we're not going to do the medicaid the medicaid expansion. lot of probably ideological. there are states that right now, they're looking back and they're saying, wow, wait a minute. the republicans in the senate are arguing to keep the medicaid expansion we should have taken it. if you think about the original affordable care act, the medicaid expansion was not truly optional. it was supreme court that struck down part of the affordable care act that really made it so that those red states could avoid expanding medicaid. i think that under different circumstances, probably everybody would have done it. going forward, there's a pretty good chance that those states that have not expanded medicaid will find a way to expand it in a conservative manner. if you look at what they did in indiana, where then governor pence designed conservative version of medicaid expansion. it takes some kind of cover for conservatives to say, i want to expand medicaid. that's okay, we'll do it in a way that reflects our value. host: one last call, cathy from pennsylvania. caller: good morning.

gop senators from red states whereby they have done a medicaid expansion. they have a tough deal because they don't want to lose the coverage expansion that they've gained but in terms of changes to hsa, et cetera, that's kind of baked. it's done. >> in the house something called a macarthur amendment which sort of came out of the blue it seemed at the very end of their process dealt with this concept of essential benefits. can you remind us what this concept of essential benefits means and what this amendment said in the house bill? >> if you purchase health insurance in the individual market through a health insurance exchange, every plan sold on that exchange is required to cover each of these ten essential health benefits. they can't have lifetime or annual limits on those benefits either. if your' in the employer sponsored market in a self-insured plan, the essential health benefits, or ehbs, don't apply. you can't have lifetime or annual limits. >> a little bit from the wall street journal under the house bill large employers are allowed to lower thei

the medicaid expansion population those that are working. we can target tax credits to choose not to participate in medicaid. people want their own health insurance. >> sir, working and affording health care are two different things. if people lose coverage they should go out and get jobs, people have jobs, it doesn't mean they can afford their health care. >> listen, there's people out there working two and three jobs, because where i represent, people that i grew up with, still don't have the means to pay for their health insurance and kids -- they are going to lose out in having health insurance. let me tell you about hiv positive man who is work, not making enough to pay for his anti-retrovirals but because of medicaid expansion now able to pay for his hiv medicines that have kept him alive. he's extremely concerned that with the repeal he's going to lose his health insurance and unable to pay for his medicine. this can be applied to many people who have chronic illnesses. >> let me ask you something, you are on the diabetes committee. i

if she has had a lapse in coverage for medicaid expansion coverage will be gone. against insurance companies,, sm denying coverage for people with pre-existing conditions she may never be able to get insurance or surgery. mr. president, public schools and schoolchildren will be hurt by trump care. schools are now eligible to receive funds for necessary services for children with disabilities. schools are reimbursed for vision, hearing and mental health screenings. these help children get services early so they can be ready to learn. right now new mexico schools are reimbursed $18 million a year on medicaid. but under trump care states woul schoolsas eligible providers and the cost would be on the schools. the problem as the schools cannot take on these kind of costs. and that might mean hundreds of schoolchildren each year will go without vision, and mental health treatment because no one else will be able to provide them. the superintendent of the district in new mexico says, and i quote, medicaid funding is vital to our continuum of care and service to the major

delivery system in the house and a roll back of the expansion and funding in the funding for medicaid in general. so you could still be impacted by some of the potential cuts that the senate is planning to make in the long-term. >> we were hearing that the cuts in the long-term would be deeper. >> yes. it's a very economical way that happens based off of inflation and how you plan to spend money but the reality potentially could be less real dollars spent in medicaid that. means that states are going to have to make really tough decisions about what services they cover and what populations get the most benefit from medicaid. >> so in a state like virginia for example that did not buy into the medicaid expansion would there be a lesser impact on those that are low income, seen yors, disabled, then places like maryland and the district that did buy into the medicaid expansion. >> yeah. i think considering what the greatest impact would be on the greatest impact as they expanded their medicaid enrollment and population. maryland had a growth of almost 50% in terms of medicaid population

