Senate GOP Leader John Thune spoke in favor of the “Big, Beautiful Bill” as the Senate began debate and voting on amendments before trying to pass it by the end of the week:

SEN. JOHN THUNE: And so yes, there are some improvements and reforms to Medicaid to make it more efficient-to make sure that the people who are supposed to benefit from Medicaid do, and that it doesn’t go to people who shouldn’t benefit from Medicaid. Now, most of the increase in spending in Medicaid has been in what we call the expansion population, and that’s the number of people out there for whom states get a 90% reimbursement from the federal government. That has grown dramatically. What does that represent? It’s a lot of able-bodied adults-people who should be working, people who are perhaps, you know, don’t need to be getting the assistance that’s designed for people who are disabled, and low-income elderly, and pregnant moms. That’s what Medicaid was about. And states have-with the federal government-a partnership shared for years at a traditional rate. The expansion population is 90% paid for by the federal taxpayers. So what do the states do? They game the system to get more federal money. They add more people to the rolls. And so you have people on the rolls today who are here illegally, and people on the rolls today who are not eligible for this program. And you have people in that program for whom there’s no work requirement. And so what this does-it makes some reforms. One of which includes work requirements. I don’t think that’s a novel concept. It certainly isn’t a concept that I think most Americans would disagree with. In fact, it was a Democrat president back in the 1990s-there was something called welfare reform. Bill Clinton, a Democrat president, proposed work requirements for welfare recipients. And you want to know something? The work requirements in the Welfare Reform Act passed back in 1996 and signed into law by Democrat President Bill Clinton had stronger work requirements than are included in this bill. Stronger work requirements-in a bill passed and signed into law by a Democrat president-than what’s in this bill, and proposed, I might add, by a Democrat president. So that’s one of the reforms that we’re making. And these are reforms, Mr. President, that are going to make this program stronger, more effective, more efficient-improve it in a way that it gets the assistance to the people for whom it was intended, and not to people who are gaming the system. And yes, we address the issue of provider taxes, which has been abused-no question about it. It’s another way to leverage federal money, get more federal money into the state coffers. And the states have used it for things not just to cover people, but also for other reasons. You have states like New York and California who have gamed the system. So the whole issue of what we’re doing with the Medicaid program is to get rid of the waste, fraud, and abuse-make it work in the way in which it was intended: to cover the people for whom it was intended, and to make sure that we have work requirements included there.

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