Patrick Keefe (00:00):
Well, welcome everybody. Welcome to Revere. Governor Haley, Senator Warren, Senator Markey, Senator Edwards, Secretary of Health and Human Services, Kate Walsh and Revere's Chief of Public Health, Lauren Buck.
(00:13)
Today we stand here together against Medicaid cuts that will harm families of Revere and as Revere's mayor, I'm proud to welcome such a strong group of leaders and I'm proud to play my part on team Massachusetts. I, along with our entire delegation, share a grave concern over the big beautiful tax bill. It's far from beautiful. It's a pay-now and pay-more-later scenario. We'll feel these impacts of the careless actions for years because, make no mistake, reduced access to healthcare healthy foods and preventative care affects all of us. We'll, not only pay in dollars, but we'll be overburdened with emergency rooms, lack of proper care, and increased underlying health conditions that may go unrecognized until it's far too late.
(01:03)
On the last Saturday of every month, the line wraps around the Cambridge Health Alliance with hundreds of families who participate in one of Revere's four food security programs. These vital services impact around 1500 families each month. Residents of Revere and surrounding communities rely on programs like SNAP and EBT to make ends meet. These are the working class people that clean our schools, work in the grocery stores, cook at our local restaurants, and may even provide daycare for our children. These are our neighbors, our children, our seniors, and our veterans. This is not a red or blue issue. This is a human decency issue that affects families from Revere to Louisiana because hunger and healthcare take no party lines. Thank you. And I want to welcome our next speaker, a fierce advocate and team leader of Massachusetts, Governor Maura Healey.
Maura Healey (01:57):
Thanks a lot, mayor. Thank you Mayor Keefe, and thank you to Jill Batty and the entire team here at Cambridge Health Alliance and the Revere Care Center for hosting us today. It's great to be here with Senators Warren and Markey, Senator Lydia Edwards from our legislature, and leaders from Massachusetts Healthcare, including our Secretary of Health and Human Services, Kate Walsh, Undersecretary for MassHealth, Mike Levine, Executive Director Audrey Gasteier of the Health Connector, President Michael Curry of the Massachusetts League of Community Health Centers, Amy Rosenthal of Healthcare for All among others.
(02:43)
We're here today because the Trump administration and Republicans in Congress are trying to decimate healthcare in America. It's going to hurt people and that's why we're here because people got to understand what's going on so that they can get out and advocate. Advocate to Congress, advocate to the Trump administration so that the proposed cuts that were announced the other night, released by Congress, 1.75 billion of which would be cuts to our own state, don't happen.
(03:17)
This is not as they would describe it as a scalpel, we've heard that term before, a scalpel to a problem, it really is just a blunt force axe and it's going to fall on a lot of people here in Massachusetts and a lot of people around this country. People will get hurt and people will die and it will raise costs for everyone else. If this cut goes through, a quarter of a million people in Massachusetts will lose their healthcare coverage.
(03:51)
I'll give you an example of what I'm talking about. Imagine a 40-year-old woman who has serious mental health issues, she's only able to work part-time, she qualifies for MassHealth. She's going to lose her healthcare coverage, she's going to lose care, she's going to lose the services that she depends on, and she's going to have nowhere to turn, and that story is going to be repeated over and over and over again.
(04:24)
These cuts target people with disabilities requiring them to fill out more paperwork, which is going to have the effect of kicking them off as well. These cuts target our seasonal workers and gig workers here in Massachusetts, of which there are many, who can't get enough hours on a consistent basis and therefore qualify for MassHealth. They and many others will lose critical services and coverage. And what's going to happen to all these people? A quarter of a million people losing coverage, where are they going to go? Some will end up in the street, many will end up in emergency rooms. Who do you think pays for it when people end up in emergency rooms? Hospitals can't absorb that. Insurance companies can't absorb that. We're going to all be absorbing that.
(05:20)
Businesses here, residents here, people are going to see their premiums go up, people are going to see a whole lot of harm. In addition to MassHealth, we talk a lot about MassHealth, there's also a really important program here in Massachusetts called the Health Connector. The Health Connector is for people who make just a little bit too much to qualify for MassHealth, but are still just getting by. Who are these people? There are a lot of people running small businesses. They're people who are self-employed.
(05:58)
Now the Republicans and Donald Trump want to slash funding for the Health Connector as well, and this is going to drive up premiums, force a hundred thousand families to go without coverage. So you can see the proposed cuts if they go through, they're devastating for Massachusetts residents, for families, for employers, for economy, for people across the state. And this doesn't just impact MassHealth or the Connector, let's talk about nursing homes.
