Sen. Grassley: Medicaid still available for those who need it

AMANA — Medicaid funding will increase under the Big Beautiful Bill and will be available to the people it was intended for, Iowa Sen. Chuck Grassley told residents in Amana last week.

The word “cuts” is deceptive, Grassley said. Congress cut the spending increase from 5% to 3%, but funding is still increasing.

Grassley talked about Medicare, Medicaid and other issues during a question-and-answer session hosted by the Amana Society Aug. 18.

Before taking questions, Grassley toured Hotel Millwright with Amana Society Chief Executive Officer Greg Leurkens and visited Warped & Woven Mill Mercantile where Amana Woolen Mill Assistant Production Paulette Dietrich explained the history of the mill where she’s worked for 35 years.

Following the tour, Grassley told Amana residents, “I’m here because Congress isn’t in session this week.” When he doesn’t have to be in Washington, the 91-year-old travels around Iowa to answer questions from voters.

Grassley said he went to Amana to learn what’s going on with small businesses in Iowa.

Medicare and Medicaid

A woman who said she worked in the health care industry asked about the effect the Big Beautiful Bill will have on Medicare and Medicaid reimbursements to hospitals.

The bill didn’t deal with Medicare, said Grassley, only with Medicaid. But Medicare reimbursements are a problem not just for Iowa, but for the entire upper Midwest, he said.

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The sensible thing would be to redo the formulas, which the Senate could do, Grassley said. “We’ve got equal representations for rural areas.”

But in the House of Representatives, California, Texas, Louisiana, Florida, New York, Massachusetts and Illinois have a majority of representatives, Grassley said. “They got a good thing going, and they ain’t gonna give it up.”

Congress is also trying to match reimbursement to quality of care. Right now Louisiana gets more money than Iowa though Iowa’s quality of care is rated better, Grassley said.

In the last 30 years, Congress has created programs to help Medicare-dependent hospitals and critical access hospitals, Grassley said. “So those programs are still in place,” he said.

Medicaid is meant for the disabled, for pregnant women, people in poverty and “grandma in the nursing home,” said Grassley. Those people will not see a change, he said.

But people between the ages of 19 and 64 who are able to work will be required to do so.

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“If you’re 19-64 you have to get a job,” said Grassley, but “job” is a flexible word. A person can work as little as 20 hours a week, or take care of an elderly relative at home, work for a non-profit organization or go back to school, Grassley said.

President Joe Biden made Medicaid available to illegals aliens, said Grassley, and Congress changed that, saving billions of tax dollars.

The program was meant for the low income and the vulnerable, Grassley said.

Ukraine

“I hope peace happens,” said Grassley in answer to questions about Ukraine. Not only in Ukraine, but in Sudan and the Middle East.

President Trump thinks he “move the ball” with his meeting in Alaska with Russian President Vladimir Putin, but Grassley wasn’t so sure.

Grassley wants the U.S. and Europe on the same page — supporting Ukraine, he said. They have to make sure Russia doesn’t invade Ukraine again. It shouldn’t have happened this time, he said.

When the Soviet Union broke up, Ukraine had 1,900 nuclear weapons, said Grassley, and the west thought the world would be safer if fewer countries had nuclear weapons. Signers of the Budapest Agreement of 1993 assured Ukraine that they would protect that country if it gave up its nuclear weapons, Grassley said.

But a line was crossed, and no one did anything about it.

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Agriculture

Asked about bringing migrant workers into the U.S. for agricultural jobs, Grassley said the U.S. brings in a million people legally each year, but the last time Congress passed an immigration bill was in 2013 and the last time they debated it was 2018 when the Deferred Action for Childhood Arrivals policy prevented the deportation of children who were brought into the county illegally, a move Grassley approved of. He doesn’t consider children brought in by their parents illegal, he said.

Legal immigration for engineering and agricultural jobs is not controversial, Grassley said, but he doubts the president would consider it while he’s focused on deportations.

“I’m chairman of the committee, so I could get it out of committee right now,” Grassley said, but it’s just “spinning your wheels.”

Education

Education, according to the U.S. Constitution, is supposed to be controlled by state and local governments, said Grassley in response to a question about educational spending.

The federal government doesn’t give much direction in education, Grassley said. It tried No Child Left Behind, but that proved to be a mistake, he said.

At that time the federal government was putting $60 billion into education, but test scores were getting worse. The policy encouraged teachers to “teach to the test,” Grassley said.

Today, more control over education is in the hands of state and local governments, said Grassley.

“Every program we’re talking about … existed before the Department of Education,” said Grassley, and those programs will continue to exist if there is no Department of Education because Congress isn’t going to repeal those programs, he said.

Partisanship

As to the partisanship, “What you think is going on in Washington really isn’t,” Grassley said. “It’s a lot worse than when I went there 45 years ago … but it's not as bad as you think.”

Media make you think Republicans don’t talk to Democrats, Grassley said. That’s not true. It’s easier for Grassley to talk to some Democrats than to some Republicans, he said.

When Grassley introduces a bill, he tries to find a Democrat cosponsor, he said. He and Illinois Sen. Dick Durban worked four years on a criminal justice reform bill, and it passed, but “no one heard about that,” he said.

“What you see in the media isn’t real.”

Biofuels

The biofuel industry could benefit Iowa in the future, “as long as we don’t have 100% electric vehicles by 2035,” said Grassley.

“If you want an electric vehicle, you can buy one, but we aren’t going to force you to buy one,” Grassley said. Congress has done away with the $7,500 incentive to buy electric vehicles.

“We set up all this alternative fuels because we thought we weren’t going to have this energy,” said Grassley. That hasn’t proven to be the case.

Grassley, Iowa Sen. Joni Ernst and Minnesota Sen. Amy Klobuchar have co-sponsored the Ethanol for America Act which deals mostly with E15 but would increase the use of E85, Grassley said.

Congress needs to pass laws concerning biofuels to bring certainty to the industry rather than leaving the industry at the mercy of the White House.

National debt

Yes, the Big Beautiful Bill increases the national debt, Grassley admitted, but it saves $1.2 trillion that would have been spent without it.

The only way to rein in the national debt is to balance the budget, Grassley said, and until Congress gets the 2/3 vote it needs to amend the Constitution to require a balanced budget, that won’t happen.