Tillis announces retirement amid Medicaid funding fight (06-30-2025--Hour2)

What's going on. Thank you so much for listening to this podcast. It is heard live every day from noon to three on WBT Radio in Charlotte. And if you want exclusive content like invitations to events, the weekly live stream, my daily show prep with all the links, become a patron, go to dpeteclendershow dot com. Make sure you hit the subscribe button. Get every episode for free right to your smartphone or tablet, And again, thank you so much for your support. All Right, so I have the audio of Tom Tillis's fine, We're not final speed, but his first speech from the Senate floor after he voted against the one Big, Beautiful Bill and then announced he would be retiring. And here were his comments, and they only run about ten and a half minutes. I chopped it into two sections here, but at the core of his argument and his disaffection is the medicaid cuts in the Senate bill, and he says it's going to hurt hospitals because they're not going to get as much money back through the medicaid process. By the way, did you see also or here also that massive bust like fourteen and a half billion dollars in medicaid fraud they just busted the Yeah, I'll get to it, but they I mean, they just made the announcement within like the last hour. Yeah, this is the problem with expanding the gov co health programs. I was saying it for fifteen years. North Carolina should not expand Medicaid, should not do this, and then they went and did it, and lo and behold, within a year, you got the FED saying, yeah, you know what, We're going to cut down those reimbursement rates. And everybody's like, oh my god, I can't believe it. Really I could, and every Republican in the state General Assembly understood that. That's why they didn't at least that's why they said, didn't expand it. For over a decade, they did not take the bait that Obamacare was offering them. And then they take it finally, caving, they take they break down, They take the bait, and now the switch. If only we could have predicted such a thing. So here's Tillis from the floor of the US Senate this weekend. Mister President. I spent most of my career in management consulting, managing large, complex enterprise projects, multi year, thousands of hours, a lot of complexity that take people, process and technology to make it work. I learned a lot in that career, and I was able to go to the legislature and take that mindset as a member of the minority for two terms, and then we got a majority in twenty ten and I found myself being the Speaker of the House. Mister President, we were in the middle of the financial crisis when I got sworn in in January of two thousand and eleven. North Carolina had a. Two billion dollars shortfall on a twenty billion dollar general revenue fund and I had six months to balance that budget. Well, mister President, we did something that not been done in North Carolina. We took the time to understand every aspect and every dollar that was being spending government. We determined how to cut government in a way that was sustainable. We cut twelve percent from the university system budget, not the rate of growth, but the actual spending. And I had some people say that it was going to be disruptive and the University of North Carolina would never be the same again. But mister President, we did it in a way that was instructed by the operations of the university system, and we did it in a way in concert with the chancellors, and you know what happened, mister President. We actually balanced the budget, We did do those cuts, and the last time I checked, the North Carolina University system is still considered one of the greatest systems in the United States of America. Why do I use that example because the medicaid proposal in this bill bears no resemblance to that kind of discipline and due diligence. It has no insights into how these provider tax cuts are going to be absorbed without harming people on Medicare. And even worse, most of my colleagues do not even understand on either side of the aisle the interplay of state directed payments and the devastating consequences of the funding flows that are going to be before as mister President, Here's how I figured out the impact of North Carolina. I used to be Speaker of the House, and I liked the Speaker and have good relationship with the Speaker and the President pro Tem. So I called them up and I had my staff asked them if they would do an economic impact assessment on what this proposed bill would do to the medicaid program in North Carolina. But I didn't want just. The view of the Republican partisan staff that were ports to the Speaker and the President pro tim on how they're going to absorb this. Bill. I decided to go to Josh Stein, the governor, and I went to his Democrat staff for Medicaid. I asked them to prepare an estimate independent of the estimate that I had done with fiscal research. But I took a step further, mister President. I went to the Hospital Association. I asked three different independent groups, a partisan Democrat group, a partisan Republican group of experts, and a nonpartisan group of the hospital Association to develop an