(06:37)
Nursing homes will close. If these cuts go through, nursing homes will close. That means less care for our parents and our grandparents, it means seniors not being able to go to a nursing home for rehab after surgery. They're going to have to rely on family members, neighbors, who knows, to care for them instead. Hospitals. Hospitals, which you know are already fragile as it is in our country, are going to be even more at risk because more people without coverage will be flooding their emergency rooms. Health centers that depend on Medicaid reimbursements will be hit hard and some of these hospitals and healthcare centers in Massachusetts will not survive, will close, if these cuts go through.
(07:29)
That means of course that people are going to be put even further away from care. Longer wait times for appointments, doctors and nurses stretched even more thin than they are already. Imagine having to travel further to have your baby, to get an X-ray, to get care for your kids, to get that needed MRI. This is all what's going to happen if these cuts go through. This, of course, comes on top of the cuts we've already seen to medical research. The budget proposal that they're trying to jam through doesn't make any sense, it makes no sense from a healthcare point of view and no sense from a cost savings point of view either because this proposal isn't going to save money or cut the deficit, what this does is just give the Republicans in Congress and Donald Trump more money to pay for the tax cuts that they want to give to the richest of the rich.
(08:33)
So this is a call to action. Everybody needs to understand what's at stake. I ask that everybody use that information and be an advocate. Use your voice. Let the White House and the Senate know to not let these cuts happen. We can't let them happen. We can't let them take away healthcare from our people here in Massachusetts, from our seniors, our families, our veterans, from young kids, from people with disabilities. We can't let hospitals and healthcare centers close here in Massachusetts. We can't see nursing homes close. So let's do everything we can to protect healthcare in our state and that means fighting back against what is going on in Washington. And with that, I want to invite Senator Elizabeth Warren up to speak, who has been a champion for so many things, especially when it comes to fighting for people's access to healthcare. Senator Warren.
Elizabeth Warren (09:28):
Thank you very much. Thank you, Governor. It is a real honor to stand here with the governor, with the senator, with the senator, with the mayor, with the doctors, with the people who fight for healthcare here in the Commonwealth. I am grateful for that and I look forward to the fact that when we partner up, that's how we make real change.
(09:51)
So last week, the House of Representatives passed Donald Trump's big, beautiful bill. This would be the greatest transfer of wealth from just one piece of legislation from the poorest Americans to the richest Americans ever before in US history. Think about that. These guys are actually out there making history by taking away from hardworking families, from people down on their luck, from seniors, from little babies, so that a handful of billionaires and corporate CEOs can get more giveaways from the government. That is the Republican plan. Billionaires win, everyone else loses.
(10:43)
Now the details are gruesome on this bill. This bill would cut Medicaid, gut the Affordable Care Act and slash food assistance. If it passes the Senate, this bill will rip healthcare away from 14 million people, over a quarter of a million right here in Massachusetts, all to pay for handouts to billionaires. This Republican bill will raise costs for working families, from groceries to healthcare to utility bills, while making the richest Americans even richer.
(11:22)
Here in Massachusetts, the consequences will be severe. In our state, Medicaid is known as MassHealth and it covers almost two million people. If this bill passes, every one of them will be at risk of losing their health coverage. That is one-third of all newborn babies and their mamas right here in Massachusetts at risk for losing their healthcare. That's checkups and trips to the doctor for ear infections and money for asthma medications and for antibiotics for more than a third of all the children right here in Massachusetts, that's paying the monthly bills for almost two-thirds of all nursing home residents right here in Massachusetts.
(12:18)
As the governor said, the pain will echo through our communities hitting even those who don't currently receive direct care. Without the guaranteed payments from Medicaid, our hospitals and our community health centers are at risk. Community hospitals, even with Medicaid reimbursement, are already struggling and right now, nearly half the funding for Massachusetts Community Health Centers, which saves money by preventing people from needing to go to the emergency room, half their money currently comes from Medicaid that is on the chopping block by the Republicans.
Elizabeth Warren (13:00):
… Republicans. When those hospitals and community health centers are forced to close, we all lose.
(13:08)
Now, right now, you probably know someone who counts on Medicaid to pay for the medicine that helps treat their cancer. You probably know someone who got the hip replacement they needed so that they can walk paid for by Medicaid. You probably know someone whose kid gets their inhaler from Medicaid, or the nursing home that takes care of their aging parents, and all of those are at risk. This is a full-blown crisis, and we are here to sound the alarm.
