Official Congressional Record
Mr. Speaker, before we left for the August recess, we celebrated 250 years of our country. We celebrated 250 years of the revolutionary idea outlined in the Declaration of Independence that all men are created equal. The Congressional Black Caucus has fought to include all the people in that phrase, that all people are endowed by their creator with the unalienable rights of life, liberty, and the pursuit of happiness, but the next part is the key: that to secure these rights, governments are created by, of, and for the people. I thought about that when the Energy and Commerce Committee debated H.R. 1, which you all call the One Big Beautiful Bill Act, which I call the big, ugly law. I thought that a government that cares for its people must ensure that their basic needs are being met. I thought about my own parents and how they saw the best of government as children during the Great Depression and the New Deal programs that helped meet the basic needs of the people and put safety nets in place to ensure that something like the Great Depression never happened again. I thought about what happens when government fails. My parents saw the worst of government through Jim Crow, which decided that ``all men'' did not include my parents because of the color of their skin. Last April, as I sat through that 26\1/2\-hour hearing, fighting the largest cuts to our healthcare safety net in American history, when Republicans voted to slash more than $1 trillion from Medicaid and gutted the Affordable Care Act enhanced premium tax credits to bankroll tax cuts, to make permanent tax cuts for billionaires, now a trillionaire, and big corporations, I knew that the impact would devastate our healthcare system. Last August, I traveled across Virginia to talk to patients, providers, and communities about what the cuts would mean for access to care, especially in rural Virginia. Now, at the time, Senate Democrats identified six rural hospitals in Virginia at risk of closure once the Medicaid cuts took effect, including one in my district, in Emporia, a very small town, that had already lost two of its largest employers, a paper mill and Boar's Head. I talked about the impact that these cuts would have on that community and how devastated that community would be if that hospital closed. I visited Tazewell, in the Ninth Congressional District, which also had a hospital on that list, and met with providers and community advocates about the impact that the closure of that hospital would have. I toured the Appalachian Highlands Community Dental Center in Abingdon, where more than 80 percent of their patients rely on Medicaid, and the rest are uninsured. At that time they had a waiting list of approximately 2,800 people who, before that clinic opened, had to wait a year for a dental clinic to come to get everything from cleaning to dentures. That clinic's co-founder shared with me how important it was for them to fill the gap in healthcare in southwest Virginia. I shared what I heard with the press, who also came to that clinic. I shared that rural hospitals and clinics were worried about closing their doors or having to end vital services. Patients were worried about losing their health insurance or having to choose between paying premiums, their utility bills, or their rent. Providers worried that uninsured patients would forego care until it was too late, like Dr. Bickley Craven of Abingdon, who cared for five different women over a year's span, who all had cancer of the uterus and were not insured. They all delayed seeking medical attention even though they had obvious symptoms. Had they sought care when those symptoms first started, they could have been treated, but some of them died because they had no health insurance, delayed seeking care because they didn't want to put the burden of that expense on their families. Now, in response to these stories, my Republican colleague, who represents that district I was in, told the same reporter that Democrats are just fear-mongering. Yet, around the same time, a rural clinic in Nebraska had just announced plans to close because of the Medicaid cuts in the big, ugly law. A week later, Augusta Medical Group in Virginia announced the closure of three health clinics in the Shenandoah Valley as ``part of Augusta Health's ongoing response to the One Big Beautiful Bill Act.'' These closures were on top of closures of clinics earlier in the year due to Federal funding cuts, delayed grant access because the Trump administration and DOGE just decided they were going to ignore appropriations bills passed by Congress, and Congress did nothing about it. Three clinics in the Capital Area Health Network in my district closed last February. This August, I checked back in. What has happened in the year since? I visited with Virginia Secretary of Health and Human Services; officials with the Virginia Marketplace, our State-based exchange; providers from free clinics and federally qualified health centers; hospitals; patients; and communities to see what happened. They painted a very dire picture. Already, 8 million Americans and counting have lost their healthcare. About 100,000 Virginians have already been priced out of their Affordable Care Act plans because the enhanced premium tax credits were allowed to expire. Mr. Speaker, 300,000 Virginians are at risk of losing their Medicaid when the cuts take full effect in January. The Virginia Joint Commission on Health Care has identified--not six, which was identified a year ago--13 hospitals in Virginia that are now at risk of closing because of these cuts. Behind these numbers are people and communities that are struggling every single day. Dr. Mohan Nadkarni, founder of the Charlottesville Free Clinic, in the Fifth Congressional District, shared the story of a 21-year-old patient with asthma, who lost his healthcare coverage and could no longer access his medication. He suffered respiratory arrest and became brain-dead. His mother had to make the awful decision to withdraw