instead it cuts back medicaid expansion and slows future medicaid growth. trump yesterday tweeting that he is very supportive the senate health care bill. joining me now, nick confessore and jennifer. all through the election campaign, it was really true that trump's rhetoric was a deviation from the rhetoric and goals of the gop donor class. at least the way he talked, the things he wanted to do were divergences from paul ryanism. >> he had a tax cut plan but it wasn't part of his stump speech. he was pro manufacturing jobs. he was pro entitlements. i think that was a big reason why he was winning some of these votes. >> it was distinguished. >> because these voters were kind of kind of stuff they were hearing from jeb bush and marco rubio. he campaigned on this stuff and now the establishment has rolled him somehow, just flipped on on this stuff. >> people would think, oh, he's going to protect ours so. >> -- social security. >> this is in the year that donald trump won that has a lot of voters that are white working class that flipped, the quintessential

obviously the medicaid expansion, the opioid issue are the areas of greatest concern for me. if it moves in a direction that

expansion population, the medicaid expansion must he maintained and completed, end quote. it is nothing short of hypocrisy. for the trump white house to claim it is taking steps to address the opioid epidemic when it is helping republicans insl congress pushed through legislation that would end the medicaid program as we know it. slashing hundreds of billions of dollars in federal funding from the medicaid program, which will ultimately pass all of those costs on to the states. let me give you a sense for just how big a burden that would be here in new mexico it's estimated that our state government would have to either come up with a way to raise $11 billion of new taxes over the next decade, or cut the equivalent amount of coverage for hundreds of thousands of new mexicans who rely on the program.ta that is a hit to the statelus budget of a billion plus dollars a year. this would have an especially hard in fact, on our states world community, when you go to small towns in new mexico like or last fall on a rural health care listening tour, you see right away the vital rol

i was able to get my diabetes handled because of medicaid expansion. i was able to see a psychologist and get my mental health issues under control and i was able to go back to work. i was able to support my family. he said, and now you guys back in washington, d.c., want to take all of that away from me. well, i will tell you. i will fight like hell to make sure that never happens. and if the majority leader wants to try to ram this down the people's throats, i will spend the rest of my life telling them why and who did what to them. mr. president, i yield the floor. mr. menendez: mr. president. the presiding officer: the senator from new jersey. mr. menendez: i ask that the quorum call be waived. the presiding officer: the senate is not in a quorum call. the senator is recognized. mr. menendez: thank you, mr. president. mr. president, i come to the floor like many of my colleagues, shocked at the republican majority's brazen, secretive effort to pass a bill that would hurt millions of americans. now, i have served in public office for more than four

before medicaid expansion, i.h.s. had trouble funding knee replacements, and the surgery was denied for years because i.h.s. could only afford to pay for life and loss of limb services. but this patient is now on the medicaid expansion. she was able to get a total knee replacement, is working full-time, staying fit, and is no longer in pain. one of the a.c.a.'s most popular provisions is the protection from discrimination, if you have a preexisting condition. this is one of the most mystifying parts of trumpcare. republicans would end that protection by allowing states to waive out and set up high-risk pools. all of us know someone with a serious illness or condition, like kitt here. kitt is four and a half years old and has type i diabetes that will require lifelong care. her mother dana is worried about trumpcare. dana says it bricks my heart that elect -- it breaks my heart a that elected officials are leaning toward dropping the federal mandate to guarantee federal health insurance for those with preexisting condi

there will be a change to medicaid expansion. it will be rolled back but in a much more gradual way than is expected in the house bill. they cut it off in 2020. the senate won't even begin the process until 2021. white house staffers were briefed on the bill last night here on capitol hill, and i spoke to mark short, white house legislative director, as he was leaving that meeting. he stopped short of saying that the president is ready to endorse this bill but said in h mind we are all one step closer to end the nightmare that is obamacare. it will be a busy day on capitol hill. >> yeah. >> okay. thank you very much. >>> as we mentioned, the senate gop health care bill will delay the rollback of medicaid expansion to at least 2023, but millions of americans may lose coverage even sooner that that. and that's because many states won't have the money to keep running the program. it has to do with the federal match rate. the expansion covers 11 million low-income adults in 31 states, and the government covers 90% of the cost. that's