(13:45)
I'm here with Governor Healy and with the senators and everyone behind me because we believe that no one in America should go without healthcare so that Elon Musk can take a rocket ship ride to Mars. We believe that no senior should be kicked to the curb because Mark Zuckerberg wants to buy another Hawaiian island. And we believe that no one with a disability who needs a home health aid should have to give that up so that Jeff Bezos can buy a third yacht. We believe that, and that is why we are here to fight back. I am proud to stand beside the governor and beside the senators, beside the mayor, to make sure that everyone in Massachusetts and around the country gets the healthcare that they deserve.
(14:41)
And with that, I will turn it over to a wonderful partner and a tremendous fighter in the United States Senate, my partner, Ed Markey.
Senator Ed Markey (14:51):
Thank you so much.
Elizabeth Warren (14:51):
Senator Markey.
Senator Ed Markey (14:54):
Thank you, Senator Warren, so much for your great leadership on this issue. To Governor Healey, thank you for your great leadership, Mayor Keefe, Dr. Currie, Jill Batty, Dennis Heaphy, Senator Lydia Edwards, Amy Rosenthal and Kate Walsh, thank you all so much for all of the great work which you do. This is an historic battle which we are right now in the middle of. This is going to be the defining battle over the Trump administration's Make America Sick Again agenda, and whether or not Donald Trump and Robert F. Kennedy Jr. are going to be successful in implementing this gutting of essential healthcare programs for our nation.
(15:46)
Lyndon Johnson, when he signed Medicare and Medicaid into law back in 1965, he basically was going to attempt to ensure that the poor in our country got the same level of healthcare as the rich. Now, it's 60 years later, and Speaker Johnson and Donald Trump and his MAGA acolytes are all marching towards the biggest cuts in the history of Medicaid and Medicare. Republicans want to slash $762 billion from Medicaid. They want to cut $500 billion from Medicare. They want to make it harder for people to be able to get their health insurance.
(16:38)
By gutting Medicaid, republicans are looking to loot a program that has guaranteed healthcare to 72 million Americans, including two million here in the State of Massachusetts. They're looking to steal from a program that pays for 70% of people who are in nursing homes are on Medicaid. 50% of all children in our nation are on Medicaid. That's the program that the Republicans are seeking to loot, the program that keeps grandma and grandpa in nursing homes, the program that takes care of 50% of the children in our nation, all in order to have a tax break for the wealthiest people in our nation.
(17:27)
Providers are going to lose their jobs. It'll be harder for families to find a pediatrician, harder for people to get mental healthcare, harder for seniors to get help as they age, families will lose access to care. And as millions more Americans lose their health insurance, skip appointments, ration medications, the billionaires who can afford concierge medicine will get yet another handout from the government. The rich will get richer in our nation and the sick will get sicker. That's what this bill is all about. Instead of fighting for guaranteed healthcare for all, Republicans have left us defending the scraps. And this isn't a big, beautiful bill, as Donald Trump would call it, it is a big, billionaire bonus and a bludgeoning of the healthcare system in our nation.
(18:22)
But the fight to save Medicaid and Medicare is far from over. Now, the package comes over to the Senate. Senator Josh Hawley is right, it's wrong to cut Medicaid and it will also be political suicide for the Republicans in Congress, and we're going to make that case to them every single day on the floor of the Senate. Senator Warren and I are committed to that battle. Today, we will use all of our efforts to stop these cuts. We cannot agonize, we're going to organize. We're going to use this opportunity to put every Republican on record on every one of these cuts. We're going to make sure every Republican is seen by every American who wants to ensure that billionaires get tax breaks at the expense of ordinary people on the streets. We're going to slow down and stop this big billionaire sellout once and for all.
(19:26)
And what we saw when they made the biggest effort after Newt Gingrich was elected in the 1990s is they passed, the Republicans and House and Senate, a huge cut to Medicare. Well, Medicare pays the bills for hospitals, along with Medicaid. The Revere Hospital went under, the Malden Hospital went under, the Stoneham Hospital went under. It's Medicaid and Medicare that pay the bills for these hospitals that then provide the emergency rooms, the ICUs, that everyone in the Commonwealth, everyone in the country, can use. That's what's at stake. It's the very nature of community hospitals, of community health centers, of all of these facilities that are funded ultimately by Medicare and Medicaid, and we're going to make sure that these cuts do not happen.
(20:23)
And with that, I turn to a great leader here in the state, a conscience up on the floor of the Massachusetts State Senate every single day, Senator Lydia Edwards.
