Madam President, the Senate is now debating the nomination of Chiquita Brooks-LaSure to head the Centers for Medicare and Medicaid Services. This is clearly one of the most important healthcare jobs in America. Ms. Brooks-LaSure brings…
Madam President, the Senate is now debating the nomination of Chiquita Brooks-LaSure to head the Centers for Medicare and Medicaid Services.
This is clearly one of the most important healthcare jobs in America. Ms. Brooks-LaSure brings decades of health policy experience to the Centers for Medicare and Medicaid Services, and I think it would be fair to say that she has worked on healthcare from just about every angle short of scrubbing into the operating room herself. I am going to talk, in a minute, about her qualifications, but I also want, as we start this discussion, to recognize that this is a job that requires urgent, hands-on professionalism--exactly the kind Ms. Brooks-LaSure brings to this.
We are, obviously, still working through enormous challenges on the COVID-19 pandemic. There are efforts by colleagues on both sides of the aisle on healthcare, and we, in particular, on this side want to expand healthcare coverage, bring down the cost of prescription medicine, and bring the Medicare guarantee into the 21st century. The American people need a chief of Medicare and Medicaid as soon as possible, and blocking this nomination slows down important work that needs to be done. Senators on the other side have objected to moving forward with the nomination. So I am going to talk for just a few minutes about these concerns--but, first, a little bit more about Ms. Brooks-LaSure.
Starting out, she worked at the Office of Management and Budget on Medicaid policy and the CHIP program, the Children's Health Insurance Program. So she was, long ago, focused on trying to improve healthcare for the millions of Americans who every single day walk an economic tightrope in balancing the food bill against the fuel bill and the fuel bill against healthcare costs. She was there for them.
She then moved to the House Ways and Means Committee as a senior staff member. She helped to write portions of the Affordable Care Act dealing with expanding coverage and updating the Medicare guarantee.
When the Affordable Care Act became law, she went to Health and Human Services, and there she played an important role in implementing the law. She was the leader in the effort to create marketplaces for health insurance with strong, built-in consumer protections. She has been a leader when it comes to defending and expanding women's healthcare under the Affordable Care Act and other essential programs. After leaving HHS, she went to the private sector and continued to work on policies that expanded coverage and made healthcare more affordable.
Ms. Brooks-LaSure has the qualifications, the experience, and the know-how to run Medicare and Medicaid, and there are absolutely no questions about it.
Now, our colleague from Texas, Senator Cornyn, has raised objections to moving the nomination forward. His objections relate to a decision by the Biden administration to rescind a Medicaid policy waiver that the Trump administration rushed to grant the State of Texas in mid- January. There are a few key points Members ought to understand about this issue.
First, nothing is going to change for health providers and patients in Texas for more than a year as a result of this decision. That means there is plenty of time to work out a solution that doesn't get rushed and follows the right process with public comment.
Second, Ms. Brooks-LaSure had nothing to do with the decision that Senator Cornyn is unhappy about. She wasn't on the job when it was made.
Third, she made clear in her Finance Committee hearing that she is committed to working on a bipartisan basis with State officials, and she said that to Senator Cornyn and to other Republican members on this issue as well. She has the track record and the experience to get that done.
I want to state again to our colleague from Texas and to every Member of the Senate: I probably spent as much time as any Member of the Senate working on the issue that the Senator from Texas is concerned about, and that is the process for granting waivers. I authored what is called section 1332 of the Affordable Care Act that was designed to say that progressive States that, for example, wanted to pursue a public option or aggregate Medicare and Medicaid money would have a chance to do it as long as they would adhere to the guardrails. Conservative States that sought to try their own approaches based on their ideas of a conservative approach to healthcare could do it as long as they met the coverage requirements of the Affordable Care Act.
I want to state again to Senator Cornyn, as I did in the Senate Finance Committee, that I am going to work very closely with him, after we confirm this nominee, to address the issues that he discussed in the committee that have concerned him.
To every Member who has issues with respect to waivers, I want each to know that there will be bipartisan interest in trying to bring people in their States together and adhering to the ideas in the Affordable Care Act, which states that States are free to pursue their own ideas for expanding coverage as long as they stay within the guardrails of the program.
We understand that Democrats and Republicans aren't going to agree on every health policy question. What I do know is that Ms. Brooks-LaSure is going to be the kind of CMS Administrator who can bring two sides together exactly as we envisioned in the Affordable Care Act with the waiver law and exactly as I have committed to working with Senator Cornyn on.
The Finance Committee has demonstrated that it can work together on big issues. In 2017, the committee passed the CHRONIC Care Act, which was a fundamental transformation of Medicare.
I have told my colleagues that back when I was director of the Gray Panthers, Medicare was about acute care. There was Part A, which was for hospitals, and Part B, which was for doctors. That was it. That was Medicare. When I taught gerontology, the first question on an exam was, What is the difference between Part A and Part B? That isn't Medicare anymore. Medicare, today, is primarily about chronic disease: cancer and diabetes and heart disease and stroke and chronic pulmonary disease.
The Finance Committee wrote the CHRONIC Care Act on a bipartisan basis. At that point, Chairman Hatch was chairman of the committee, and I was the ranking Democrat. We worked in a bipartisan way, but the Trump administration, after the retirement of Chairman Hatch, basically put everything on the back burner.
When we confirm Ms. Brooks-LaSure--and I am convinced that she is going to be confirmed--she will work with Democrats and Republicans to
make sure we are updating the Medicare guarantee for this century. In particular, what that involves is making sure that there are more opportunities for those who receive traditional Medicare to get the benefits of the CHRONIC Care Act. Already, the CHRONIC Care Act works well for what is called Medicare Advantage. We need to do more to make sure it is available for those who receive traditional Medicare.
Now, there are other issues the Finance Committee is working on that Ms. Brooks-LaSure will play an important role in--one being improving mental healthcare because mental healthcare has gotten short shrift in America for far too long. We know that Americans feel like they are getting mugged when they walk into a pharmacy and go to the window to get their prescription medicines. Look, for example, at insulin. Insulin prices have gone up twelvefold in recent years. The drug is not 12 times better. It is the same drug, but they are getting clobbered because the pharmaceutical companies can get away with it. So those are the kinds of practices that Ms. Brooks-LaSure is going to take on, and she is going to do it in a bipartisan way.
The Centers for Medicare and Medicaid Services is right at the center of taking on these and other important healthcare challenges. This critical Agency--one of the most important places in American healthcare--needs a leader, and it needs one now. She is, in my view, an excellent nominee. She is going to work with both sides here in the Senate, including on the issue our colleague Senator Cornyn has raised. I want to restate my interest in working with both Ms. Brooks-LaSure and Senator Cornyn on this matter my colleague from Texas has raised.
We are going to be voting in a couple of minutes, colleagues, and I urge a strong vote for an eminently qualified nominee, Ms. Chiquita Brooks-LaSure.
I yield the floor.