Establishing the Congressional Budget for the United States Government for Fiscal Year 2025 and Setting Forth the Appropriate Budgetary Levels for Fiscal Years 2026 Through 2034

Floor Speech

BREAK IN TRANSCRIPT

Mr. DURBIN. Madam President, this has been an amazing week in the U.S. Senate, and I have served here for over 25 years. Just 2 days ago, our colleague Cory Booker, from the State of New Jersey, ended a filibuster on the floor after 25 hours--broke the record, longest speech in the history of the Senate. And an impassioned speech it was. I was happy to be here for a major part of it.

There was a big celebration on our side of the aisle. The Galleries were filled in a way I have never seen before, cheering Cory Booker for his achievement. It is a moment all of us who are lucky enough to serve in the Senate will remember the rest of our lives. But I remember another moment that affected more people than this miraculous feat by Cory Booker.

It was July 28 of 2017. It was 2:30 in the morning. I was seated at this desk, and a historic vote was about to take place. The vote was whether or not we would keep the Affordable Care Act--or ObamaCare, as it was known then--extending health insurance to millions of Americans, some of whom had never had it.

At the time, President Trump was in office, and he and the majority of the Republicans were determined to eliminate the Affordable Care Act, to eliminate the insurance that millions of American families depended on to protect their kids and themselves.

It was the closest possible vote. In the end, at least three Republican Senators voted to save the Affordable Care Act, but the one key vote and the one I remember was John McCain's. John McCain, an extraordinary man, served this country in ways that we could hardly ask anyone else to serve: a prisoner of war for over 5 years during Vietnam, came battling back, and was elected to the U.S. Senate from Arizona.

And he was a real maverick. You never knew where John was going to end up, but you always wanted to end up with him, if you could, because it was always a spirited contest, and he usually won it.

And this vote was dragged out for a long period of time--2:30 in the morning, for goodness' sake. And somebody said: John McCain is the last person to vote, but he has been called off the Senate floor to go into a room behind and take a telephone call from Donald Trump.

Donald Trump, President, in his first term, was asking John McCain to cast the deciding vote to eliminate the Affordable Care Act, health insurance coverage for millions of Americans.

Madam President, I sat here, and I watched as John McCain came in from that phone call. And no one knew what he was going to do. Really, no one knew. John was the kind of person, you could never quite be sure.

And he walked in the well near the table where the Republicans gather for votes, and he stood there. And he barely raised his left arm-- because it was broken while he was a prisoner of war--just enough to get his thumb up and go ``no.'' No. That was it.

John McCain, with that ``no'' vote, saved the Affordable Care Act, and millions of Americans' health insurance was protected.

This was during Trump's first administration, and he had other priorities, and they certainly didn't include ObamaCare. He wanted to eliminate it. John McCain's courage came through that night. He broke with his party because he knew what was at stake. He knew that, for millions of Americans, there was no alternative when it came to health insurance--it was the Affordable Care Act or nothing--and he had the guts to vote no.

Oh, he was pilloried and criticized by the Republican faithful from one end of the country to the other, but those of us who believe he did the right thing will never forget that moment of courage.

In a strange way, today--Thursday, April 3, 2025--we are returning to that moment in history. The Republicans under President Trump, in his second term, want to perpetuate his tax cut that he gave primarily to the wealthiest people in America and add to it at the expense of healthcare for America.

When we talk about healthcare in America, one of the programs that is so critical is called Medicaid. In days gone by, Medicaid was a rarely used health insurance plan for the poorest and disabled people in America, but it has changed. It has become much different. And let me tell you why that is an interesting context for where we stand now.

Many Americans from coast to coast followed the stock market today. The reaction of the stock market to the Trump tariff tax and the chaos that has been created since he announced we were going into a trade war with virtually every nation on Earth--they watched carefully as the stock market reacted to it today.

The Dow Jones Average, which is supposed to be an indicator of the state of the economy, lost 4 percent of its value today. I don't know what that means for most people, but I know that most people watch it because it involves their own retirement plans: IRAs and 401(k)s and other plans that they have based on the value of stock. There has to be a sinking feeling--I am sure there is--in many households and families across America to see so much of the value that they have saved up for a lifetime disappear in one day reacting to the Trump tariff tax and what it meant across the country.

And here we come this evening, the same day as this Dow Jones plunge of 4 percent, to discuss--what?--healthcare, again, under President Trump. And this time it is connected to retirement and savings and the future of a lot of families.