Senator Lydia Edwards (20:37):
Good afternoon. I'm here today with incredible colleagues and leaders at the federal level, at the local level. And fundamentally, I think what we need to say and be very clear to everybody, we know that healthcare, access to affordable healthcare, is a basic fundamental human right, and this attack is an attack on our dignity, it's attack on our humanity. This gut punch is delivered so sloppily and so cruelly that I can't imagine there's any other point besides to just punish people. It does not help our economy, it actually hurts our economy, and the fact is, if this cut goes through, people will be making financial decisions when they should be thinking about medical decisions. They'll be deciding whether they can afford their diabetes insulin, whether they need to cut it up, which child gets to go to the hospital, which one gets to go to the dentist. They'll be making financial decisions, not healthcare decisions, and we're all worse off for it.
(21:42)
If we do not block this cut, we will see the racial disparities in our healthcare grow even wider. We'll be having people who don't have access to basic healthcare clinics, like we are standing here at today or in East Boston. And by the way, in Massachusetts, we have led the way in healthcare and access to healthcare in so many fundamental ways, and it is working. We are a healthier state because of it, we have lower medical debt because of it. People are able to start new businesses. Young people are able to, when they get off their parents' insurance, are able to bravely step out into the world for their first new job. That's what healthcare and access to healthcare does for people, it strengthens our economy, it encourages us to move and to think creatively.
(22:31)
If we make this cut, it's going to retract our economy, our creativity, and it's going to punish our most vulnerable. I'm standing here today to fight against that cut, and I'm so proud of the state legislature and my colleagues and the governor for our continued investment in healthcare in Massachusetts. But we know our success is something that they're trying to punish, and we're going to stand up, we're going to fight back, and I'm so honored to stand with those individuals who have been fighting for years to make sure that we have not only access to healthcare, but also eliminating racial disparities.
(23:07)
And with that, I want to introduce a leader in that particular world, Dr. Michael Currie.
Dr. Michael Currie (23:17):
Thank you. I often get to say, people ask me, "Why do you live in Massachusetts when you can be in 80 degree weather somewhere else in the country during the winter months?" And I remind myself, as I travel the country, we talk about policy and the impact of Medicaid cuts on health centers, why I live here is because of the phenomenal people that are standing behind me, our phenomenal governor who warned us that loss of access to care will mean deaths, when the Senator Warren talks about visiting and she knows health centers well and the risk that we may lose health centers is real. It was real before these policy shifts on the federal level, and could be exacerbated and become a reality now.
(23:59)
Senator Markey and I are historians and we talk about the history of Medicaid, and I love an African proverb that says, "If you know the beginning well, the end won't trouble you." So he talked about 1965, many people don't realize that Medicaid and Medicare were civil rights bills that actually integrated hospitals across this country and gave access to millions of African Americans and other people of color who are locked out of our healthcare system. So this is a sobering moment for me right now to think about what this could mean. Please think for a moment about the faces and stories of who will be impacted by these cuts of Medicaid.
(24:35)
We tend to talk numbers, but we don't talk people. These are the people who will suffer from all parts of the Commonwealth if they do not have access to Medicare and Medicaid at their local health center. A middle-aged woman from Southeast Massachusetts who lived with PTSD and chronic pain for many years, she was increasingly isolated and depressed. With Medicaid, she connected with her local health center and a team who managed her multiple physical and mental health issues. This is real stories. A senior from Boston with diabetes who needs access to care and medications for his chronic health condition. Without access to his medication, he is too dizzy to walk without two canes to support him, and will end up in the emergency department due to a fall. The mayor said it, "Pay now, or pay greater later." A Haitian immigrant at a health center in Western Mass who was living with an untreated HIV/AIDS diagnosis, who when able to access care, also discovered that her youngest child was also positive HIV, MassHealth gave them both access to care that they could afford and could manage their HIV care.