life support. Christina Rivera of Augusta County, who founded a Charlottesville- based nonprofit, shared the impact of losing her enhanced premium tax credits. Last year, she paid $235 a month for health insurance due to the marketplace. This year, her premium is $1,336 a month. She works for a nonprofit. Like most families, she doesn't have an extra $14,000 laying around to make up the difference this year. She needed lifesaving spinal surgery. Without her insurance, she would have lost everything: Her farm, her home, her livelihood. She is trying to make do. Now, our Governor and general assembly are trying to fill the gaps, but they estimate that insurance coverage losses, administrative cuts, decreased provider reimbursements alone, all because of the big, ugly law, could cost the Commonwealth of Virginia between $1.8 billion and $2.6 billion in revenue in one year. On top of that, the Commonwealth has to invest new State funds to overhaul eligibility and payment systems, with penalties assessed for errors. Virginia hospitals face an estimated $1.2 billion cuts in payments in 2028, which they expect to balloon to nearly $37 billion over the next decade. Rural and safety net providers, such as federally qualified health centers and free clinics providing care to underserved patients, will bear the brunt of these cuts. Now, I know what you are thinking: What about the Rural Health Transformation fund? That is like putting a Band-Aid on a big, giant, gaping wound. It is not enough. So far, nationally, over a thousand hospitals, clinics, and nursing homes have already closed their doors, cut services, or are at risk of doing so, citing the healthcare cuts in the big, ugly law. As of July 1, over 80 hospital wards, over 40 maternity wards, and nearly 320 clinics have closed. In a country that has one of the highest maternal mortality rates in the industrialized world--and if you are a Black woman, you are three times more likely to die because of a childbirth related issue--these expectant mothers are now having to travel farther away for maternity care. Seniors are losing access to long-term care. People with disabilities are facing devastating disruptions in critical service. People with mental health conditions, who are in crisis, can't get access to care, and our healthcare leaders are sounding the alarm. Let's talk about the closing of a maternity ward. In Virginia last year, Centra Southside Community Hospital in Farmville closed its labor and delivery unit at the end of the year, citing its reductions in Federal healthcare funding--Medicaid cuts primarily--among the reasons for the decision. Between 2022 and 2024, that hospital alone was the most common delivery hospital for women in Prince Edward County, where it is located. Now those women have to drive an hour away; like Tami Jaynes, who the day I was in Charlottesville, Charlottesville Tomorrow shared her story. Pregnant with her eighth child, near full term, Tami woke up in the middle of the night with a sense that something was wrong. She couldn't remember the last time she felt her baby kick. She thought about going to the emergency room in Farmville, which is an hour away, but they don't have obstetric services anymore. They closed them because of the Medicaid cuts. Some patients have been going to Lynchburg, Richmond, or Charlottesville, which are all over an hour- long drive away. Tami decided to switch to a local nonprofit in Farmville that had limited services. It was close to home, though they weren't open until the next morning. Tami thought: I can drive to Lynchburg, an hour away, or I can wait and go to an already scheduled appointment I have here, at that clinic, at 8 a.m. That is what she decided to do. She decided to wait. By the time she got to her doctor's appointment, the ultrasound showed no heartbeat. Later that day, Tami delivered her eighth child, Jacob, stillborn. Reading Tami's story, I could not help but think back to the fear that I had 11 years ago this year, when I woke up in the middle of the night, and my placenta had ruptured. I was 10 minutes from the emergency room. I would not have survived, trying to get to a hospital an hour away. That is what is happening because of these cuts. People already at risk are dying. Frankly, the American people are sick of it. They are sick of their budgets being squeezed by Republican-driven sticker shock, as premiums more than doubled for nearly 22 million families across the Nation. They are sick of making impossible decisions every day just to make ends meet. Small business owners are sick of having to close their doors because they can no longer afford to buy insurance on their own. They are sick of having to choose between putting food on the table or keeping a roof over their head, paying their premiums or paying their utility bills. They are sick of a forever war of choice in Iran with no clear end in sight, causing energy prices to go up, and the dumbest trade war ever with Canada--Canada--is about to make everything go higher as the cost of oil and key components of fertilizer and aluminum and food stocks go even higher. The American people are sick of Republicans turning their backs on the American people. They are sick of Donald Trump saying the affordability crisis is a hoax. They want solutions now. We have legislation pending right now that would reverse these cuts. We just need the Speaker to bring it to the floor for a vote before the harshest parts of the big, ugly law, including these Medicaid cuts, take effect in 2027, conveniently after the midterms, but the American people aren't stupid. While the full impact of these cuts continues to unfold, more families will lose coverage, more providers will face difficult financial decisions, more communities will be left in the cold, and that is just healthcare. We will talk a little bit later about food security, but for now, I yield to the gentlewoman from California, Sydney Kamlager-Dove, to share what she has heard.
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