Cory Booker

Mr. BOOKER

Mr. BOOKER. That is accurate. It is stunning that they know that they can't do this, so they are going to use some budget trickery to mask the truth. Math doesn't lie. Numbers don't lie. You may be able to mask it so you could use rules of reconciliation and try to force it through, but the result for the American people is going to be the same. Chuck, people will lose healthcare, healthcare benefits, and watch the deficit of this Nation not increase but explode, which means the cost of our debt payments alone are going to be more than the very programs that they are going to be slashing for families. That is outrageous, cruel, unacceptable, and we have to do everything we can as a people to stop it.

Mr. BOOKER. Yes, sir.

Mr. BOOKER. I was reading stories, and many of them will live with me. There is a family who is taking care of their two parents in their nineties and their disabled adult children. They are desperately relying on these programs. No matter what you do or say or call it or label you slap on it, those are the kinds of Americans who are stepping up to take care of their loved ones who will get hurt.

Mr. BOOKER. Yes.

Mr. BOOKER. Yes, Senator Schumer. To tell a family to just double up or triple up drives up their costs. It is often that the elder who is living with them who might have dementia demands care. So the family member who is caring for them has to decide, Oh, my God. Am I going to give up my job, which I need to pay the rent? Am I going to stay home to take care of them or go to the job and let really difficult things happen? This is the thing that the leader is pointing out that, I think, is really important.

Mr. BOOKER. Yes, please.

Mr. BOOKER. I appreciate the Democratic leader's question. I think that all 100 of us in this body are getting what I have gotten. I can't go to the grocery store. I can't walk my neighborhood. I just did a travel around the country to do what a lot of us elected officials do, and I got stopped in the airport by people who want to tell me stories about a parent with dementia or a disabled child or a child with a rare disease who has seizures. It is story after story after story. There are people who have been writing in to me, some of them on scraps of paper, just to try to tell us: Please--they are not saying don't do $880 billion in cuts; they say any diminution of resources. They live on such a precipice that any diminution of resources would drive their families into crisis and despair. Many of the professionals I am quoting are saying: We don't need to be cutting. We need to be finding ways to extend services to do more. How can we do more? I talked earlier about the fact--and you helped with this, Senator Schumer, when we were battling, many of us, and I know my friend Lisa Blunt Rochester was a leader in the House when we said: Why are so many women dying in childbirth in a postpartum period in America? It is shameful that we are the worst Nation of all the wealthy nations, and that is for us as a whole, but for Black women, it is almost four times as much. So what do we do here, Chuck? You remember this. Excuse me. Senator Schumer, what do we do here?

Mr. BOOKER. ``Chuck'' is OK. We came together, and we said: This is a time for Medicaid expansion. It was to say to a woman: You don't just get 60 days postpartum; we are going to expand that beyond 60 days. State after State--red and blue States--said: You are right. This is a crisis. That which should be the happiest period of a woman's life is the most devastating with women hemorrhaging and dying. We began to treat that. Now what is the threat? The threat is that they are going to cut these things that we did to help more people, to stop more folks from dying. And here is the trick: You know this battle well. I wasn't here, Chuck. You were here, and I know my chief of staff was on your staff, writing this in. This is why you all said: We are going to try to incentivize States to expand Medicare. We are going to cover 90 percent of the costs. I still don't understand why some States--talk about cutting off your nose to spite your face--said no. In my State, the Republican Governor said: Heck, yes. Sign New Jersey up. But many of those States have this automatic trigger that if the funding is cut--even if they say we are not going to cut $880 billion, just $250 billion--well, that is going to trigger many States to give up that Medicare expansion and go back to the days where millions upon millions of Americans don't have coverage at all. So, again, this whole speech is because, Chuck--Senator Schumer--it has been business as usual in this place when that kind of threat has been happening; that of the stories that I read that I had to struggle through. We should be doing hearings. We should be bringing in the people. I know the values that we share on both sides of the aisle. How could we be so abjectly cruel, and why? To push through a tax break plan from which families in the neighborhood I live won't see the benefits.

Mr. BOOKER. Thank you for allowing me to yield the floor for you to ask a question. I see my colleague here from Delaware. I am going to read a few more stories, but I suspect that she, too, has a question because she and I did not just meet when she was sworn in here in January. God bless her. She is my colleague, but she is my sister, and she has inspired me for years. When she heard I was doing this--and I am not sure how much this is done on the Senate floor--my sister came over and prayed with me that I could stand for a long time because she knew what we were trying to do, which was to try to create--with whom we served--John Lewis-type good trouble in this institution, to not do things as normal, and to begin to say that the voices I am reading are of Democrats and Republicans. The voices I am reading are of Democratic and Republican Governors, of Democratic and Republican heads of hospitals, of Democratic and Republican heads of medical associations, of Democratic and Republican constituencies. This is not right or left. This is right or wrong. My colleague--my colleague--I am going to put her on blast, but God bless your friends who remind you of who you are when you forget. She didn't know that I really wanted to give a speech that was speaking to all of America, but she came up here, and when we were praying, she said: I pray that you speak words of love because she and I know love is ferocious. It is the strongest force on the Earth. It is not soft. She asked God to give me words of love today. So I know that this friend of mine--my sister here, my colleague-- whom I have worked with for years and years and years, asked me if she could come to the floor and ask a question. So, as I am instructed to do, if you were asking me to yield for a question, then I am going to say: Go ahead if you want to ask me.

Mr. BOOKER. I will yield for a question. I yield for a question while retaining the floor.

Mr. BOOKER. I am so grateful for that question. It sobers me when you ask it because just a reduction in Medicaid--I love that metaphor use-- is pulling a string out for families who are barely holding it together right now--families with children with disabilities or who are developmentally disabled who have been struggling so much to get their children into programs that could help move them--some of them to independence, some of them into adulthood where they can get jobs. So many of these things that help to propel these children would be undermined. Just transportation services going away would create hardship and devastation on families. So here we are in America, when costs are going up, housing is going up; we are about to have these awful tariffs where the price of vehicles will go up, the price of transportation will go up. So the ripple effect of an impact on children, just by a fraction of the cuts that they are proposing--not to mention the grandeur of the $880 billion--would have a devastating impact on millions and millions of children. But it doesn't stop there. You quoted King. King said in the letter from the Birmingham jail: We are all caught in an inescapable network of mutuality, tied in a single garment of destiny. To think that there could be an injury to their family and their child and have it not affect you is not only self-defeating ignorance, it is callous and uncaring, and it demands us to step up for those children that you so rightfully asked me about in your question.

Mr. BOOKER. I will definitely yield for a question while retaining the floor.

Mr. BOOKER. Well, that is the thing that is so significant. Already, Governors and mayors are writing letters and speaking up. When I go to different cities in New Jersey, I am often called by local leaders because they know, No. 1, the stories of the people who rely on Medicaid--the seniors, the children, the disabled families. But more importantly than that, they know their hospitals who already have very fragile budgets, to carve out millions and millions of dollars, as I said, over tens of millions of dollars for our level 1 trauma hospital in New Jersey, that would devastate the entire economic model for our hospital. It would affect jobs. It would affect the economy. It would affect small businesses. It would be devastating.

Mr. BOOKER. Yes.