if you shut down medicaid expansion too fast or you starve medicaid, there's not enough money. the problem is the resources are not there to run the program. if they would be willing to keep the resources there for an extended period of time, and that's all about discussions and negotiations, and make the exchange more solid, right now on the exchange, you know, under the house bill, and i think under the senate bill -- we haven't seen the numbers under the senate bill, but under the house bill, you can get a tax credit for 3 or $4,000 to buy health insurance. what can you buy for 3 or $4,000 for a year to buy health insurance? if you can, you can't afford the deductible. if we can get away from the political sloganing that we see and we can get reasonable people in a room -- because i've been there. i was there when we balanced the budget, i was there during welfare reform. you get reasonable people in the room, we can stabilize these symptoms and then we can, on a bipartisan basis, begin to deal with the primary cause of rising health care korscosts. right now we're not there

. >> reporter: what did medicaid expansion allow you to do? >> it allowed us to get people into treatment, which was key. otherwise, they would be out on waiting lists, and people would overdose. >> reporter: the opioid epidemic claimed 4,100 lives in ohio last year, 308 here in akron. n.at would you say to the folks in washington who are talking about cutting back on medicaid? >> please, don't do it. o u're going to have the blood of a lot of innocent people on your hands. >> reporter: the body count is so overwhelming here that the medical examiner's office had to call in a mobile morgue to help house victims. it will be here through the july 4 weekend, anthony, when another surge in deaths is expected. >> mason: adriana diaz in ohio for us tonight. thanks, adriana. when we come back, if you want to prolong your career, change it. th mason: the era of working for rie company and retiring with a gold watch has gone the way of the edsel. 30 years ago, about half of ngedican workers changed careers after the age of 45. these days, it's closer t

one of the big questions we had, the medicaid expansion, how and when it is phased out. it is phased out and longer -- more gradual phase out than with the house bill. >> that's right. what they do is under obamacare it's 90% the feds put in 90% and state puts in 10. what this does is in 2021 that lowers to 85 and 2022 goes to 80% fed coverage and 2023, 75% but the house bill went cold turkey after that. this is a longer phase-out which will make people happier with the bill, whether it convinces them it's a good bill, i don't know. but it will make him happier it is a slower phase-out. >> in plain english, this is a more gradual phaseout but deep cuts to medicaid in this bill based on our understanding. nancy pelosi is talking about medicaid now. let's listen in. >> we don't call that access. that's the most expensive kind and detrimental to the health and well being of the american people. back to the jobs lost by the health care bill, it is -- we haven't seen a budget. the budget we have seen from the president would lose 1.4 million jobs. some of that is overlap with

since the suicide of kurt and young and middle-aged adults which is the medicaid expansion. they must be maintained and completed. it's nothing short of hypocrisy. they pass on to the states. in ne new mexico it's estimated that our state government would have to either come up with a way to raise $11 million of the taxes over the next decade or cut the equivalent amount of coverage for hundreds of thousands of new mexicans that rely on the program. that is a hit on the budget of a billion plus dollars a year. this would have an impact on tho communities where you go to small towns in new mexico as i did last fall on a listening tour you see right away theou vital role that hospitals play in the rural communities. it is difficult to care for the populations that live over the spaces and are on average older, less affluent and more prone to chronic diseases. medicaid expansion and of a needs-based tax credits for individual healthcare market plans have been critical financial lifeline for the health providers. thanks to the games that we have seen in new mexico instead of uni

she's off of medicaid expansion. and i think it's really important that we also, to acknowledge the comments we've had about the importance of community response, thank the people who have this disease who have stood up, who have identified themselves as people suffering from addiction, have done the hard work of getting better, and then have turned their efforts to make sure that they help with the prevention recovery efforts that we need to undertake. i'm going to keep ashley in my thoughts today. she's about 17 or 18 months in sobriety now. she continues to get treatment for recovery. she's going to be reunited with her 3-year-old son soon. there is hope if we go at this with the all of the above approach. thank you so much. >> thank you, senator. thank you again. there are stories like that that we all can share, attorney general dewine has shared many with me as he's on the front lines. i appreciate, and i think this entire panel, if you couldn't tell, appreciates the time you put into this testimony. you all co