Let me tell you a story about one. I am going to try to mask the details because I don't want anyone to reflect on the actual person. But he is a friend of mine, and he is a professional in Illinois, a wonderful guy, a community leader. And he had a beautiful family--he still does, for that matter--but his wife developed Alzheimer's. This lovely woman reached the point where she had to be put into a care facility to take care of her day-to-day. It breaks my heart to even think about it, but it was a fact. He didn't see it coming. There is no way he could have.

But, for years now, she has survived physically while mentally she has deteriorated to the point where she cannot communicate with him or others. It is an expensive undertaking, that type of care facility. He can afford it, but many people can't.

So what do they do? What happens when your mother or grandmother, when someone you dearly love in your family, reaches a point where they need this kind of care? Well, you do what you can, the best you can, with your own savings and your own resources. But, ultimately, the major source of funding for people who are in these facilities is Medicaid.

If you cut the Medicaid reimbursement, it limits the opportunity for these people to get good, professional care--people you love, people who it has broken your heart because of their illness, but you want to give them the very best in the parting years of their lives.

So when you cut Medicaid, which is going to be proposed by this Republican budget resolution, it is at the expense of families' peace of mind and resources they have saved for their own future, their own retirement.

That isn't the only one. In the State of Illinois, half of the children who are born in the State are paid for by the Medicaid system. What happens if you cut back on Medicaid reimbursement in those cases? It means less prenatal care; the likelihood, I am sorry to say, that kids, some, will be born with problems that could have been avoided and, more seriously, whether or not these children will even survive birth. That is what Medicaid is all about.

We are talking about cutting health coverage for those in care facilities, as well as those in hospitals or giving birth.

Why? Why would the Republicans even suggest that we cut this just like they did years ago when John McCain cast that deciding vote? Why under a Trump Presidency do they go after healthcare first? Why is that their target?

They believe that the vulnerable people who receive this kind of healthcare assistance won't be able to fight back--and they are desperate to raise more revenue for what purpose? To give tax cuts to the wealthiest people in the America.

For goodness' sakes, Elon Musk does not need a tax cut. He is a multi-multibillionaire, the wealthiest man in the world. Why in the world would he cut back on any kind of healthcare for Americans to give a man in that station in life a tax break? That is what it is all about. But there is more to the story.

I am honored to represent Illinois. I love the whole State. It is where I was born. And I am honored to represent the great city of Chicago. Oh, it is controversial. There are some people in downstate Illinois that say they ought to go off and be their own State, retire them. I am not one of those people. I am proud of the fact that Chicago is part of our State.

But my roots are in downstate Illinois, born in St. Louis, raising my family in Springfield. I have lived in and represented the smaller communities downstate in the rural areas. That is how I got to Congress in the first place, and that is how I stayed in the U.S. Senate.

What are these cuts Republicans are proposing in Medicaid going to do to rural and downstate Illinois and other rural and downstate areas around the Nation? The reality is very clear: Fewer resources to hospitals in sparsely populated areas mean that many of those hospitals will not survive. Today, more than half of those hospitals are hanging by a thread, operating in the red. To cut Medicaid reimbursement to those hospitals is literally going to close their doors and turn out their lights.

How important is a little hospital in a community downstate? It is the economic engine. It is the hub of life for the economy of that area. Take away that hospital, and it not only endangers the people living around it, it also means a lot of jobs are lost, too, and businesses that the people frequent often are going to be threatened as well.

So why would we cut Medicaid reimbursement and close these downstate hospitals, giving a tax break to the wealthiest people in America? It makes no sense. Where are our priorities? Where is our humanity to even consider that?

I don't understand on the other side of the aisle how Republican Senators--many of whom represent smalltown America, too, and really care in their hearts about it--can stand by and let this happen. The net result of this is going to be the quality of life threatened by the people who live in those areas.

I want to tell you a story about a community I visited 2 weeks ago-- two communities. One was Taylorville, IL. And I asked the hospital administrator in Taylorville, which is about 30 miles from Springfield, to come and invite other hospital administrators from the area and tell me what the Medicaid cuts proposed by the Republicans to give tax breaks to the wealthy will mean to these hospitals. To a person, they said the same thing: They may survive, but it is a big question.

And what difference will it make? Well, in some of these hospitals, it means that, instead of 30 minutes' drive to the hospital to deliver the baby, it will be an hour and 30 minutes. I can still remember our first babies in my family. The thought of being in the car for an hour and a half with my wife in labor would scare me to death. That would be the reality for people, and alternatives are just not available.