Mr. BOOKER. Thank you. Thank you very much. I am going to continue elevating here, throughout the hours and hours of my speech, the voices of Americans from all backgrounds, all geographies, elevating the stories of leaders--Democrat, Republican, and Independent. I want to start with Matthew Cook, who is the president and CEO of Children's Hospital Association. Matthew Cook writes: The House budget resolution directive to the Energy and Commerce Committee to cut 880 billion in spending will almost certainly lead to deep reductions in Medicaid funding for children who rely on the program and destabilize the financial viability of the providers caring for them. To the point that my colleague from Delaware asked: Slashing funding would mean fewer healthcare providers, fewer services, and longer wait times for patients who already-- Who already-- face significant barriers to care. These cuts will impact the 37 million children on the Medicaid Program, including the nearly 50 percent of children with special healthcare needs. Three million children in military-connected families-- I am going to repeat that. Three million children in military-connected families, more than 40 percent of the children living in rural areas and small towns, patients in rural communities would be hit especially hard as hospitals and clinics in these areas rely heavily on Medicare funding to stay open. Here is a letter from the Mental Health Liaison Group: In the midst of our Nation's ongoing mental health crisis-- I am going to pause there. When I ran for President and moved around the country, in townhall meeting after townhall meeting after townhall meeting, I was even surprised with how many Americans--I don't think we had a townhall where someone didn't want to stand up and tell me about the mental health crisis in America and how poorly we were doing. So when the Mental Health Liaison Group starts off with that, it hits me very hard. I still remember meeting with a guy in a New Jersey diner who had mental health issues, was a teacher in a high school, and he stabilized his mental health because of his prescription drugs but then stopped being able to afford them, started skimping on the drugs, had a mental health crisis, lost his job, and his whole life destabilized. Just because of not being able to have access to a costly prescription drug, a valued teacher had his life upended. I start this letter again: In the midst of our Nation's ongoing mental health crisis, including its devastating impact on youth and our ongoing overdose epidemic, it is paramount that access to lifesaving MHSUD services is not reduced and the integrity of the Medicaid Program to serve as a vital Federal and State partner safety net is preserved. Limiting access to Medicaid threatens to undermine gains in reducing overdose mortality rates and could lead to increasing rates of incarceration and hospitalization. My colleague from Delaware knows this. The biggest mental health institutions in America--the biggest ones--pick your State, from Illinois to Los Angeles, the biggest mental health institutions are Los Angeles prisons, are Chicago's prisons and jails, wasting taxpayer dollars. Where folks got their mental health treatment, their lives could stabilize. They could be workers. They could be helpers. They could not be sick. Here is Chip Kahn, the CEO of the Federation of American Hospitals: Key Republican lawmakers recognizing that so many constituents rely on Medicaid for critical care made it clear that their vote today was based on an understanding that the final reconciliation bill would not include devastating cuts or changes. I believe that is gratifying. Chip Kahn writes: It is important that these members came to the same conclusion. Medicaid cuts should be off the table. Medicaid cuts should be off the table. It is up to these lawmakers to follow through and ensure spending cuts don't come at the expense of care for over 70 million Americans, including kids, seniors, and hard-working families. I love the appeal in that letter because it was an appeal that I am reminded of when my colleagues Lisa Murkowski and the great John McCain and an extraordinary friend Susan Collins when they voted to save the Affordable Care Act. They listened to the appeal of people like this gentleman. My colleague sitting there, it is like, often, we resort to words of vicious cruelty. John Lewis didn't do that when he advocated against the most horrific racists. He didn't take on words of hate. We have got to appeal to colleagues of good conscience, not to let--as this person says, no Medicaid cuts; no Medicaid cuts. I know President Trump has said that Medicaid cuts are off the table. He said that over and over and over again. We will see. We will see. Modern Medicaid Alliance: With over 70 million children, seniors, and hard-working families who are relying on Medicaid for their health and well-being, it is critical Congress listens to State and local government officials, faith leaders, healthcare providers, and hard-working Americans, and blocks proposed cuts to the program. As organizations representing and caring for the millions of Americans who receive coverage and benefits through Medicaid, we know firsthand how the current level of cuts being considered by Congress would impact their care. They will cause Americans to lose coverage, reduce health access, and increase costs. We oppose any cuts-- We oppose any cuts. We oppose any cuts or harmful policy changes to Americans' Medicaid benefits as part of the budget reconciliation process and call on congressional leaders to reverse course and protect the program moving forward. Here is the Modern Medicaid Alliance: The latest House vote breaks a vital promise to more than 70 million Americans who depend on the Medicaid Program and now face the potential for unprecedented, destabilizing cuts to their coverage and access to care. The full extent of cuts being considered go far beyond addressing ``waste, fraud and abuse'' and would undermine Medicaid coverage for those who depend on it. Already, Senators are issuing stark warnings about the impact of Medicaid cuts on the stability of their communities, State budgets, hospitals and providers. We urge members of the House and Senate to block any Medicaid cuts or harmful policy proposals as part of the ongoing budget process. Sister Mary Haddad, President and CEO of Catholic Health Association: We are deeply concerned that the budget resolution would force the House Energy and Commerce Committee to slash $880 billion from the Medicaid Program, an essential healthcare program for nearly 80 million low-income Americans. Medicaid provides coverage for one in five individuals, funds 41 percent of all national births, and is the largest payor for long-term care and behavioral health services. These cuts would have devastating consequences, particularly for those in small towns and rural communities, where Medicaid is often the primary source of health coverage. Medicaid is not just a health program; it is a lifeline. It provides access to care for those who need it most--poor and vulnerable children, pregnant women, elderly adults, and disabled individuals in our Nation--while ensuring their dignity. Their dignity. Here is the Partnership for Medicaid again: The Partnership for Medicaid, a nonpartisan nationwide organization representing clinicians, healthcare providers, safety-net health plans, and counties, calls on Congress to reject cuts to Medicaid during the budget reconciliation process. The Partnership for Medicaid stands ready to work with policymakers to identify more sustainable strategies to strengthen Medicaid and improve upon its promise of providing high-quality coverage and access to care populations. So this is another organization saying: Hey, put me in. Let us help you improve this program, and maybe we can achieve some of our mutual goals. Here is Susan Kressly, president of the American Academy of Pediatrics, the great AAP: The American Academy of Pediatrics urges lawmakers to reject the budget resolution before the U.S. House of Representatives and to protect programs that are vital to the health and well-being of children. We oppose the proposed funding cuts to programs like Medicaid and the Children's Health Insurance Program, which cover nearly half of all U.S. children, as well as the Supplemental Nutrition Assistance Program. These cuts would have devastating consequences for children and families. We are going to talk about cuts to SNAP later, but I love how Dr. Susan Kressly, president of the American Academy of Pediatrics, can't help but mention them together. Why is a doctor concerned about healthcare also mentioning SNAP? Well, fundamental to our children's health and well-being is having access to fresh and healthy foods. This is me being a little critical of people saying they are MAHA-- Make America Healthy Again--and then immediately cutting kids' access to fresh, healthy fruits and vegetables. I love this doctor. It is almost like you are doubling down on the injury to our children. We are cheapening highly processed and sugar- filled, nutritionally empty foods, denying access to fresh, healthy fruits and vegetables, and then not letting people with chronic diseases get healthcare. I love this doctor for pointing out those connections. Now I am going to go to Brian Connell, who is the vice president of the Leukemia & Lymphoma Society: The fiscal year 2025 budget resolution would create not just the opportunity but the obligation for the House Committee on Energy and Commerce to make dangerous cuts-- Dangerous cuts-- to the Medicaid program in the budget reconciliation process expected in the coming week. The hundreds of billions of dollars of cuts demanded by the budget resolution cannot be achieved without slashing benefits for enrollees or altogether taking away Medicaid coverage for millions of Americans. To be clear, the Leukemia & Lymphoma Society and the patients we represent are clamoring for Congress to lower healthcare costs, but the framework before the House today would pave the way for policies that do just the opposite, putting affordable access to healthcare out of reach of millions of Americans. Feeding America--I love this organization: Cuts to vital federal nutrition programs like SNAP, necessitated by this resolution and the Senate version passed last week, will harm families grappling with high food costs, hurt rural economies and strain food banks already overwhelmed by rising demand. We urge the House to reject spending cuts to nutrition programs in the budget reconciliation process and support the work the House and Senate agriculture committees are doing to create a strong, bipartisan farm bill. The Federal AIDS Policy Partnership: We are writing on behalf of 95 national, regional, and local organizations advocating for Federal funding legislation and policy to end the HIV epidemic in the United States. We urge Congress to reject all proposals to enact cuts to Medicaid, whether through per-capita caps or block grants, restrictions to the Federal Medical Assistance Percentage, or FMAP, or mandatory work requirements during reconciliation for the 2025-2026 fiscal year budgets. Medicaid is the most important source of health coverage and lifesaving care for people living with HIV-- The most important source of health coverage and lifesaving care for people living with HIV-- providing coverage for more than 40 percent of the people living with HIV and contributing 45 percent of all Federal funding for domestic HIV care and treatment. The next letter starts: To be clear, the cuts outlined above are being proposed for one simple reason: to pay for $4.5 trillion in tax breaks that disproportionately benefit the wealthy. Congress can and must take a different path-- Congress must take a different path-- one that lifts more families out of poverty and provides more Americans with the opportunity to reach their full potential. A people-first agenda should include expanding the child tax credit for the 17 million children who don't receive the full credit due to low family incomes, expanding rental assistance, increasing SNAP benefits to reflect rising grocery prices and closing the Medicaid coverage gap. If Congress focused on ensuring that wealthy Americans pay their fair share rather than providing additional tax breaks, we could fund these initiatives and so much more. This is a group of groups that you will recognize or many people will recognize: American Association of Nurse Practitioners, Gerontological Advanced Practice Nurses Association, the National Association of Nurse Practitioners in Women's Health, National Association of Pediatric Nurse Practitioners, and the National Organization of Nurse Practitioner Faculties. They write: We are deeply concerned with the impact of these cuts on the healthcare system and their potential to harm our most vulnerable patients. Further, these cuts will threaten the viability of practices that treat Medicaid patients, financially destabilizing and having a disproportionate impact on those who provide care to underserved and rural communities. Association of American Medical Colleges, AAMC: We remain extremely concerned that the budget resolution's reconciliation instructions would result in unsustainable cuts to Federal healthcare programs--specifically Medicaid-- by requiring at least $880 billion in savings from the House Energy and Commerce Committee. Cuts of this magnitude would jeopardize both access to care for millions of Medicaid enrollees and the financial stability of the providers who care for them. Here is one from Chimes International: Cuts in Medicaid will have a dramatic negative impact on our healthcare system and the first responder community. Millions of Americans will be at risk of losing access to housing, thereby increasing homelessness for some of the most vulnerable members of society, especially in areas that already lack affordable housing. Provider organizations like ours will be forced to close the doors of residential facilities and reduce support staff, which is already in short supply. Katie Smith Sloan, who is the president and CEO of LeadingAge: States would have to fill in massive budget holes if Federal funding to Medicaid programs were cut. Even if a cut such as a change to the expansion FMAP proposal does not seem to directly impact aging services, it would because the cost of the cut would have to somehow be absorbed by State budgets. That type of hole cannot be filled in via more efficiency. Balancing the 10-year program budget cycle on the back of the Medicaid program is not a good tradeoff for the American people. Alan Morgan, who is