>> people will move off of the medicaid expansion on to the private health insurance market. and that can be a good thing. it isn't so much whether we are spending lots of money on medicaid, it's whether or not people are covered. i have concerns about the bill, but let's acknowledge as folks would move off medicaid, they would go on private insurance, coverage would continue, and in some cases that gives the patient more options for doctors they can see than does medicaid. so i think coverage will continue. >> dickerson: will you support this bill, senator? >> right now i am undecided. there are things in this bill which adversely affect my state that are particular to my state. a couple things i'm concerned about. if those can be addressed, i will. if they can't be addressed, i won't. so right now i'm undecided. >> dickerson: senator toomey, on this question of people moving off of medicaid into the private market, the concern from critics is this puts them in a market where they will be unable because the subsidies are going away or are low nerd this bill or the tax credit

it's tough unless you do something to the medicaid expansion. and that's the crux of the fight right now. >> gregg: i want to see if you take issue of the cbo report that says people with pre-existing conditions would lose coverage under the house bill which has passed. now senators are looking at it. i looked at that bill, does not say that at all. people with pre-existing conditions would be covered, but only those who allow their coverage to lapse would have to pay a higher premium, but only for a short period of time. >> that is the case. they're also talking about creating risk pools for those who have a difficult time obtaining insurance because of illness or pre-existing conditions. the republicans have ways to deal with the issue. the pre-existing conditions is one of the reasons why premiums were so high for everybody. it is a great talking point for democrats though, they are sticking with it. i think it has been successful. if you look at the polls people say they don't like the republican solution. the democrats are good at making th

we need to give up a medicaid expansion plan. i do not believe in healthy 20 and 30-year-olds being on that, they need to go pay for their own. and i also believe the reason republicans are really mad is because of the individual mandate you have to pay if you do not carry health insurance and it can get very expensive. this year, my husband had to pay $695. i do agree with them on that. we need to come to the table and negotiate, and i do think that medicaid expansion program can be given up. caller: -- it up inn you say give terms of expansion to the cuts 231 states,ans -- the cuts the republicans are willing to make, that is something you are willing to negotiate away as a democrat? that is something senate democrats have brought up a lot of focused on this week. caller: yes, but i said the expansion part of it, where they want to get new money to put people on. not the new medicaid program, but the expansion, and the gop needs to give up the tax breaks. if they want to reduce the deficit, instead of reducing it $200 million -

shows the percentage of insured and uninsured americans in medicaid expansion states as well as those in non expansion states from two thousand and thirteen to twenty sixteen uninsured people in the expansion states year over year were able to get insured either through a public option or private now from twenty thirteen the first year the a c eight opened and roll it all the way up to twenty sixteen the number of uninsured in expansion states were literally cut in half that is a very significant shift under the a c. a even those in non expansion states saw benefits with the number of uninsured seeing a slight drop there too and across the country states who participated in medicaid expansion under obama care all saw a huge drop in the rate of uninsured bringing their number whelm below the national average of twelve point four percent states like california washington minnesota iowa wisconsin all across the rust belt benefit from that expansion states that didn't participate in medicaid expansion have numbers significantly higher than the national average states like texas oklahoma g

how many people get health care through medicaid and obamacare's medicaid expansion? >> the children. 35 million. two in every five kids in america and also 27 million adults adults, 11 million part of the medicaid expansion program. and there are nearly 19 million disabled or elderly. moment of the money is spent on the disabled or elderly. more than 60% of all medicaid dlarps go to care for these two groups. >> checking the numbers and running the facts. context, that's critical as we know for a number of republican senators especially from states that didn't used medicaid expansion to add people to health care rolls. look at the numbers. is inevitable. have a philosophical argument and part of it is about the role of government in health care but inevitable if you scale that back that the numbers, the access to health care goes down. >> i would add one more number to your list here. that is, that two out of three residents of nursing homes are medicaid beneficiaries and we have a population that is aging as baby boomers get older. this goes to the point that refuti

