market. It is the story of R&D work with federally funded research dollars from Washington State University. But that is about producing an apple that, once you cut into it or bite into it, doesn't brown. That is an amazing feat. It doesn't brown. That means all of a sudden, apples on a fruit tray or use in various things, people decide, wow, not only do I like the taste, I like the fact that it doesn't get discolored.

So we don't want to see markets close to our Washington apples. We want to see markets opened. We want the R&D and innovation that succeeded in growing this market be matched with the market opportunity around the globe, and that is why we were able to get reduced the first Trump administration tariffs on apples that shut us out of a $120 million market in India.

My colleague, who is on the floor, Senator Klobuchar and I wish we had a Zoom or an app that shows us, but literally, she and I got to go to India, and right after an official greeting of Prime Minister Modi, we were standing there in somewhat of a reception. And she and I pounced on him, and the first thing that we did is we started talking about agriculture. What was good is that he wanted to talk about agriculture too. That was the good news. That was the good news.

But we had a very long conversation with him about opening up markets and why this matters so much to agricultural families across the United States. And he said--we were kind of surprised, but he said, yeah, maybe we need to figure out a new agreement that we need to do together. And when we came back, we were able to open that market, not only to apples and to chickpeas and lentils. It was a partnership that I think is going to continue to grow at a critical time.

So don't try to jam the tax bill with tariffs. Don't try to stick in something that is costing the American people a lot of money. Try to work together as a body to say that this approach to tariffs needs to be reviewed, but certainly make sure that we are thinking about the small businesses, the individual consumers, the individual investors who are getting hard hit right now over this and let's move forward on trying to come together on what will really help make American agriculture opportunity, small business success, opening markets the main focus of our work.

I yield the floor.

I yield the floor.

Recognition of the Majority Leader

Mr. President, I rise today to speak about the important role that Congress plays in ensuring our economy remains strong, and very important for the American people, to lower costs.

That is why today I am inducing legislation by myself and Senator Grassley. Congress has a duty to ensure that our country remains competitive and leads in the global marketplace. American families rely on our economy for goods and to make ends meet and to provide shelter.

American manufacturers rely on an economy to maintain resilient supply chains, keep production lines open--and that means aircraft from Everett, WA, or cars and trucks from Detroit, MI.

American farmers rely on our economy to keep fields planted-- production in eastern Washington and northern and central Iowa depend on the cost of fertilizer, seed, and equipment.

Small business owners across the country depend on consumer confidence in our economy so that they can keep sales and stay afloat. Sharp increases propose a major threat to that economy.

Inflation and high costs are a threat to stability and prosperity of American

businesses of all size, to our farmers, and to our consumers. We live now in an interconnected world--a global economy--and advances in technology and transportation have brought that world closer and closer together. We have a global economy.

That is why it is so important to have rules-based trading systems that have been in place since World War II, and it is the bedrock of a global economy. That is to have rules. Rules-based trade is essential to have predictable and stable trade and promoting economic growth and development and global cooperation.

No doubt, opening up markets has grown the pie, not just for those economies, but for the U.S. economy. When you establish clear rules- based mechanisms, you can also resolve trade disputes and encourage more investment and more trade.

Businesses need this certainty to move forward with deals, to reach new markets, and grow. But now we are seeing a barrage of tariffs on at least 185 countries.

We cannot have arbitrary policies create chaos and uncertainty. These kinds of chaos and uncertainty kill business investment and make for very challenging stock market assessments of investments for the future based on predictability.

The current approach, in my opinion, is outside the predictable, rules-based system. It is arguable that the current approach is literally a misconstruction of statutory authorities.

But what we know today for sure is that 95 percent of the world's consumers are outside of the United States. That means the global middle class includes almost 4 billion people. Those are markets for American businesses, for farmers to reach to grow and prosper.

According to the World Bank, in the recent decade, trade has lifted 1 billion people out of poverty. My colleagues here, who have worked on deals in the past that opened up markets in places like Chile, Peru, Singapore, the Central America Free Trade Agreement, the update of the USMCA, all know that this hard work created economic opportunity.

Our trade agreements helped American farmers export $176 billion in agricultural products last year. They helped ensure that the United States is the world's largest agriculture exporter, with soybeans and corn leading the way as the top export.

I want to return to trade agreements. I want to open up more markets. I want us to have a robust export opportunity for the excellent U.S. manufactured and grown products.

Our trade agreements have ensured that the U.S. remained the second largest exporter of manufactured goods in the world--$2.06 trillion in 2024.

And it is clear today, the United States must be competing hard to win in the race for emerging technologies like AI and quantum. Our foreign adversaries and our competitors are in this global race too.

So that is why economic disruption puts America at risk. Straining ties with trade alliances also put us at a security risk. Trade wars have lasting consequences. Trade wars devastate Americans working families and small businesses and manufacturers.

Article I, section 8 of the U.S. Constitution gave Congress--gave Congress--the explicit authority to impose duties and regulate commerce, given the far-reaching impact to our national economy that I just mentioned.

As ranking member of the Commerce Committee, and my colleague from the Senate Finance Committee, we both know how much our Nation needs to continue to have interstate commerce and to have foreign commerce.

Since the 1930s, Congress has enacted or directed the President to negotiate trade deals, including authority to negotiate the agreements and impose or adjust tariffs.

But I think these Presidents have used this authority correctly by opening up markets, lowering tariffs, and establishing a rules-based trading system. The current approach, I believe, is creating uncertainty and certainly raising costs unnecessarily.

Businesses rely on certainty and transparency from a rules-based trading system. So how has Congress done on these issues? Well, it is time, I believe, for Congress to reassert ourselves in our constitutional duties.

Article I of the Constitution also gave Congress the power to declare war. The Founding Fathers wanted to prevent any single individual from unilaterally committing our Nation to war. The Founding Fathers wanted to ensure that we had a strong check and balance.

I believe the same check and balance needs to exist now as it relates to protecting our commerce activities and any Presidential overreach that is not a rules-based approach.

Congress, in the War Powers Act, decided to reclaim its authority because they thought a President had overreached. Senator Grassley and I are trying to do the same thing today by introducing the Trade Review Act of 2025.

Trade wars--which frequently trigger sharp price increases, foreign retaliation, and huge shock impacts to our economy--could affect the livelihood of workers, supply chain manufacturers, and hard-won markets that American exporters have wanted to see continue to be open.

I want to thank Senator Grassley for his leadership over many years for American farmers, for the people of Iowa, and for our country. I want to thank him for working with me on the introduction of the Trade Review Act of 2025 that ensures that Congress plays its constitutional role in making sure that, as our Founding Fathers intended, we set the duties and regulate foreign commerce.

This important reassertion of Congress's constitutional role is important so we have a strong voice in trade policy. This legislation, as I said, modeled after the War Powers Act, says that a President must notify Congress within 48 hours of imposing or raising tariffs, provide an explanation of why they are warranted, and an assessment of their likely impact on American businesses and consumers.

Our legislation, though, protects that constitutional authority by also saying these tariffs should be reviewed by Congress for approval or disapproval, and doing so is in the best interest of our country.

I can't tell you how challenging I think competition in a fast-moving information age global economy is. We can't afford a trade war that lasts for 2 or 3 years, leaving our product off the shelves.

We must reassert Congress's role over trade policy and ensure that a rules-based trade system is based on transparency, consistency, and the benefits of the American public.