the CEO of the National Rural Health Association--this letter is powerful. He represents the National Rural Health Association: Any cuts to the Medicaid program will disproportionately affect rural communities. Rural Americans rely on Medicaid coverage, with about 20 percent of non-elderly adults and 40 percent of children living in rural areas enrolled in Medicaid and CHIP. In almost all States, rural areas have higher rates of Medicaid enrollment than metropolitan areas. Cuts to Medicaid would shift healthcare costs onto rural families, many of whom already struggle with financial instability. Medicaid cuts would force families to face higher out-of-pocket expenses, leading many to delay or forgo necessary treatments. The burden would worsen health outcomes, especially for those managing chronic conditions like diabetes, heart disease, and cancer. To the extraordinary prescience of my colleague from Delaware, who knew this letter was coming, I imagine, this is a letter from the U.S. Conference of Mayors, the National League of Cities, the National Association of Counties, the National Conference of State Legislatures, the Council of State Governments, and the International City/County Management Association. I am going to pause for a second just to remind folks--because I have been involved in the U.S. Conference of Mayors and the National League of Cities. I have dealt with the National Association of Counties on things that were important here in the Senate. All of these groups are bipartisan. All of these groups represent Democrat and Republican mayors, Democrat and Republican city council people. I was actually a nonpartisan mayor. New York does not have partisan elections. So they have nonpartisan folks. This is a group of people who have those jobs where the rubber meets the road. A change in State policy, a change in Federal policy--we had to eat it when I was mayor if it cost us more money. I was a mayor that talked like lots of mayors do, not in partisan lingo. They just talk about: Hey, it is an unfunded mandate. Hey, that is adding more bureaucracy. Hey, that is going to cause more people in my community to be homeless. It is going to cause more children in my community to use an emergency room as their primary care physician. When I meet a mayor, I look at them and I thank them because it is one of the hardest jobs in America. So this organization that represents Democrats and Republicans--they write: As a coalition of bipartisan membership organizations representing State legislatures, mayors, cities, and counties, we are committed to working collaboratively to strengthen the Medicaid program so that the States and localities can continue to meet the needs of their residents effectively. We write to express concern over proposed changes to Medicaid financing and requirements that could significantly impact State and local budgets, healthcare infrastructure, and millions and millions of Americans who rely on the program. I would say so far there are at least half a dozen to a dozen of these letters where bipartisan groups are saying: Let us help you. Don't rush this through in a way that is going to cause havoc to State and local governments, cause havoc to children and seniors and the disabled, cause havoc to hospitals and businesses, cause havoc to rural communities, cause havoc to the idea of what it means to be an American: that we take care of our own, that we stand up for each other, that we lend a hand, that we lift folks up. And here it is, this voice of bipartisan sensibility that says: Hey, hold a hearing. We will come. Put some of us on a commission. This is a group called Advocates for Community Health: Medicaid's successes as a national program derive from its variations across different States. Different States doing things in different ways. Medicaid looks different in every State and territory because the program is able to reflect and accommodate the specific needs of the State's patients, providers, and communities. These State-based programs are vital to the patients served by community health centers, patient-to-direct primary care providers that serve rural and underserved communities nationwide. As the House and Senate work toward a budget reconciliation package, Advocates for Community Health encourages a cautious approach to changes to Medicaid policy as broad changes have a potential to destabilize State Medicaid programs and community health centers, impact local economies and job creation, and further exacerbate rural healthcare access challenges. Families USA. Their executive director--his name is Anthony Wright: Americans are storming townhalls, calling their Representatives in Congress, and demanding that House Republicans stop their plan to massively cut the healthcare that Americans want and need. President Trump and some Republicans have said they won't touch Medicaid, but their vote today is when we see who walks the walk. The vote is the walk-the-plank moment for moderates who say they don't want Medicaid cuts but are being asked to cut over $880 billion to the care and coverage of their constituents. Policymakers and the public alike understand that there is no version of this budget resolution that does not include deep cuts to vital programs, services, and benefits the American people use every day to help them see a doctor, pay rent, or feed their families. Justice in Aging is an organization that is led by its executive director, Kevin Prindiville. He writes: With this vote, lawmakers endorsed taking away Medicaid from millions of Americans, including older adults, all to bankroll tax cuts for the wealthy. Thanks to our collective advocacy, the vote to pass this dangerous budget blueprint did not come easily, and we will make sure lawmakers know that voting to enact these cuts would be voting to abandon older Americans. The National Alliance for Caregiving: The House budget blueprint to eliminate at least $800 billion in Federal funding unfairly targets critical healthcare and supportive services that older adults, people with diabetes, and their family caregivers depend upon to maintain health and economic security for families and themselves. Home- and community-based services funded via Medicaid are cost-effective. They save millions of taxpayer dollars on unnecessary and often unwanted institutional care. Most of all, Medicaid-funded HCBS-- Home- and community-based services-- offers consumers a choice in how they receive care in the dignity of their own homes. In the dignity of their own homes. Dignity. The Coalition for Whole Health Legal Action Center: Among the options being discussed are work requirements for enrollees, despite the fact that most people receiving Medicaid do work, and other cuts to Federal funding that would disproportionately harm people with substance abuse and mental health conditions and those with arrest and conviction records by making it harder to access critical health coverage and service, medications, and support. Such individuals already face pervasive stigma and discrimination, including significant barriers to employment that threaten their stability and well-being, at a time when overdose and suicide are claiming more than 400 lives a day. We cannot afford to reduce access to comprehensive healthcare services that people with substance abuse use, mental health conditions, and those rebuilding their lives after incarceration desperately need to recover and thrive. Let me tell you something about that that really strikes me. I was blessed to go to colleges, and there, people would use drugs. Now I live in a community where the consequences for drug use often mean jail time. In fact, if you look at low-income people, their chances of being incarcerated are far greater than college kids, who have drug usage rates at about the same. So now you say to somebody who has an arrest record and served some time that when they come out, they can't get help? People with mental illness are over-incarcerated. You are going to say to them ``You have this mental illness. Now you have a record, and you also can't get healthcare services?'' That is, again, self-defeatist when it comes to our Nation trying to give people ways of elevating themselves above their past mistakes or the diseases that challenge them. Here is another group, Community Catalyst: These cuts will hit hardest where healthcare access is already fragile. Here is the Alliance for Ageing Research: We, the undersigned organizations, urge you to oppose any cuts to Medicaid and the Supplemental Nutrition Assistance Program, SNAP, including those called for in the proposed budget resolution. We are concerned about the negative impact these deep cuts will have on the Americans living with chronic disease and other disabilities. But we are willing to draw your attention now to how devastating it will be on those with Alzheimer's and related diseases, including frontotemporal degeneration and Lewy body dementia, and their family caregivers. April Verrett, the president of SEIU: Let's be clear, Americans have flooded congressional phone lines, rallied at townhalls, and lifted their voices to make it clear that they do not want massive cuts to the healthcare and public services they depend on. Despite that, today Speaker Johnson pressed a budget resolution forward that puts our Nation on a disastrous path to ripping away healthcare from 80 million children, pregnant women, veterans, seniors, people with disabilities by gutting Medicaid. Lee Saunders, the president of AFSCME: This budget proves that extremists are more concerned with giving wealthy trillions in tax cuts than helping working people. Voters across the country are packing townhalls to demand no cuts to Medicaid and SNAP. They are calling Representatives and asking them, Please save these services. They want elected leaders who will lower rising costs, who make it easier to afford rent and food, but instead of listening to workers, the House moved forward on a budget plan that will cause millions to lose their healthcare, increasing food insecurity for families, and jeopardize Medicare and Social Security in the long term. He calls this ``shameful.'' The Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition: We are deeply concerned about the budget resolution passed in the House of Representatives this week. This budget resolution will likely lead to cuts to the safety-net Medicaid programs, which provide health insurance to almost 80 million Americans, including children, pregnant women, elderly adults, people with diabetes, and low-income adults and families. This action would disproportionately impact Americans who most need us, including those with diabetes or other chronic conditions who rely on Medicaid to access medications and technology that they need to manage their conditions. Members of Congress should, instead, work to ensure access to health insurance through the Medicare program--work to ensure access to healthcare without barriers for the most vulnerable Americans. Here is the Alliance for Childhood Cancer: Work requirements may also impact caregivers of children with cancer who are unable to work due to the demands of cancer treatment for young adults with cancer who may not be eligible for insurance via their employer or may not be able to work due to their diagnosis. Many young adults rely on Medicaid, especially Medicaid expansion, for coverage, and research shows a clear increase in survival for young adults with cancer in Medicaid expansion States. UnidosUS: The proposed resolution would slash at least $880 billion from programs that have long provided lifesaving, affordable coverage to millions of Americans. Medicaid alone serves 80 million people, covering nearly 40 million children, half of those with special healthcare needs, and more than 40 percent of all births. In Latino communities, Medicaid reaches 20 million individuals, protecting nearly one-third of community members, more than half of Latino children, and roughly 30 percent of Hispanic elders. Without these vital programs, it would be higher hospitalization rates, delayed diagnoses, and increased mortality. This would become the norm, placing an unsustainable strain on public health and national financial security. As UnidosUS recently pointed out, these proposed cuts would represent the largest cuts to Medicaid in U.S. history. The Coalition of Survivors of Domestic Violence and Sexual Assault: On behalf of the adult and child survivors of domestic violence and sexual assault, we serve and advocate for them. We, on behalf of them, write to ask you to reject cuts to Federal Medicaid funding. Survivors rely on Medicaid every day to escape abuse, to rebuild their lives after violence, to care for their children and families. The Catholic Health Association of United States, the United States Conference of Catholic Bishops, and Catholic Charities USA: Weakening Medicaid through structural challenges such as per capita caps or block grants would undermine these values and risk leaving millions without access to essential health services. Furthermore, policies like work reporting requirements have shown clear evidence of creating artificial barriers to care, generating paperwork and bureaucracy while doing little to support people looking for work. These requirements also fail to recognize that most people on Medicaid already work and ignore the realities of low-wage workers, caregiving responsibilities, and health limitations, and studies have shown they frequently result in loss of coverage for eligible individuals and children. The Disability and Aging Collaborative and the Consortium for Constituents with Disabilities on behalf of 107 national organizations and more than 230 State and local organizations: The undersigned members of the Disability and Aging Collaborative, the health and long-term service and support task forces of the Consortium for Constituents with Disabilities, and allied organizations write to urge you to exclude Medicaid cuts, work requirements, or any changes that limit funding or eligibility from budget reconciliation or other legislation. People with disabilities, older adults, family caregivers and their children, direct care workers and other low-income individuals and families depend on Medicaid every day for their health, safety, and independence. Medicaid enables our communities to go to work and to care for loved ones. It is our community's lifeline, and we cannot afford for any part of it to be cut. (Mr. BANKS assumed the Chair.) The Jesuit Conference: Programs that meet basic needs such as SNAP, Medicare and Medicaid, health insurance premium tax credits, and Social Security should be protected