-- from the medicaid expansion. americans support the medicaid program. they understand that even if they don't need medicaid, neighbors, friends, family may need it, and they understand that they may need it unexpectedly in the future, like elana did. medicaid expansion has met that -- has meant that for over 265,000 new mexicans. they have health care coverage that they didn't have before. pretty remarkable thing. in six short years in new mexico, after the passage of the affordable care act, you had people who didn't have any health care, and now 265,000 have medicaid coverage. and they're in this, could be in a situation just like elana. many of these are hard-working families living in rural new mexico, native american families living in new mexico. the senate republican bill, like the house republican bill, will end medicaid expansion in new mexico for people like ealn -- elana. mr. president, this bill cuts medicaid overall more deeply than the house version. when president trump said that this -- the house v

expansion all have driven medicaid to a fwroeing role. together these provisions have resulted in large increases in the use of medication assisted treatment. a number of states have been using medicaid as a central part of their attack on the opioid epidemic. the state of ohio really reported substantial increases in access to care for people with opioid abuse disorder. in ohio medicaid pays for about half of all the -- prescriptions in that state which is one of the key drugs in medical assisted treatment. private insurance covers about 42%. recent changes there have bolstered the ability of private insurance to shrink the treatment gap. they are the parity act applied to private insurance, the essential health benefit provisions in the small group and individual market and the vablt of subsidized insurance policies for low income. in 2011, a survey of individual market insurers revealed that 34% of policies sold did not cover substance use disorders. today that is no longer the case. finally, grants to state. the recently enacted 21st

expansion or traditional medica medicaid. lots of children are not going to get care for a congenital heart disease or anything else. >> jennifer, you referred to walk the plank. you've got the folks, collinss, fur c murkowski -- alaska has high health care costs and the question of whether the subsidies are enough when they're properly indexed there matters a lot. joan is right that rand paul could take one of those two slots and you can also see collins taking one. and to me the big question is heller. heller is the only senator who represents a state that hillary won who is a republican who is up in 2018. he's also has medicaid expansion. how could his political calculation be to vote for this bill? >> i don't see how it can be. what's worse is the governor of nevada came out against the bill pretty hard today, as did john kasich who said he had serious concerns putting really the pressure on to rob portman who is another one who i think in the end will find it very hard to vote for the bill. this bill managed to find the

i said before medicaid expansion is one problem that i see. the per capita is another, this chart deals with one of the medicaid problems, medicaid expansion. ending medicaid expansion in nevada, west virginia, arkansas, alaska, four states. alaska, they project will lose $2 billion worth in medicaid over the decades. arkansas would lose 7, west virginia would lose 12, nevada would lose 12. that adds up to $33 billion, federal medicaid cuts from ending medicaid expansion. $33 billion just for states. not really high population states, no california, new york, texas or big states like that. $3 billion lost in medicaid, $33 billion lost in medicaid, what is this? the orange bar graph shows the same number, $33 billion, tax cuts for the 400 highest income households in the country, the same number. so 400 households get a tax cut of $33 billion, not in some other bill down the road, not in some other year, not in the budget bill or tax bill, they get this massive tax cut in what is called the healthcare bill. at the same time, it is equivalent to

medicaid expansion doing this to 2024, 7 years from now. and i have to say republicans need plan b. if you want to rip this away rip it away like a band-aid, rip it away like a band-aid, what incentives can get insurers to serve 2 people? neil: the vote is still scheduled for the july 4th research, unlike speaker paul ryan, mitch mcconnell doesn't care whether the votes are there, he is sending a message to donald trump, i will be here long after that. he will go through with the vote whether the votes i there were not. what do you think? >> the way i looked at mitch mcconnell he was getting away from i'm done. after that, this thing is going to get carved up like a smoked sturgeon. the biggest thing we have going forward, we spent $574 billion last year and higher this year, next year, the year after, i spent a little time reading the bill, the words grants, waiver, tax credit, subsidies were all over it, government centric and never going to end. the new york times telling you, that is not going to happen. >> a lot of democrats say this is heartless and mean. we have a government

