Medicare and Medicaid Was A Giant Leap Forward

Floor Speech

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Ms. PLASKETT. Madam Speaker, 57 years ago this week, President Lyndon B. Johnson signed into law the Medicare and Medicaid Act. By increasing healthcare access for elderly and low-income Americans, this act was a giant leap forward in building a more perfect Union.

Today, nearly 64 million Americans are enrolled in Medicare, and over 83 million Americans receive assistance from Medicaid.

We know that these programs are highly effective. Extensive research shows that Medicaid coverage is associated with a range of positive health outcomes. Medicare and Medicaid save lives. Medicare and Medicaid also have considerable economic benefits. Medicaid significantly helps reduce poverty and has been tied to economic mobility across generations and higher educational attainment, income, and taxes paid.

Despite the benefits of Medicare and Medicaid, my Republican colleagues are trying to dismantle these programs.

In 2018, a House Republican budget proposed slashing $537 billion from Medicare over a decade. Yet, while House Republicans try to gut Medicare and Medicaid, House Democrats are working to expand these programs to more Americans.

I am fighting particularly hard to improve Medicare and Medicaid in my district of the Virgin Islands of the United States and the other U.S. territories, which have long suffered from healthcare inequities.

Before 2017, in the Virgin Islands, nearly 30 percent of residents didn't have health insurance. This is a rate disproportionately higher than the national average of approximately 9 percent. As of 2021, 34,000 individuals in the Virgin Islands, over a third of our population, relied on Medicaid and CHIP.

However, the Virgin Islands has historically been denied the same Medicare and Medicaid benefits available to the States. Unlike the States, Federal Medicaid funding to the Virgin Islands is capped. Before the storms of 2017, the Federal Government covered just 55 percent of Medicaid costs to the Virgin Islands, which is substantially lower than the 83 percent that would have been covered if the Virgin Islands were treated as a State.

In addition, the Virgin Islands and U.S. territories are excluded from receiving low-income subsidies under the Medicare prescription drug benefit, and they are excluded from DSH, the Disproportionate Share Hospital program under both Medicaid and Medicare.

Through recent legislation, I worked to temporarily increase the Federal share of Medicaid funding to the Virgin Islands from 55 percent to 83 percent and increase Federal Medicaid funding to the Virgin Islands by hundreds of millions of dollars. This has allowed 20,000 of our most vulnerable Virgin Islanders to retain access to healthcare.

Unfortunately, these provisions are only temporary, and a permanent solution is needed to ensure the people of the Virgin Islands have access to affordable healthcare. That is why I introduced H.R. 3434 with Representatives from the other territories.

This bill would eliminate the unfair Medicaid funding limits for U.S. territories, increase Medicare reimbursements to hospitals in the U.S. territories, allow residents of the U.S. territories to be eligible for low-income subsidies under the Medicare prescription drug benefit, permit DSH payments to U.S. territories, and take other measures to improve access to health insurance.

Madam Speaker, I am calling on the Senate to address the Medicaid issue for the Virgin Islands, Puerto Rico, Guam, Northern Marianas, and American Samoa to help almost hundreds of thousands of Americans. I am calling on the Senate to address this in any healthcare reconciliation bill with what was passed for the territories here in the House.

When President Lyndon B. Johnson signed the Medicare and Medicaid Act into law, he promised: ``No longer will older Americans be denied the healing miracle of modern medicine. . . . No longer will young families see their incomes, and their hopes, eaten away simply because they are carrying out their deep moral obligations to their parents and to their uncles and their aunts.''

Unfortunately, this promise has yet to be fulfilled to residents of the Virgin Islands and the U.S. territories. As we mark 57 years of this legislation, let us commit to fully realizing this hope by expanding access to Medicare and Medicaid to all Americans.

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