and remain as robust as possible. We oppose modifications that would have the effect of reducing important benefits or excluding vulnerable people from participating. Thank you, the Jesuit Conference. Why? I mean, we have just read dozens and dozens of letters from real people who are relying on these programs to take care of their elderly parents, to take care of their loved one with dementia, to take care of their children, to take care of their adult children with disabilities, to take care of their children with special needs, to take care of their families, to take care of their communities, to take care of rural towns, to take care of the hospitals that take care of people. Why? Why? Why are all of these people lifting their voices now, pointing to the crisis that can't be normalized, pointing to the challenges? Because we have seen this reconciliation process call for $880 billion of cuts, when, as I read earlier, there is only one place that the majority of those cuts can come from, and that would be hundreds of millions of dollars in cuts to Medicaid, which organization after organization told you it is already a delicate balance; that cuts to these programs could ultimately tear down people's access to lifesaving benefits. People use the word ``dignity'' over and over again--dignity. It is a value in our country that we treat our elders with dignity, that we give people struggling with chronic disease dignity, that we give parents who are slammed with the unimaginable diagnoses for their children--we help them to access dignity. People that we have talked about and that we read their letters, they all said: We can help you find efficiencies. We can help you make the programs work better. We can help you, but why are you doing this if it is all part of a larger package to give tax cuts to the wealthiest Americans, to give tax cuts to billionaires? How does that work? That Elon Musk should get richer and richer and richer, and families--the love in these letters--who love their children, who love their aging parent, who love that person with dementia, even though they don't recognize them anymore. But that doesn't stop the heroic love. And they piece together their finances in a nation where housing costs are going up, food costs are going up, and transportation is going up. They piece together the fragile finances of their lives. The Medicaid funding is one part of it that gets yanked away, and everything unravels. Why, they ask, why? They plead for help. They ask us to do something. I want to read some articles, coming from a variety of backgrounds-- but perhaps this one from PBS, ``A closer look at who relies on Medicaid.'' This is what PBS wrote: As congressional Republicans seek about $4.5 trillion to extend expiring tax cuts, the Federal Government will need to find savings elsewhere. You are going to give that $4.5 trillion that disproportionately go to the wealthy, and you are going to have to find savings elsewhere. Experts say budget cuts could affect Medicaid coverage for as many as millions of Americans, at a time when the program may need more funding, not less. The proposed House bill requires the Committee on Energy and Commerce to find $880 billion in spending cuts, which means some aspects of Medicaid, which the committee oversees, may be on the chopping block. Medicaid is a massive . . . program that provides free and reduced-cost health care for eligible enrollees. It offers critical coverage to a wide variety of Americans, including children, adults with disabilities and older people in nursing homes. Even for Americans who have private insurance, Medicaid can play a part in their health care. That's because Medicaid is such a large engine of funding for so many aspects of the country's health coverage. So many benefit from these aspects of this country's health coverage. The public health insurance option is funded in part by the Federal Government and in part by states, covering around 72 million [Americans]. The Federal Government spent about $880 billion on Medicaid in fiscal year 2023, the most recent year for which there's data, according to an analysis by the nonprofit health policy research organization KFF. Medicaid is an extremely popular entitlement program, said Robin Rudowitz, director of the program on Medicaid and the uninsured at KFF. More than 9 in 10 adults say Medicaid is ``very'' or ``somewhat'' important to their local community, according to recent KFF polling. Forty percent of respondents said they wanted Medicaid funding to remain the same, while 42 percent wanted to increase funding for the program. Just 17 percent wanted to decrease funding ``a little'' or ``a lot.'' Some studies have found that expanding Medicaid can save money for states, including in spending reductions in corrections health care as well as mental health and substance abuse care. Pulling away from the article for a second, that is so logical. Expanding health coverage for people with mental health challenges or substance abuse means an investment now and saves a lot of money for society later and saves them from being rearrested because of their disease. Back to the article: President Donald Trump has said his administration will not cut Medicaid benefits, and will instead reduce spending by eliminating waste and fraud. [Well,] according to health policy experts, there may not be a way to fund the tax cuts without cutting Medicaid. Doing that will have real implications, said Allison Orris, senior fellow and director of Medicaid policy at the Center on Budget and Policy Priorities. Another nonpartisan group. ``It's fair to say if Medicaid is cut by hundreds of billions of dollars, people will lose coverage. But some of the ways in which they will lose coverage and health care and access are a little bit tricky,'' she said. [So] who and what relies on Medicaid? Medicaid covers low-income Americans in all 50 states, as well as D.C. and the American territories, but the program's benefits are farther reaching. Medicaid pays for around 2 in every 5 births in the country. The program accounts for about 20 percent of both hospital funding and total health care spending nationwide, according to KFF. That organization's analyses of hundreds of studies conducted since 2014 largely found that Medicaid expansion helped cut hospital costs associated with uninsured patients. Many studies also found that Medicaid expansion helped with overall hospital funding and resulted in fewer hospital closures. And Medicaid--not Medicare--is the single largest payer of long-term coverage, including nursing home care. Here are some of the ways Medicaid is crucial for so many Americans' health care. Long-term care for people with disabilities. According to KFF analyses, 35 percent of Americans with disabilities have Medicaid, [that is about] 15 million people. That compares with 19 percent of people without disabilities, [and] the majority of whom have employer- provided health insurance. Currently, Medicaid covers about 60 percent of long-term care coverage, much of which provides care for younger adults with disabilities. Nursing homes. Medicaid is the primary payer of nursing care in the U.S.; it covers 63 percent of nursing home residents. For many older adults, ``Medicaid is the safety net,'' says David Grabowski, professor of health care policy at Harvard Medical School. ``An individual can be middle-income their entire life and then reach their older, long-term care years and have to enter a nursing home.'' Because nursing homes can be so expensive, families can quickly deplete [all of] their assets, then rely on Medicaid to cover long-term care. Another group: Children. Thirty-seven percent of people enrolled in Medicaid are children, but they account for only about 15 percent of the program's spending. In 2023, KFF found that of the 72 million people enrolled in Medicaid, about 30 million were children. Millions more children are enrolled in the Children's Health Insurance Program, which some states run with Medicaid expansion funds. They are tied. Forgive me. That is off the article. Back to the article: So far, political conversation has not yet focused on cutting CHIP. Rural maternal health. Medicaid covered around 40 percent of births nationwide in 2023, KFF found, and nearly half-- Nearly 50 percent-- of all rural births. Studies also show that being enrolled in Medicaid leads to improved health outcomes for children, including declines in infant and child mortality, preventive care visits on par with privately insured children and even potentially positive outcomes into adulthood, such as improvements in education. That is what studies show being enrolled in Medicaid leads to. How about Native Americans and Alaskan Indians? Four in 10 American Indian/Alaskan Native people are enrolled in Medicaid, the highest enrollment rate among any race and ethnicity category. This includes about 23 percent of nonelderly AIAN adults and 44 percent of [American Indian/ Alaskan Native] children. How the Federal Government funds the states' Medicaid plans. Medicaid began as an optional program in 1966 alongside Medicare, with around 8 million people eligible for enrollment. By the 1980s, all states had opted into providing health insurance through Medicaid. Though eligibility requirements have changed over the last 60 years and vary by state, the most significant change to Medicaid was the enactment of the Patient Protection and Affordable Care Act in 2010. It required states to cover adults with incomes up to 138 percent of the [federal] poverty line. After the Supreme Court ruled in 2012 that expansion for states should be optional, 40 states and Washington, D.C., have expanded Medicaid. Forty of our 50 States accepted ``federal funds at a much higher rate than the match rate for non-expansion coverage.'' That is a good summary by PBS of how far-reaching this program is, how many Americans in every single State, from all backgrounds, from both sides of the political aisle--Independents, old, young, hospitals, businesses, care professionals, and more--this is who we are. We have expanded the program. We have made it better. We have brought improvements. And yet we are doing a process, and it is not going through a committee. We are not soliciting the best ideas from both sides of the aisle about how to make it more efficient, more effective. We are not bringing in private sector professionals to give advice and input or hospital providers or people that are seeing things that we can learn from and craft legislation to make the program better. And the letters are even showing that we are not even doing any of those things, and then we are cutting the very programs that allow people access to fresh, healthy food, that then cause us to need more health care for chronic diseases. This alone would be bad enough if we were gutting a program with no input from professionals, if we were taking away healthcare from seniors, children, expectant mothers, the disabled. That would be bad enough. But why? Again, why? Because it is part of a larger budget package to give trillions of dollars in tax cuts disproportionately to the wealthiest Americans and still add trillions to the national deficit. I talked about American Indians and Alaskan Natives. I mentioned that I recently visited some proud Native Americans and heard their stories and was inspired by their conviction and their grit, and how under incredible odds, they were able to create better lives. After extraordinary oppression and vicious policies and more, they found a way forward. There is a disproportionate number of Native Americans and Alaska Natives that rely on these programs, people who have maintained extraordinary dignity despite promises made and promises broken. So many people are talking about that idea of a sacred trust; that the richest Nation in the world, to honor its ideals of freedom, has to focus on keeping people free from fear that one medical bill will throw their family in crisis or fear that one diagnosis for their child will unravel their lives or fear that, if their parent gets dementia, there will be no care for them. So much of this conversation is within this larger understanding of who we are, and what do we stand for. I want to take a look at some of the things the Trump administration is doing that is going to undermine not just Medicaid but health insurance coverage for Americans, for all Americans, and raise the cost of healthcare, and negatively impact our health. At a time when basic prices of everyday goods are going up, the President is making healthcare harder to access and drug prices even higher. I want to explain this. On his first day back in office, Trump rescinded the policy that extended the enrollment period for ACA plans. This policy gave Americans sufficient time to enroll in healthcare for the year, and enrollment in the ACA continues to go up as people see how affordable this program is and how they can get quality healthcare. But the first thing--one of the first things he does--is rescind the policy that extended the enrollment period. In addition to this, Republicans in Congress want to take away the tax credits that make healthcare more affordable for so many people. Millions of working-class Americans rely on Affordable Care Act tax credits to access affordable, quality healthcare and coverage. I could go on with the things. For example, currently these tax credits, they are set to expire at the end of this year. If these tax credits were taken away, families will pay up to 90 percent more for their healthcare, and 5 million Americans could lose their healthcare altogether. All, again, if this goes through in 2025, billionaires and CEOs will get a huge tax break while working Americans relying on this tax credit will lose it. Think about that. This would allow billionaires and CEOs to get more of a tax break, while these tax credits that help more Americans access healthcare would expire. For New Jerseyans, ending the ACA tax credit would make health insurance less affordable for 352,000 hard-working people and their families and would force 75,000 people to go uninsured--75,000 people in my State alone. Last year, 24 million people chose Affordable Care Act plans during the most recent open enrollment due to these expanded tax credits that made plans available to people for little or no monthly premiums and extended the enrollment period, which I just said the President has rolled back. President Trump also overturned an effort for Medicare to lower drug costs like implementing a $2 monthly out-of-pocket cap on certain generic drugs as well as a measure that would reduce Medicare payments for rare disease