does, that is this medicaid expansion that happened the affordable care act. where it happens, in states that expanded medicaid, you see those back on the ing idea of phasing it down. this is from the "washington morning.s senate measure transform medicaid from open-ended entitle one in which federal funding distributed on per capita basis, the senate measure seek to phase out the program's expansion. although at more gradual rate version.house the senate bill is expected to go further than the house to cutting pproach medicaid in the future. in 2025, the measure would tie spending on the program to even slower growth index than the one used in the house bill, prompt states to reduce the medicaid program. that provision, nod to by ervative lawmakers led patrick tumey, of pennsylvania, moderates, ting including senators who also expanded state that medicaid under the aca. some republicans worry such a move states to cut services or coverage, potentially leaving low-income people without sufficient healthcare. let's go on to kevin in daytona florida. kevin on me

i was in florida for nine years and we did not have medicaid expansion and people were cut out. in states that had medicaid expansion, richard, it ends up being more expensive with worse outcomes. why? because people get medicaid and there are doctors that don't cover medicaid, they end up in the emergency departments for much more expensive, much more fragmented care. so we really have to, as a country, we're here in the week that amazon is buying whole foods and we still haven't allowed telehealth to cross states. imagine every atm you had to have a different card. we're living in the '90s as it relates to trying to do some of the things that would affect both the care and the cost of health care. >> what should we expect as those who are uninsured, what will that means if it does pass, the senate republican health care bill, what's it mean when i go in to see a doctor? >> so, if you're a younger person with moderate to high income in a state like massachusetts, where health care is affordable, it will be better for you. if you're an older lower income person in a place that h

i worked on medicaid expansion in the state legislature in arizona and that helped us get many people off the streets and into treatment programs that are really important, especially if you believe in opioid treatment. number two, a lot of people depend on medicaid expansion for nursing care, a population that also votes and their family members vote. this type of cap that will happen over time, they will stop medicaid expansion over time, then also cut the amount that it contributed to and sticking only to the consumer price index will end up kicking off thousands and thousands of people every year off medicaid. that is going to be mean-spirited, by any definition. >> i want to go back to what amanda said, her point just on the raw politics of this. let's just say this passes the senate. there is a compromise with the house and the president actually signs a form of this bill. is there a political danger that in the short term, people are not going to see a difference? in fact, it could get worse and republicans are going to now -- >> they do have the stabilization fund. you see all

the 10% is the medicaid expansion. >> expansion, right. that's about 180,000. that's correct. we need to find a way to either keep medicaid expansion, give states the options, give states the flexibility to build in better programs or to have folks in that expansion population be able to afford with tax credits and other supplements to be able to afford. that's where the opioid money comes in, and that's where i think it would be important for my population, which is really reeling, and if people around the country don't think they're going to get it, it's coming to their state. >> what happens as a practical matter to someone on medicaid and has it taken away. >> that's my concern. i'm not dropping them off a cliff. i didn't come here to hurt people. i came here to help them. so i'm pushing for a longer glide path, and also when that person -- a better case scenario is to have somebody on a private insurance plan that they can manage themselves. but if it's unaffordable, they're not going to do it. and so let's get that where it's instead

and states enrolled roughly 20 million people in the medicaid expansion program. the combination of enrolling so many people in the medicaid expansion program and paying 50% more than for traditional medicaid, means that when states have to foot 10% of the bill, which they will by 2020 -- when states have to foot that 10% of the bill, they cannot afford that 10%. unfortunately, under the affordable care act, state taxpayers will not be able to pay what in california is $2-point it billion extra per year as the state's 10% share. similarly in louisiana, my state, our taxpayers -- me, my colleagues, my friends, my neighbors -- would be on the hook for $310 million per year. our state is having a budget crisis because we can't afford $300 million, now it is a $310 million recurring bill every year. one thing that is not said is that medicaid expansion in its current format is not sustainable. we have to do something -- to preserve the benefits of that patient, we have to make it sustainable for the federal taxpayer and state taxpayer. for whoever is watching this is