(25:42)
I want to give a personal story. I'm a child of Roxbury, a child raised in elementary housing projects. My mother raised me and my sisters on MassHealth because she was a housekeeper who had a job that didn't have health insurance benefits, that didn't pay well enough for her to provide coverage
Dr. Michael Currie (26:01):
… to provide coverage for us as children. She raised us on Medicaid. The bill is projected to cut 625 billion from Medicaid and will have devastating impacts on health centers across this state and across the country. With the loss and revenue from the cuts, health center leaders will be forced to make difficult decisions to cut services, close sites and lay off staff, resulting in decreased access to care to the neediest patients. Over 386,000 community health center patients are covered by Medicaid, or MassHealth as we say in Massachusetts. One in seven Medicaid enrollees are served at a community health center. 47%, and across the country even higher, community health center patients are covered by Medicaid. On average, 31% of health centers' revenue come from Medicaid. 92% of patients were working full-time or part-time, not working due to caregiving responsibilities, illness, or disability, or school attendance. This is the face of the Medicaid population. So as we talk about fraud, waste, and abuse, as we talk about changes in Medicaid policy, I want to bring a face to that. For the million patients we serve across the Commonwealth, 60-plus percent of them are people of color. They're LGBTQ or they're at a low poverty level. Their food insecure, housing insecure, they're underemployed, underinsured, and they'll be churning on and off Medicaid and now to uncompensated care.
(27:30)
So it's important that we have a face to these policy changes that are happening on a federal level. I will end where I started. Thank God I live in Massachusetts because we have phenomenal leaders that are willing to stand up and fight for what we know is right. We did it with health reform in 2006 and we'll do it again under this current administration and we'll fight for Medicaid. Thank you.
Jill Batty (27:58):
Hi, everyone. I'm Jill Batty and I'm the Chief Financial Officer here at CHA. That means I'm really more of an accountant, so you're going to hear more of an accounting kind of a summary today. But I just want to say how happy I am to be standing up here with these individuals, all of whom have demonstrated that they care about the residents of Massachusetts, and that they stand behind and are strong champions of healthcare programs that matter for patients, families, and communities.
(28:25)
Welcome to the CHA Revere Care Center. Together, with the rest of our care centers, we offer more than 800,000 outpatient visits annually and 38,000 of them occur here in Revere. You heard the mayor reference our mobile food market. Last year our volunteers and partners distributed 156,000 pounds of food, including fresh produce and vegetables, along with blood pressure checks and other wellness screenings. We matter here in this community and we want to be here for the future. CHA is a public hospital system. We include two acute care hospitals and extensive behavioral healthcare. We also focus on the healthcare services that matter the most to our patients, our families, and our communities, whether it's accessing primary care and behavioral healthcare in your neighborhood, maternal and child healthcare in the community, or specialty services that are coordinated and available to you regardless of your ability to pay.
(29:26)
Medicaid plays a special role in facilitating the services that we provide. Over 50% of our patients rely on Medicaid. As poignantly shared by one of our clinical social workers in oncology, she said, "I have witnessed firsthand how MassHealth has allowed people to focus on recovery instead of getting coverage for essential care." On behalf of her and her clinical team, I'd like to share one more story. You've heard a few stories from Dr. Curry and some others, but I'd like for you to imagine this story if this individual were dealing with Medicaid of the future. Rose, now 50 years old, cherishes her role as a grandmother. Since a thyroid cancer diagnosis in her 30s, MassHealth coverage has made such a difference in her cancer treatment and ongoing primary care at CHA. Due to MassHealth coverage, she received the necessary surgeries and multiple rounds of cancer treatment amid several recurrences. Now she's in remission and well enough to be the primary caretaker of her beloved granddaughter.
(30:26)
Our ability, CHA's ability to provide early and ongoing excellent treatment for people like Rose is dependent on state and federal government partnerships through Medicaid. However, the current Congressional Reconciliation bill passed by the House last week and now moving into the Senate for debate will fundamentally erode Medicaid and diminish the federal partnership. These unprecedented cuts to Medicaid jeopardize health and well-being of the two million people who rely on it in Massachusetts, resulting in a vast increase in the number of uninsured patients, barriers to care when people need it the most, less care capacity and services for patients of essential providers like CHA that serve as a lifeline in our communities.
(31:10)
Make no mistake if these cuts happen, it will be devastating to CHA, our patients and our communities, but the reality is it's going to affect every person who deals with the Massachusetts Health system. It is that devastating. This magnitude will negatively affect everyone within Massachusetts that has impact with our healthcare systems. Therefore, we stand together with our distinguished leaders and urge Congress to reject these harmful Medicaid cuts and to preserve the access to care that has occurred here in Massachusetts and indeed across the nation that really serves as a foundation for health and health improvement.
(31:56)
With that, I'm happy to turn the podium over to Dennis Heaphy, who's going to give us a perspective as a participant in the program.
Dennis Heaphy (32:43):
Can you hear me?
Speaker 1 (32:44):
[inaudible 00:32:44] the mic.
Speaker 2 (32:47):
Maybe if we put this a little closer.