drugs and drugs that treat life-threatening conditions. I just don't understand that. I really see that as cruel. Americans struggling to afford their drugs had a cap of out-of-pocket expenses on certain generic drugs, and that was overturned. Costs are going up. Costs are going up. And now this President is expanding costs for out-of-pocket generic drugs as well as Medicaid payments being eligible for rare diseases. I had the privilege of becoming close to John McCain. I came here in the Senate, got this admonition, almost, from Bill Bradley, somebody who held my seat beforehand, and he challenged me to go and have lunch with or meetings with all my Republican colleagues at the time. That was way back in 2013. And I was told by John McCain's staff that I had like 10, 15 minutes, but I was going to take it. This is John McCain. He is legend. And I go in and meet with him, and I don't come out of that office for 90 minutes. We both got emotional as he showed me pictures and documentation from his time as a prisoner of war. In 2017, he was under extraordinary pressure in this healthcare crisis, and there were thousands of Americans descending on our Capitol. I will never forget the ``little lobbyists,'' they called themselves, kids in wheelchairs that would roll up to Congress people and raise their little voice, respectfully, and ask them not to take away their health coverage. I remember people coming in here with preexisting conditions and saying: Don't repeal my healthcare and not even have a plan to replace it. President Trump was asked about healthcare when he was Candidate Trump for this office, and he said he had, I think it was, ``conceptions of a plan.'' And since he has been in office, I haven't heard a vision for healthcare besides budget proposals that would cut people's healthcare. But John McCain, I will never ever forget that moment. I was actually standing on the Republican side, if I remember correctly, having conversations, and he came to the floor, after listening to Arizonans tell stories like the ones I have been reading, and put his thumb down. He wrote a speech about his decision, and I want to read a part of that now. I have been a Member of the U.S. Senate for 30 years. I had another long, if not as long, career before I arrived here, another profession that was profoundly rewarding and in which I had experiences and friendships that I revere. Make no mistake, my service here is the most important job I have had in my life. I am so grateful to the people of Arizona for the privilege--for the honor--of serving here and the opportunities it gives me to play a small role in the history of the country I love. I have known and admired men and women in the Senate who played much more than a small role in our history--true statesmen, giants of American politics. They came from both parties and from various backgrounds. Their ambitions were frequently in conflict. They held different views on the issues of the day. They often had very serious disagreements about how best to serve the national interest. But they knew that however sharp and heartfelt their disputes and however keen their ambitions, they had an obligation to work collaboratively to ensure the Senate discharged its constitutional responsibilities effectively. Our responsibilities are important--vitally important--to the continued success of our Republic. Our arcane rules and customs are deliberatively intended to require broad cooperation to function well at all. The most revered Members of this institution accepted the necessity of compromise in order to make incremental progress on solving America's problems and to defend her from her adversaries. That principled mindset and the service of our predecessors who possessed it come to mind when I hear the Senate referred to as the world's greatest deliberative body. I am not sure we can claim that distinction with a straight face today. I am sure it wasn't always deserved in previous eras either. I am sure there have been times when it was, and I was privileged to witness some of those occasions. Our deliberations today, not just our debates but the exercise of all our responsibilities--authorizing government policies, appropriating the funds to implement them, exercising our advice and consent role--are often lively and interesting. They can be sincere and principled, but they are more partisan, more tribal more of the time than at any time I can remember. Our deliberations can still be important and useful, but I think we would all agree they haven't been overburdened by greatness lately. Right now, they aren't producing much for the American people. Both sides have let this happen. Let's leave the history of who shot first to the historians. I suspect they will find we all conspired in our decline, either by deliberate actions or neglect. We have all played some role in it. Certainly, I have. Sometimes, I have let my passion rule my reason. Sometimes I made it harder to find common ground because of something harsh I said to a colleague. Sometimes I wanted to win more for the sake of winning than to achieve a contested policy. Incremental progress, compromises that each side criticizes but also accepts, and just plain muddling through to chip away at problems and to keep our enemies from doing their worst aren't glamorous or exciting. It doesn't feel like a political triumph. It is usually the most we can expect from our system of government, operating in a country as diverse, quarrelsome, and free as ours. Considering the injustice and cruelties inflicted by autocratic governments and how corruptible human nature can be, the problem-solving our system does make possible, the fitful progress it produces, and the liberty and justice it preserves, are a magnificent achievement. Our system doesn't depend on our nobility. It accounts for our imperfections and gives an order to our individual strivings that has helped make ours the most powerful and prosperous society on Earth. It is our responsibility to preserve that, even when it requires us to do something less satisfying than winning, even when we must give a little to get a little, even when our efforts managed just 3 yards in a cloud of dust, while critics on both sides denounced us for timidity, for our failure to triumph. I hope we can again rely on humility, on our need to cooperate, on our dependence on each other to learn how to trust each other again and, by so doing, better serve the people who elected us. Stop listening to the bombastic loudmouths on the radio and television and the internet. To hell with them. They don't want anything done for the public good. Our incapacity is their livelihood. Let's trust each other. Let's return to regular order. We have been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle. That is an approach that has been employed by both sides: mandating legislation from the top down, without any support from the other side, with all the parliamentary maneuvers it requires. We are getting nothing done. All we have really done this year is confirm Neil Gorsuch to the Supreme Court. Our healthcare insurance system is a mess. We all know it, those who support Obamacare and those who oppose it. Something has to be done. We Republicans have looked for a way to end it and replace it with something else without paying a terrible political price. We haven't found it yet. I am not sure we will. All we have managed to do is make more popular a policy that wasn't very popular when we started trying to get rid of it. I voted for the motion to proceed to allow debate to continue and amendments to be offered. I will not vote for the bill as it is today. It is a shell of a bill right now. We all know that. I have changes urged by my State's Governor that will have to be included to earn my support for final passage of any bill. I know many of you will have to see the bill changed substantially for you to support it. We have tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical Members, trying to convince them it is better than nothing--that it is better than nothing--asking us to swallow our doubts and force it past a unified opposition. I don't think that is going to work in the end and probably shouldn't. That is prescient. I mean, that is prescient. As a great New Jerseyan, Yogi Berra says ``It's like deja vu all over again.'' To hear what John McCain was criticizing--one party behind closed doors without consultation of experts, against the wishes of Republican Governors, is trying to force something through past a united opposition--he literally is describing what is happening right now and condemning both sides of this institution for playing this record over and over and over again. Yes, I am a Democrat, and I admit that our healthcare system needs so much help and so much reform. One out of every three of our tax dollars is being spent on healthcare. That is ridiculous. And what are we getting from it? A society that is getting more and more sick. And what are our solutions as a body? Did we come together as a team? Did we set up a special conference, set up a special committee to study the issues, to bring in the experts, to involve the best technology, to learn the lessons from private sector and public sector, from universities, from scientists--are we doing that, or are we doing exactly what John McCain said we shouldn't do, exactly what he described why he voted no? It is maddening in this country to create greater and greater healthcare crises and for us not to solve it but to battle back and forth between trying to make incremental changes or to tear it all down with no plan to make it better, leaving more and more Americans suffering what is still one of the most significant ways people go bankrupt, which is not being able to afford their healthcare. And what are we doing it for this time, John? Senator McCain? I know you wouldn't sanction this. I know you would be screaming. I have seen how angry you can get, John McCain. I have seen you tear people apart on the floor, Democrat and Republican, for doing the same stupid thing over and over again. Listen to John McCain explain why he voted no the last time the Republican Party tried to unite and tear down healthcare with no idea how to fix it and threatening to put millions of Americans in financial crisis and healthcare crisis. I can't believe we are here again with thousands upon thousands upon thousands of Americans writing letters, storming into townhalls-- hospital leaders, private sector leaders, Republican Governors, Republican mayors, Democrat Governors, Democrat mayors, all saying: What are you doing in Congress and why? I think what is even more outrageous this time is the why--to redo the tax cuts that independent budget analysis says, no, that the overwhelming benefit went to the billionaires who sat on stage with Donald Trump during his inauguration. We are not saving any money in our budgets. Their plan is to expand our budget crisis. Their plan will add trillions of dollars to our budget and give tax cuts to the wealthiest and not help the people that John McCain is talking about. His echoes haunt me that he said we are mistaken when we don't come together across the aisle--across our differences--to try to make things better. There is a healthcare crisis in this country. One out of three dollars in our government is going to healthcare. And we have more chronic disease in this Nation than we have ever had before. And there is no solution being offered in this reconciliation to deal with that. In fact, we are making it worse because we are denying children access to healthy foods. This is ridiculous. If they are successful, what kind of country will we be with more stratifications of wealth, with people who have done so good? I am not one of these Democrats who hates successful or wealthy people. Heck, people in my neighborhood--I am the only Senator that probably lives in a low-income neighborhood--strive to be wealthy. They are doing great. The top quartile of our country the last 20 years has made extraordinary wealth. God bless them. But when you see that 70, 80 percent of Americans don't want Medicaid cuts because most Americans know neighbors, family members, church members who rely on Medicaid; they know that their grandmother in a nursing home relies on Medicaid; they know that the disabled child next door relies on Medicaid. And now we want to gut it $880 billion? John McCain--most people remember the thumb down. They don't remember his words; they don't remember the warnings. This man is in Heaven now and his words, they speak to us in this moment again. Why won't we listen to them? Our deliberations today, not just are debates but the exercise of all our responsibilities--authorizing government policies, appropriating the funds to implement them . . . They can be sincere and principled, but they are more partisan, more tribal more of the time than at any time I can remember. Our deliberations can still be important and useful, but I think we would all agree they haven't been overburdened. . . . Right now, they aren't producing much for the American people. Both sides have let this happen. Let's leave the history of who shot first to the historians. I suspect they will find we all conspired in our decline, either by deliberate actions or neglect. Listen to John McCain: Our system doesn't depend on our nobility. It accounts for our imperfections and gives an order to our individual strivings that has helped make ours a most powerful and prosperous society on Earth. Listen to us: Let's trust each other. Let's return to regular order. We have been spinning our wheels on too many important issues because we keep trying to find a way to win without the help from [the other side]. That is an approach that has been employed by both sides: mandating legislation from the top down, without any support from the other side . . . We are getting nothing done. All we have really done this year is to confirm Neil Gorsuch. . . . I voted for the motion to proceed to allow debate to continue and amendments to be offered. I will not vote for the bill as it stands today. I will not vote for the bill. We have tried to do this by coming up with a proposal behind closed doors in consultation with the administration-- Donald Trump-- then springing it on skeptical Members, trying to convince them it is better than nothing . . . asking us to swallow our doubts and force it past a unified opposition. I don't think that is going to work in the end and probably shouldn't. Well, this shouldn't work either. This shouldn't work either. This is wrong. This is wrong. I see the leader here. I am sorry, sir. I should be conserving my energy.