that was on the medicaid expansion before. so in texas where i live, there are going to be millions more with health insurance as a result of this bill because texas didn't expand medicaid, but these tax credits will be available to everyone in texas who is under 100% or 138% of the poverty line. >> how does the cbo get to the fact 20 million fewer will have health insurance? most of that figure, the medicaid expansion if you repeal it, the raw number of people were made eligible for it become ineligible. they lose their medicaid card. so if what you're saying is no, they are just trading in their medicaid card for a different kind of insurance that's a tax credit, how does the cbo get to 20 million people losing their health insurance? >> we don't of course have the score of the senate bill yet. >> the house version is similar. >> right. i think so too. and the vast majority of the cbo's coverage score is driven by one thing, joy. it's the repeal of the mandate of the 23 million who will lose coverage, about 18 million of tha

because of medicaid expansion, those on the other side are not. we went there to see the divide. >> reporter: this is the line that divides our community health. the state of texas decided not to. with the medicaid expangsz. they are next door to each other and we are seeing vast differences in health. >> i have a disease. i have congestive heart failure. i have crohn's disease, high blood pressure, fibromial shah, vertigo and probably some are missing. >> reporter: this 59-year-old texas resident is a mother of two. she worked for years filling other people's prescriptions as a pharmacy technician, she doesn't get medicaid. if she lived in arkansas, she would. >> you benefit from seeing them because you have chronic kidney disease. >> i don't have insurance of any kind. >> reporter: what do you say to your neighbors who say, we don't want to pay for your health care? >> it's not as though i never worked a day in my life. i worked. so, you work and you can't get it. you're sick and you can't get it. what is it? >> reporter: she lives on the texas

let's take "the new york times," medicaid expansion. theacare raised eligibility cutoff. dollars per single person. the federal government paid 90% of the cost for newly eligible beneficiaries. in the senate bill unveiled yesterday, they allow 31 states who expanded medicaid to continue getting federal funding through 2023 with reduced 2020 one. it sharply cartel to federal support for medicaid expansion in 2024, probably causing many to end the expansion. future spending per enrollee based on how much each state has spent historically. states have the option of receiving a lump sum block grant for beneficiaries. the budget office estimate similar policies passed by the house will cut 800 billion over a decade. a budgethe program on that substantially reduces future medicaid spending. here's what "the new york times" editorial says. it will be devastating to older americans. contrary to what many think, the program does not only benefit the poor. many middle-class seniors depend on it after they have exhausted their savings. medicaid pays for 2/3 of people in nursing home

and the end of medicaid expansion slower under the senate version. again, just compared to the house version, does this bill have more heart, as the president would say, jonathan? >> you know, i'm torn this morning. on the one hand, this is no longer an obamacare repeal bill. that's good. on the other hand, this is just a giant cut in medicaid pap that's what this bill amounts to. that's bad. >> huh. >> because delaying -- look, we have a very long future ahead of us. if you delay three years the medicaid cuts, you have the convenient feature which doug knows well, which is cbo scores over a ten-year period. by delaying it three years you reduce the headline number how people lose health insurance. over the long run it cuts medicaid more. why? it doesn't reduce the deficit barely at all, according to previous estimates. we won't know for sure until next week. the only thing it does, finance a giant tax cut for the rich. obamacare repeal is a smoke screen. a medicaid cut to advance tax cuts for the rich. >> breaking that apart. and jonathan, when you

one thing we need to understand about medicaid expansion when people get on it, they are only on it for 18 months. people get on it and they rent for a lifetime. they were absolutely not. they try to get a job. some of them have problems. i don't know how many of you are aware -- am sure most of you are aware of the problems connected to drug abuse and how hard it is for somebody to get clean and stay clean. the same issue as they are at the mentally ill who need constant treatment if they suffer from these very severe illnesses. of course the chronically ill meet comfort as well. if you don't have a system that does that come you have a problem. you have a loss of coverage of millions of people. the non-offending they put into medicaid, just medicaid as a whole is even less than what the house had and what the house had was not adequate. we may have been able to struggle to receive maximum flexibility including the ability to exclude pharmaceutical companies from being able to put high-priced drugs on our formulary, but we were not given that flexibility. the senate then came and drama