Dennis Heaphy (32:49):
Thank you.
Speaker 2 (32:53):
Okay. Take [inaudible 00:32:54]. Does it work better? You want to try?
Dennis Heaphy (32:54):
Thank you. Can you hear me?
Speaker 2 (32:55):
Can all hear?
Dennis Heaphy (32:57):
Thank you. Hi, thank you. Thank you for being here. My name is Dennis Heaphy and I'm a MassHealth consumer and I work for the Disability Policy Consortium in Boston, a statewide advocacy group.
(33:10)
And as I was coming over here and thinking about what I was going to say, a woman and her young daughter got on the bus. And the woman had had a stroke, a very severe stroke. She's a hemiplegic, was basically dragging her left leg and her holding her left arm up, and her daughter had a developmental disability. And I was thinking, "Who's going to take care of these two people if MassHealth is not able to provide services for them with all these cuts to come? Because these folks definitely need home and community-based services, the same services that I rely on, the service that keep me out of a nursing home. But these people need these services for this woman just to help raise her daughter. I just can't get them out of my head. And for me, if I go to a nursing home, I'll die. It'll cost the state can't imagine how much money to even put me into a nursing home, but I'll die because I have very complex medical needs. Bed sores, trips back and forth to the emergency department because of my complex medical needs, which are very well taken care of in my home at far lower cost. But when my PCA hours will be cut, I won't be able to get enough PCAs to provide the care I need.
(34:37)
And it's not just about me as a quadriplegic or for this woman and her daughter, it's for all people in Massachusetts who rely on MassHealth. I think of all the kids in MassHealth, almost 50% of kids in Massachusetts that rely on MassHealth. And all the adults, all the folks in Massachusetts who work, who earn the insurance that they receive in MassHealth. And we don't talk enough about that. I really don't think we talk enough about how smart and grateful we are to live in the state where there's an investment in people's ability to pay into MassHealth and actually earn money and still be able to maintain their Medicaid. And that's something we just don't talk enough about.
(35:20)
I also think about all the folks from other countries that are here that are documented folks and are getting insurance in Massachusetts, and Massachusetts might be penalized for actually doing the right thing and doing them what's effective, cost-effective, and also effective in terms of caring for other people from the human lives.
(35:41)
I also think about all the folks, all the businesses that will be harmed by these cuts that will come, whether it's home health agencies, community-based organizations that provide behavioral health services, they'll all go out of business. That's increased unemployment in the state. And so the ripple effect of these cuts will be astronomical and it's going to really harm the state and increase the levels of poverty and unemployment.
(36:12)
And so I'm begging legislators at the federal level, thank Senator Warren, thank Senator Markey and Representative Pressley and all the other folks in Massachusetts, our delegation, for the hard work they're doing. When they say you have to do more, it's really not enough. You have to convince Republicans that are in states that will really be harmed. These are expansion states, that they need to really push back and go against the Trump administration and say, "We need to do what's best for our people and we're not going to go based on what this one person wants."
(36:54)
And so I guess I'm here pleading not just from Massachusetts, but all folks on MassHealth, also folks on Medicaid and Medicare, I'm a dual eligible, in the country, because to hurt Medicaid hurts Medicare, because there's such a high percentage of folks who are on Medicare that are also Medicaid actually. And so if I don't have the services I need in Medicaid, it's going to increase my Medicare costs. The concepts are very simple, but you can't be simplistic in how you deal with them, and that's what we have right now. That's the problem we have. If people are trying to find simplistic answers, answers to problems which really are simple and straightforward, but they're not being addressed appropriately.
(37:43)
I'm not going to babble on you, but just say, I don't want to go to a nursing home because I know I will die. I've had friends that go to nursing homes, they've gone to nursing homes and they've died. I don't want to see that woman and her daughter or others like them, do that to services that they need in the home to live decent lives in Massachusetts. And so I'm grateful to live in this state and I am petrified for it. No, it's, funny. I'm not going to use the word petrified. I'm angry. I'm angry. And it's about taking action and really not being afraid of really saying, "We're not going to stand for this. We're going to address it."
(38:19)
And so that's what I really am here to say, is say, no, not in Massachusetts and possibly no in other states either, because people with disabilities, people with low income, all people deserve healthcare. So thank you. Thank you.
Speaker 3 (38:42):
Thank you so much, Dennis. Thank you. Thank you. Dennis, thank you so much. We're happy to take questions on topic.