Mr. BOOKER. I would yield for a question while retaining the floor.

Mr. BOOKER

Mr. BOOKER. And, again, you and I and the Presiding Officer, there are a lot of people here I know that operate from just a place of just like decency. There are problems with government. We need to fix them. We need to make government more efficient. We need to deal with the national debt. There are so many things that people on the right and the left don't agree on. You and I can agree that, God bless America, the government could be a lot more efficient. But the question is, They are not playing on the level. There are lies about USAID like, I don't know, 5 million condoms going to Gaza or something outrageous and easily proven false, time and time again. The President of the United States, again, this doesn't shock people anymore, he is a President, more than any other modern President, by independent fact-checkers, has been proven to lie over and over again. But as I sat there listening to his speech, and he just goes on and on about transgender mice when that was proven to be utterly a lie or else somebody just misreading the kind of mice that are used in medical experiments which have a similar word. So are they lying in order to attack these programs? DOGE is insidious in the fact that they keep posting things and then having to pull them down because, just, independent folks. And I have article after article--we are so far behind on this agenda of things to get through, I am not going to read them all, some of them I will submit to the Record--but not people on the left calling them out for what they are doing and saying being a lie about Social Security. So you are pointing out a pattern. First, they tell terrible lies to try to whip up public sentiment against entities created in a bipartisan way, by the way.

Mr. BOOKER. Using congressional powers, approving spending, approving programs, approving Agencies. Let's create incredible lies. Magnify them on social media, try to spread them with our influencers and everybody. So now people believe that somehow, oh, the President talked about all this money going to transgender mice. That is a lie. But we are going to use that as an excuse to attack the scientific funding. We are going to use that as an excuse to attack Medicaid. We are going to use that as an excuse to pull the people fighting Ebola out of East Africa. And so I was told by a colleague of mine, a Republican colleague of mine: When you come here, don't try to get in the head of your colleague and understand what their motivations are. But this, to me, is a pattern in which they are trying to undermine public confidence. And the result of this pattern has seniors--letter after letter I wrote--using things like ``I am losing sleep.'' ``I am terrified.'' ``I am scared.'' ``Help me, please.'' Telling the most painful stories about retirement insecurity, about health challenges. And so, again, I have this expectation, whether you are a Republican or Democratic President, you don't insinuate fear amongst vulnerable communities. You don't insinuate fears amongst our elders who deserve respect and deserve to retire with dignity. You don't do that. You stand boldly in front of them and say: Do you know what? There are some things we are going to improve. We are going to try to bring the best minds in America to make the best customer service because every independent group has been saying that the customer service is failing. Yeah, we want to go after fraud and abuse. We are not going to do it. The first thing we are going to do is fire the inspectors general who have a better record than Elon Musk does over this last decade rooting out fraud and abuse under Democrat and Republican Presidents. It just doesn't add up. It is not on the level. So before I allow you to ask this next question: What does this amount to, Senator Murphy? Ultimately, what this amounts to is an attack on the programs, the healthcare, the services, the retirement security that millions of Americans rely on. And often, for them, what they are relying on is the difference between safety and security and chaos and destitution. I am not exaggerating that. When somebody's Social Security check is the only income they have and they have already downsized--as you said, brought in roommates-- doing everything they can to cut costs because, under this President, costs are going up. This is why we have to stand and not let this happen.

Mr. BOOKER. Yes, I will yield for a question while retaining the floor.

Mr. BOOKER. Right. But that is the problem, right? Is that if you have an idea, bring it. Let's have an actual debate. Let's bring in experts. Let's have a debate. The person you are talking about, Bush, who had that idea, he had the good sense to say: Do You know what? I am not going to try to kill the Agency. I am not going to lay off thousands of their employees. I am not going to drive the services it provides, make them worse, to be called out by right-leaning newspapers and right-leaning writers. I am actually going to bring my idea forward, and let's have the debate in Congress. Let's bring people together. Let's hold the hearings. Let's have the conversation. I can deal with that because--this is going to surprise you, Senator Murphy--I have had conclusions about policy positions that I have changed over the years. When I had a debate, I had a contest of ideas, people have persuaded me. But that is not the way Trump operates. He tried to kill healthcare without a plan. The powerful letter I read by John McCain about why he voted no, it was because it was first: Kill this thing that people rely on. Don't worry. Trust me. We will figure it out later. That is what is happening with Medicaid right now. There is no conversation about how to better provide healthcare to the tens of millions of people that rely on Medicaid, from our seniors to expectant mothers to people with disabilities--no conversation. They are just sending people into dark rooms and saying: Here is $880 billion I need. Find a way to cut it. Let's kill it and see what happens.