Why in the world would it reach a point where we would cut that kind of coverage, that kind of protection, that peace of mind to give tax breaks to the wealthiest people? It makes no sense.

Medicaid and the CHIP program cover nearly 40 million children, half of all the kids in America. Medicaid provides health coverage for 60 percent of seniors in nursing homes, the ones I mentioned earlier, and it is the largest funder of addiction and mental health treatment.

I will tell you, I know the cases pretty well of people who are desperate for addiction treatment. They realize that they are addicted. They realize they have a problem, and they are anxious to get started and cleaning their lives up. Medicaid is the source of funding for that kind of counsel, and to cut back on that is to really sentence these people to a lifetime of fear and, sadly, cost many of their lives.

In Illinois, 3.4 million people are enrolled in Medicaid, 1.5 million children. Under the Republican plans to slash Medicaid, 775,000 adults in Illinois who gained health insurance thanks to the Affordable Care Act, the same one that John McCain saved in the first Trump Presidency, would lose their coverage almost overnight. How would you like to be in a situation where you don't have health insurance at a critical moment?

I know. I was there. I was a student at Georgetown Law School. I got married in my second year. God sent us a beautiful little baby girl right away. We were so happy. And then a few weeks after she was born, we learned she had a serious congenital heart defect. I was a law student. I didn't have much income, and I had no health insurance. So my wife and I took our baby girl over to Children's Hospital here in Washington, DC.

We sit in the charity ward, and we waited until our name was called. And we saw a doctor who I prayed to God would be able to save our baby's life. I never felt more helpless in my life than I did at that moment, to have this little girl come into this world and her father couldn't provide health insurance.

Luckily, she survived. Great people did great favors for our family that I will never forget. I have never forgotten when there is a health crisis or health issue that is debated on this floor.

All of us want good health insurance, and to cut the programs for no reason other than to give tax breaks to the wealthiest people makes no sense whatsoever. It is not sensible. It is not thoughtful. It is not humane. That is what this debate is all about.

Are we going to protect health insurance for Americans so that they have some peace of mind that they have access to good care, or are we going to cut them off, and tell them they are on their own, whether it is mental health counseling, addiction counseling, or the birth of a child, or basic healthcare? That is what is at stake here. That is what is at stake.

So I would plead with my colleagues--and I know that it is unlikely. I have seen the votes. I know the party discipline. I have seen it on my side of the aisle. I am sure it is on the other side of the aisle. I am praying to God there is going to be one or two John McCains who are going to step forward and lift their hand enough to vote and save health insurance for Americans across the board. I know some people would be unhappy; in fact, some may threaten to defeat you politically because of it.

But I am sure that after John voted no to save the Affordable Care Act despite President Trump's telephone call in his first term, John had the satisfaction of knowing that, for millions of Americans, he was the man and his vote was the vote that made the difference. It might have denied some tax breaks for some wealthy people, but for others, it gave them peace of mind. John was just enough of a maverick to be willing and able to do it. He will be fondly remembered in history as a result of it.

Madam President, I am going to close by saying that this is an issue that is near and dear to my heart, and I think a lot of other people too. They have gone through experiences much like my own. I know they realize that we have few moments of opportunity of service in the Senate to really make a difference in the lives of American families, to give hope to people who have given up because of a mother who is in a nursing home or because of a child with an illness.

I received letters. Sophia, a single mom from Palatine, IL--17 years of age, she gave birth to a baby boy. Her son was born with many medical complications. He had to undergo two surgeries in his first day of life. Can you imagine?

By the age of 4, he had undergone eight separate surgical procedures to address ongoing medical challenges. How did Sophia of Palatine afford the lifesaving care for her son? He was covered by Medicaid.

She wrote to my office. She said:

I don't want Medicaid. My son needs [Medicaid]. I could not be able to afford the thousands of dollars of medical care [to keep him alive without it].

Amber from Springfield, IL, told my office in no uncertain terms: You cut Medicaid, you endanger my sick child's life.

That is what it is. It is a life and death issue. It is not how many dollars you have leftover when you file your taxes. It is a life and death issue that we are debating.

I want to thank those who have spoken this evening already--Senator Schumer and Senator Merkley--for their leadership on this issue. I plead with my colleagues on the other side of the aisle: Please, there has got to be someone over there who will step up and have a McCain moment that will save healthcare for millions of Americans, and I am praying that it happens.

BREAK IN TRANSCRIPT

Source