Speaker 4 (38:48):
Governor, question for you and the secretary, prior to all this happening, you had a budget proposal with some controversial cuts in it, DMH, DPH. Should these cuts
Speaker 5 (39:00):
… has to go into effect. What would the budgets of the future look like? What areas would you potentially be cutting if there's this big a deficit to MassHealth?
Speaker 6 (39:12):
As we've said all along, the situation with the federal administration and what the Trump Administration is doing makes it challenging for any state right now in the country, including ours. So we're going to continue to just do our best to fight for the funding that we need, that we're entitled to under law. There's a lot in litigation, and certainly to do what we're doing today in advocating to the public that they join us in advocating for these funding streams. They absolutely need to continue because people will get hurt and people will die. Any other questions on topic?
Speaker 7 (39:49):
For the senators, we've heard a lot about the states, so if this bill does pass, can you talk a little bit about what, if anything, Senate Democrats can do to prevent it from passing? What are you guys going to do?
Elizabeth Warren (40:01):
So, Eddie… So right now it has passed the house in its current version, it's going to the Senate and there's a lot of pushback in the Senate. There are a lot of folks who understand even on the Republican side that this is a real problem to make these kinds of cuts. So our job at this moment is to raise the stakes here so everyone across this country can see exactly who's going to be hurt and exactly who's going to be helped by the Republican budget. We really want to underscore this is about taking away healthcare from newborns so that Jeff Bezos can buy a third yacht. And that's something that I think most Americans, whether you live in a red state or blue state, are not in favor of.
(40:56)
And that's what we want to underscore right now at this minute, so that while the Republicans are at home with their constituents not having town halls, we want them at least to hear nationally about what this bill is all about. And the only way we can do that is to raise it. We will talk about it on the floor of the Senate. We've already had hearings. Senator Markey has been part of this. I've been part of this, but this is the moment to talk about it. And then I just want to make sure you know where it goes from here. If the Republicans change the bill but pass it will have to go back to the house again. So we will then keep the focus as well on all of the House Republicans.
(41:40)
Remember two things. When this bill passed the house, it passed by a single vote, a single vote. We get just one Republican in the house to go the other way and this bill does not make it through. But also, remember 2017, I know how frustrating it feels Republicans are in control of the White House in control of the Senate, in control of the house. But that was true in 2017 when they went after Medicare and Medicaid, the Affordable Care Act, and you may remember it passed the house, they all went over and celebrated with Donald Trump, popped the bruskies mean what's not to celebrate about taking away healthcare from millions and millions of people.
(42:23)
It came to the Senate, the Republicans had a majority, and at the last minute we won it by a single vote, not because we had somehow more Democrats than we'd had before, but because we got the word out and we got the word out all across Massachusetts, but all across the rest of the country. And that's what we're here to fight for right now. Anybody else? Can I add-
Speaker 8 (42:49):
All issues go through three phases, political education, political activation, political implementation until last Thursday night, Friday morning, no one was quite sure what was going to be in this bill. Will the moderates win? Will the reasonable Republicans win or will they have to capitulate? Well, now the story is clear. The cuts to Medicaid are draconian. The cuts to snap are draconian. The tax breaks to billionaires are the highest in American history. So the story line gets very simple as we move to the political education phase over the next couple of weeks and then to the political activation phase. Because all across our country in facilities like this, in purple states, in red states, there are going to be meetings and the hospital CEOs, the community health leaders, the behavioral health leaders, the community leaders will be talking to the senators about the implications for their medical facilities.
(43:55)
So it's no longer just theoretical, it's no longer just a political debate in the salons of Washington. Now it's very real. We saw this in Massachusetts with the Steward Health crisis. We saw them loot the hospital system in our state. We saw Nashoba Valley go under. We saw the hospital in Dorchester, Carney, go under because of millionaires and billionaires who wanted to loot the system. Well, this is the Steward Health system on steroids across the whole country. It's a looting of the healthcare system for the wealthiest people in our country. And I think as each day goes by in these red and purple states, they're going to see what the political consequences are. And this time we have evidence to prove that when the Medicare cuts happened in 1997 by the scores by the hundreds all across the country, hospitals went under. I just named three.
(44:50)
And by the way, who goes under? It's those that have the most elderly patients in them because of Medicare and those who have the working class who use that facility as well. Those are the facilities which go under and we're going to have a battle on the floor of the Senate and Senator Warren, when she gets to the microphone, people back up on the Republican side because we're coming loaded for this fight. We're not going to back down. And I think ultimately Republicans are going to see that they're going to proceed at their own political peril. And Massachusetts is a perfect example with steward of what has happened.