Mr. BOOKER. Ready, fire, aim. Senator Murphy, I prepared for so many days on this, and we are talking about the points so I am going to submit--there are lots of articles here that I am going to submit to the Record. Mr. President, I ask unanimous consent to have printed in the Record a Washington Post article about ``Long waits, waves of calls, website crashes: Social Security is breaking down.''

Mr. BOOKER. Thank you to the Presiding Officer and my friend whom I am keeping up at 3 a.m. He is a kind and generous man to be here. Here is a closure of Social Security offices, 47 closures across the country in red States and blue States, everywhere between. Closures of Social Security offices. I know everybody is talking about cutting Social Security, but what they are doing right now--right now--is grinding the services of Social Security, grinding them down. The article from the Associated Press, ``A list of the Social Security offices across the US expected to close this year,'' can be found online at https://apnews.com/article/social-securi ty-offices- closures-doge-trump-b2b1a5b 2ba4fb968abc3379bf90715ff. I want to read some of the places: Alabama, 634--this is without the rest of the language I just put in the record, but just for folks out there who are watching. These are the places, Social Security offices that provide really important services to your community, that this administration and Elon Musk are closing: Alabama, 634 Broad Street; Arkansas, 965 Holiday Drive, Forrest City; 4083 Jefferson Avenue, Texarkana. In the great State of Colorado, they are closing 825 North Crest Drive, Grand Junction. In Florida, they are closing 4740 Dairy Road in Melbourne. In Georgia, they are closing 1338 Broadway in Columbus. In Kentucky, they are closing 825 High Street in Hazard. In Louisiana, they are closing 178 Civic Center Drive, Houma. In Mississippi, there are three places they are closing: 4717 26th Street, Meridian--Meridian, excuse me, to the great people who live there--604 Yalobusha Street in Greenwood, 2383 Sunset Drive in Grenada, MS. In Montana, they are closing 3701 American Way. They are closing Social Security offices in North Carolina: 730 Roanoke Avenue, Roanoke Rapids. They are closing 2123 Lakeside Drive in Franklin, NC. They are closing 2805 Charles Boulevard in Greenville, NC--I know that town. They are closing 1865 West City Drive, Elizabeth City, NC. North Dakota, they are closing 414 20th Avenue SW--forgive me the great people who live in this community--Minot. I am sure I am butchering it. In Nevada, where my mom lives, in the city my mom lives, they are closing 701 Bridger Avenue, Las Vegas. In New York, 75 South Broadway, White Plains--my mom worked there-- and 332 Main Street in Poughkeepsie, NY. In Ohio, 30 North Diamond Street, Mansfield. In Oklahoma, 1610 SW Lee Boulevard. In Texas, they are closing two offices: 1122 North University Drive. I know the people are going to write me letters that I am mispronouncing their town names. Nacogdoches? Anyone from Texas here? No? I am sorry. 8208 NE Zac Lentz Parkway. In West Virginia, they are closing 1103 George Kostas Drive. In Wyoming, they are closing 79 Winston Drive, Rock Springs, WY. They are cutting the Social Security staff. How deeply are they cutting? They are cutting thousands. We have already talked about it. Mr. President, I ask unanimous consent to have printed in the Record an article from the Associated Press, ``Social Security Administration could cut up to 50% of its workforce.''

Mr. BOOKER. Thank you. The article that I won't read out of generosity to my dear friend that is presiding, but it details in painful ways what these cuts could mean to people in the country. Just trying to move a little quicker through my documents because I am way behind. The impact of these cuts--one of the big places they are going to impact is in rural America, already suffering so much. There is a lot of sources that are talking about the rural areas of our Nation they are going to cut. And I would like to enter into the Record another Associated Press article entitled ``New Social Security requirements pose barriers to rural communities without internet, transportation.'' A new requirement where Social Security recipients go online or in person to a field office to access key benefits instead of just making a phone call will be difficult for many people to meet. This is an article from March 22, which can be found online at https://abcnews.go.com/US/wireStory/new-soci al-security-rules-present- barriers-rural -communities-120054669. Thank you very much to the kind friend who is up with me late--or early, I should say. One more article I want to ask for the Record. I feel like I can take liberties with the Presiding Officer because I have known him for 20- plus years, consider him a real friend. He married up, and he is going to teach me how to do that. I guess I am not allowed to insult a colleague on this. That is a violation of rule 19, I think, but that is a joke. But you did marry up. You know that.

Mr. BOOKER. So this is former Social Security officers who are speaking out about what is happening. People who worked at the Agency see what is happening. Two former senior officials at the Social Security Administration--one under a Democratic President, one under a Republican President--wrote this column published in The Hill. The title of the column is ``Social Security faces a crisis with staff cuts, closures.'' Again, these are folks from both sides of the aisle yelling into the wilderness, hoping that more people will understand what is happening to Social Security, what these cuts in staff are actually going to do to the quality of life for millions of Americans who rely on Social Security, disproportionately impacting people that are living in rural areas. Red States, blue States, Republicans, Democrats--this is not a normal time, America. The bedrock commitment made is being undermined by the most powerful man in our country and the richest man in the world. The title of the article, ``Social Security faces a crisis with staff cuts and closures,'' written by, again, somebody who worked under a Republican, somebody who worked under a Democrat. Mr. President, I ask unanimous consent to have that printed in the Record.

Mr. BOOKER. I want to end with what I have been trying to do since I started some, I think, about 8 hours ago--yeah, 8 hours ago, I began. I want to begin by doing what I said I was going to do, is not just lift my voice but lift the voice of New Jerseyans and Americans. And so here are some words. This is one employee from New Jersey who contacted me to say that the teleservice center has received many calls from the public from New Jersey to Georgia and other States. What they all have in common is the fear of losing their livelihood as a result of identification verification, in-person visits. Seniors, disabled, and others that are economically disadvantaged need a voice, Senator Booker. And the voice I hear all throughout the day from seniors are voices of fear. Please review any policy of in-person identification for the public. A person from my State begging because they are hearing the fear of the seniors that they pledged themselves to serve. Another Social Security employee from New Jersey contacted me and said: I worked at Social Security for almost 19 years. I was approaching my 19 years in July. However, I took the early- out retirement because there is a lot of uncertainty within the agency. The resignation of others also brings additional phone calls and workloads into the office. This adds additional stress and no additional bodies to handle the workloads. It also provides poor, unfair service to the public. Here is another story from a Social Security employee in New Jersey: I am a claims representative for our Social Security field office. The most dramatic changes I have noticed from our recent change in operations is that our appointment calendar seems to be filling up more quickly for simple post- entitlement changes that were formerly handled over the phone. This occupies appointment space for most urgent and critical issues that would warrant an office visit. We have identified verification protocols already in place to keep identity thieves in check. To the extent that some fraudsters are still getting through requiring people to come to our office and verify their identities is obviously a less efficient solution to the problem. A better solution to enhance security is to use two-step verification systems and document fraud attempts in our technician dashboards so scammers can't just shop around for field offices to fool. Regarding the in-person identifying policy, I believe that it is causing more harm than good. I've had claimants appearing in person frantic that they will lose their benefits because of this. My office lost four staff members. Two are members of management. This is nothing but chaos here. I can foresee more loss and further decline and poor morale. That is from a Social Security employee in my State describing what is going on in their office. Another New Jersey Social Security worker: I work in one of the smaller offices in New Jersey, and we are currently combined with another office that is undergoing renovations, which has caused the number of claimants coming into the office to double over the last few months. Although we do have extra staff because the staff have been deployed to our location, it doesn't change the infrastructure of the building, such as the number of desks available to do in-person interviews and provide adequate waiting space for double the amount of claimants. In our office, we only have nine desks where we can interview the public safely and use safety protocols. Three of these are front windows where we can do quick changes and six of them are where we could do short interviews for benefit applications. Right now, being that most interviews are being done over the phone, we have over 20 people interviewing at a time now. Imagine having to do these interviews in person. We can only have six to nine interviews at a time instead of 20-plus because there are only six to nine desks available. This doesn't seem very efficient. Maybe they should--too bad they can't call the Department of Government Efficiency, which caused the problem. Here is another Social Security worker and their story: Foot traffic in a field office on a daily basis is already overwhelming. The public coming in randomly to show their identity would be a disadvantage for the elderly, people with vision issues, disabled, and someone with no car. This really hits home with me. My older brother lost his right leg to diabetes, is legally blind, unable to drive. He called me concerned about this, knowing there is no way he can get to his field office and cannot afford to lose his retirement. I am hoping this is reconsidered. Social Security is not a program; it is a promise. We owe it to seniors and working people who paid into Social Security their whole lives to make good on the promise of a secure retirement, not to attack Social Security, to drive them to fear and worry, and when they call for help, to put them on hold for hours or drive them to offices that may be closing or are overcrowded or are unable to help our elders. Does this sound like America at its best? Does this sound like America being made great again? This is outrageous. These are our elders. They deserve dignity, respect, and they deserve their Social Security. I am going to move on to the next item, but I want to reiterate again that I am determined to stand here as long as I physically can. We are 8 hours into it. Dozens and dozens of people--I read their stories. As I have gone around the country and I have gone around my State, there is this growing anger and rage and fear. There is chaos. There is confusion. They read the newspapers and see that programs are helping them when an unexpected disease or cancer or crisis hits them, and they see that a bunch of folks are trying to figure out how to cut $880 billion from things like Medicaid. The stories got me a little emotional just because I am hearing about so many people who--not to their fault, not to their problem--are hit by a crisis, a challenge, an accident at work are now sitting back and are going to see what we do. People have told us that their whole delicate, fragile world works because they have a transportation program that could be on the blocks of cuts in Medicaid or their home healthcare worker or their medications. Even while these big issues are being discussed, we are seeing, as we have been documenting here, again, from Republicans and Democrats, how the administration is already taking steps to roll back programs, to seize funding that people have used to access the ACA or to lower their prescription drug costs or that is funding the research that we are competing with China on through the NIH. Republicans and Democrats, we have read already, have been saying: Hey, wait a minute, you shouldn't cut things that produce money for your country in the long term. But now here is something that I want to get into, which is education in our Nation. I believe that genius is equally distributed in the United States. There are as many geniuses being born in the wealthiest parts of New Jersey and Pennsylvania as are being born in the lowest incomes. In a global knowledge-based economy, the most valuable natural resource any nation has is the genius of its children. One genius--one Einstein, one Madame Curie--one genius could change humanity forever. I hear the stories about China graduating more people in STEM than we have total graduates in our entire country. It is a global competition. If we are to be this Nation that Andy Kim talked about where every generation has the right as an American to expect that the next generation will do better, not worse, so much of this revolves around what we all know: how important education is to a democracy especially--the best ideas, the best innovations, the best artists, innovators, entrepreneurs, scientists, doctors, teachers. We need to invest in the best pipeline possible. But now, not with Congress, which established the Department of Education, but by Executive fiat undermining separation of powers, the administration wants to dismantle, defund, destroy the Department of Education, scatter its responsibilities across Agencies that themselves are going through massive personnel cuts and are not equipped to handle it. This is ultimately about whether or not we as a nation believe that every child deserves an education. We should organize ourselves to meet that calling. Our Nation's children are that precious resource. One of the most noble professions are people that teach our children. So let's go right into it. At the signing ceremony to commemorate the establishment of the Department of Education, President Jimmy Carter said: Today's signing fulfills a longstanding personal commitment on my part. My first public office was as a county school board member. As a state senator and governor, I devoted much of my time to education issues. I remain convinced education is one of the most noblest enterprises a person or society can undertake. Pastor Carter also said that the Department of Education was created because education is so important to our Nation's future that it must have a robust level of national support. Here is a letter I really wanted to read. I am a member of a Baptist church with the great Pastor Jefferson, but I actually studied Torah. In my Torah study with Rabbi Davidson, when I heard about all these cuts in the Department of Education, he wanted me to hear from a great rebbe, Rebbe Menachem Schneerson, a Lubavitch rebbe who in 1979 wrote a letter not in support of religious schools but wrote a letter in support of public education, in support of the creation of a special Department of Education. He wrote this letter in 1979. I was so moved by it--thank you, Rabbi Davidson--I want to read it here. This is the rebbe: I am certain that you will agree that the state of education in this country, as many others, leaves much to be desired;-- He was not happy-- that the status quo (as reflected in juvenile delinquency, [et cetera]) is far from satisfactory, and, what is worse, has been steadily eroding; and that some determined nation- wide effort is called for to upgrade the quality of public education in this resourceful country. I trust you will agree that such an enormous effort, which is surely in the highest national interest, can come only from the Federal government with the fullest cooperation of State, County and City. In my view, a separate, adequately funded Cabinet-level Department of Education, subject to legislative safeguards to ensure that the traditional primacy of States and localities in education affairs would not be jeopardized, could well meet the challenge. The main reasons why I support said proposal are as follows: 1. The creation of a distinct Cabinet-level Department of Education would have a salutary impact on all who are involved in education, particularly parents, teachers, and students. The very innovation of upgrading the status of Education from that of an adjunct to, or division of, another national agency, would pointedly underscore its proper place among the Nation's priorities. Look how prescient the rebbe was and what he might say if he was alive today. 2. The workshops of child education are the school and the home. For various reasons, which need not be discussed-- ``I am worried about the home,'' he basically says. Too much of school is left to the streets. Insofar as the street is concerned there is very little we can do as things now stand. More can be done, and needs to be done. . . . But in the final analysis it is the public school where the greatest improvement can and must be achieved. 3. Among the factors that lie at the roots of shortcomings of public education, two--in my opinion--command primary attention: One has to do with the general curriculum, which should place much greater emphasis on character building and moral and ethical values. The other has to do with the quality of teaching--by qualified, dedicated and motivating teachers. The latter point requires the upgrading of teachers' salaries on par with comparable professions in other fields of science and relieving them, as far as possible, of other frustrations and stresses. I want to do a side note here. I am a big believer that we should slash public school professionals' tax rates. We need the best minds coming into the profession. Why not as a country say: If you are going to take a job as a teacher--which, unfortunately, pays too low in our country--let's do that instead of, again, giving these massive tax cuts disproportionately to the wealthiest in our country. The upgrading of the Nation's educational system will, of course, require considerable Federal [investment]. But this is one area where spending has built-in returns, not only in the long term, but also in . . . immediate gains in terms of diminishing expenditures in the penal system, crime prevention, reduction in vandalism, drug abuse. . . . In the longer term, it would also bring savings in expenditure on health and welfare, and--one may venture to say--even in the defense budget, since a morally healthy, strong and united nation is in itself a strong deterrent against any enemy. 5. The creation of a separate Cabinet-level Department of Education, as I understand it, has been conceived not for the purpose of merely improving administrative efficiency, nor merely as coordinator of existing programs, or for similar technical reasons. The main purpose is to breathe new life into the whole educational system of this Nation, and to involve the whole Nation, through its Federal government, in this massive and concerted effort. As such--I am convinced-- [a national Department of Education, Cabinet-level] deserves everybody's support. Thank you, rebbe. Unfortunately, this administration has not listened to the rebbes. What does the Department of Education do, and how is this administration attacking it? Let me read you an excerpt. The New York Times: ``Can Trump Really Abolish the Department of Education?'' March 20: President Trump signed an executive order on Thursday that directs the federal Department of Education to come up with a plan for its own demise. Only Congress can abolish a Cabinet- level agency, and it is not clear whether Mr. Trump has the votes in Congress to do so. I will tell you, in the Senate, if he needs 60 votes, he doesn't. But he has already begun to dismantle the department, firing about half of its staff, gutting its respected education-research arm, and vastly narrowing the focus of its civil rights division, which works to protect students from discrimination. Mr. Trump's long history of attacking the Department of Education represents a revival of a Reagan-era Republican talking point. It has unified Democrats in fiery opposition. Yeah. But is shuttering the department possible? And if not, how has Trump begun to use the agency to achieve his policy goals? What does the department do? Founded in 1979, its main job is distributing money to college students through grants and loans. It also sends federal money to K-12 schools, targeted toward low-income and disabled students, and enforces anti-discrimination laws. The money for schools has been set aside by Congress and is unlikely to be affected by Mr. Trump's executive order. I don't agree with the New York Times because time and time again, the money set aside by Congress is being clawed back by the President against the people that the Constitution of the United States of America says has spending power. Those federal dollars account for only about 10 percent of K-12 school funding nationwide. While Mr. Trump has said he wants to return power over education to the states, states and school districts already control K-12 education, which is mostly paid for with state and local tax dollars. The federal department does not control learning standards or reading lists. The agency does play a big role in funding and disseminating research on education, but those efforts have been significantly scaled back by the Trump administration. It also administers tests to track whether American students are learning and how they compare with their peers in other states and countries. God forbid we measure people's performances. It is unclear whether those tests will continue to be delivered given the drastic reductions in the staff and funding necessary to manage them. Still, closing the department would not likely have much of an immediate effect on how schools and colleges operate. The Trump administration has discussed tapping the Treasury Department to disburse student loans and grants, for instance, and Health and Human Services to administer funding for students with disabilities. . . . Any effort to fully eliminate the department would have to go through Congress. Republican members would mostly hear opposition from superintendents, college presidents, and other education leaders in their school districts; schools in Republican regions rely on federal aid from the agency, just as schools in Democratic regions do. ``They are going to run into opposition,'' says Jon Valant, an education expert at the Brookings Institution. ``They have a laser-thin majority and a filibuster to confront in the Senate.'' Even if congressional Republicans stuck together . . . Dr. Valant predicts their constituents would protest, given the department's role in distributing money in programs like Pell grants, which pay for college tuition, and I.D.E.A., which provides support to students with disabilities. ``It's a very hard sell. . . . I am . . . skeptical.'' Efforts to eliminate the Department threaten the enforcement of critical laws. There is the Elementary and Secondary Education Act, which has supported school districts since 1965 in low-income areas; the Individuals with Disabilities Act, which ensures 7.5 million students with disabilities receive an education; the Higher Education Act, which helps more students afford college; and title IX protections to guard against sex discrimination. This doesn't just hurt our country, but undermining those resources for our students hurts generations to come. I ask unanimous consent that the New York Times article entitled ``Trump Firings Gut Education Civil Rights Division'' be printed in the Record.