Speaker 9 (45:26):
Make them pay. The only thing I would add is this is a crisis in Massachusetts. It's devastating in the United States. If you look at the mix of federal and state support, we're about a 50/50 state states like Mississippi are 80/20. So I think for us, this is terrible and we have an infrastructure to deal with it. There are states who will be utterly decimated. Healthcare systems are decimated, and those are states with large numbers of rural hospitals who are closing units. This is not a regulatory issue.
Speaker 10 (46:02):
Senator, you had talked about the wealth transfer aspect of this. Beyond the people who are directly potentially going to lose their insurance. Could you talk about just societally in the United States beyond simply the population that uses Medicaid, how does the wealth transfer happen?
Elizabeth Warren (46:15):
Yeah, the wealth transfer works a couple of ways. The first one is that the hospitals and community health centers that currently provide services get full reimbursement from the Medicare and Medicaid programs. They lose that reimbursement and that means that that very slim margin, that is the difference between operating and the black and operating and the red is gone. And these hospitals, some of which are holding on right now by their fingernails end up closing when they close, they don't just close for Medicaid patients, they close for everybody. So anybody who's feeling chest pains and needs emergency medical care right now is just out of luck.
(47:08)
Anyone whose kid falls at the playground and needs what looks like 126 stitches is just out of luck. Anyone who's looking to deliver a baby is just out of luck. So that's how it starts to echo through the system. The other way it echoes through the system is providing alternative ways to get access to healthcare is part of how people are able to start their own businesses Know not everybody is going to work for a giant corporation, and if you're not working for a giant corporation that can actually help you with healthcare, you've got to rely on these other systems that work through the government.
(47:48)
So everybody who wants to start a little business, one of the first questions they have to ask is, what's my idea for the business? How am I going to get financing and how am I going to pay for my healthcare during the time that I'm trying to get this business up and running? You take away these supports and you take away much of what entrepreneurs rely on to be able to get those businesses up and running. All of the people right now who are working, God dang it, many of them are working two and three jobs, but it's not enough where they are to give them full coverage healthcare. So they've got to rely on programs like Medicaid in order to be able to stay in those jobs and to take care of themselves and their kids. When somebody gets sick, you lose that.
(48:42)
Now you've got more people who are back in the hospitals for uncompensated care and more to the point not getting the healthcare they need when they need it. It is cheaper to take care of the child when the tooth first hurts rather than after an infection has set in. And that's true all the way through the healthcare system. And then I will mention the last one, although there are more, and that is for people with significant disabilities who need that home health aid, people like Dennis, the difference between Dennis getting some help so that he can stay in his own home, in his own apartment and having Dennis have to go to a facility that will provide round the clock care for him is a difference, not just of quality of life for Dennis, it's also a straight dollars and cents difference.
(49:38)
It costs more money for Dennis to have a tougher, more restricted life in a nursing home than it does for him to be in his own home. But the way we make that happen is we make it happen through these federal supports that we keep in place. If Dennis's home Health aides are gone, then Dennis is off in a nursing home and we have traded something that is barely working for something that is just not going to work. And that echoes through our whole Commonwealth. And that's just some of it. Those are the ones that come to mind for me [inaudible 00:50:24].
Speaker 8 (50:23):
And I'll just say briefly, in Revere in 1900, life expectancy was 48 years of age. That was it. It's programs like Medicaid and Medicare that have changed the trajectory of ordinary families. The wealthy always did well, but it's communities like Revere, that is the target of programs like that that Lyndon Johnson is putting in place until 1965. When a senior got sick, it was most likely going to lead to bankruptcy. That was all that happened. And then it changed the trajectory of the entire family who then had to support that senior.
(51:04)
The same thing is true now with Medicaid because it sits there as a support for the entire family. Otherwise, there was a cascading effect economically in that family, which is how it was before 1965 in our country in Revere, Massachusetts. So that's what this fight is all about. It's whether or not we're going to provide, as Ralph Waldo Emerson said, health is the first wealth. That's what Medicare and Medicaid provide for every citizen. It's not meant to be wealth for those who are already wealthy. They already did well before 1965. In our society, that's the transformative moment and economically it has then served as the underpinning for every family to be able to more than survive, but to thrive.
Speaker 11 (51:51):
Thank you all.
Elizabeth Warren (51:52):
Thank you all. Thank you all for coming.
Speaker 11 (51:52):
[inaudible 00:51:53].
Elizabeth Warren (51:52):
Thank you.