intact assessment, independent. Not talking, not sharing, reporting to me. And what I found is. The best case scenario is about a twenty six billion dollar cut. Now we've got a. Delay, so it maybe two years, it maybe one year. All it does is make. That twenty six billion dollars happen in yere one or year twelve. But the impact is the same, mister President, and it's indisputable. Now when I actually pre is that at this report that you can find on my website. I had people in the administration say, you're all wet. You don't know what you're doing. I said, well, why don't we assemble a series of meetings. We're going to provide you are analytics. You go through it, tear it apart, mister, And I told him, Mamett Eyes, who I considered to be one of the most capable people in the Trump administration. He's a brilliant man, and I'd encourage my Democrat colleagues to talk to him. He knows this stuff and he's very focused on getting efficienci's out of CMS. So we had three different conference calls with CMS with Eyes on the phone and on the video and me on the video, and I said this, guys, I would love nothing more than you to prove me wrong. I would love nothing more for you. To tell me it's not twenty six billion or thirty billion, that it's two point six billion or two billion our two hundred million. But after three different attempts for them to discredit our s tons the day before yesterday, they admit it that we were right that between the state directed payments and the cuts scheduled in this bill, there's a reduction of state directed payments and then there's the reduction of the provider text. They can't find a hole in my estimate. So what they told me is that, yeah, it's rough, but North Carolina's use the system. They're going to have to make it work, all right, So what do I tell six. Hundred and sixty three thousand people in two years or three years when President Trump breaks his promise by pushing them off of medicaid because the funding's not there anymore? All right? That was his mic that cut out. I did not do that because the funding's not there anymore, guys. That's what he's That was the last bit. What do I tell the six hundred and sixty three thousand? So again it's like, okay, well, what population are we talking about? Are these the people that are of working age but refusing to work because part of this is a work requirement. The cost of Medicaid has blown passed all expectations over the last four years. Jeremy Negozian over at National Review. He has a very in depth piece called Explosive Medicaid Growth, calls for significant reforms given the countryes deteriorating financial prospects. Congress must address Medicaid's uncalled for growth. Though the federal state program is meant to provide health care for only the poorest Americans. It has expanded beyond that important purpose through and after the pandemic, despite the growing economy. Medicaid is the third largest government program, and it has grown faster than both Medicare and Social Security, despite these latter programs bearing the load of increased numbers of re tiring baby boomers, with fewer people needing the support as the pandemic faded away and the economy grew, Medicaid would have been expected to shrink in the past four years. Yet here we are with growth defying all projections. States have strong incentives to game Medicaid because the federal government is footing the bill. It is the exact same problem, I would add that we have with the entire health insurance and healthcare industry, where the doctors don't know what things cost, the patients don't know what things cost because there is a middleman between us and it is the insurance companies, and they do the negotiations with these hospital associations and these provider associations. The doctors don't know and the patients don't know. And when nobody knows what the cost of it is, sure, yeah, we'll just say yes. To anything. I'll get everything done even if you don't need it. All right, if you're listening to this show, so you know I try to keep up with all sorts of current events, and I know you do too. And you've probably heard me say get your news from multiple sources. Why well, because it's how you detect media bias, which is why I've been so impressed with ground News. It's an app, and it's a website, and it combines news from around the world in one place so you can compare coverage and verify information. You can check it out at check dot ground, dot news, slash pete. I put the link in the podcast description too. I started using ground News a few months ago and more recently chose to work with them as an affiliate because it lets me see clearly how stories get covered and by whom. The blind spot feature shows you which stories get ignored by the left and the right. See for yourself. Check dot ground, dot news, slash pete. Subscribe through that link and you'll get fifteen percent off any subscription. I use the Vantage plan to get unlimited access to every feature. Your subscription then not only helps my podcast, but it also supports ground News as they make the media landscape more transparent. Part two. Part two of Tom Tillis's speech from the US Senate Chamber where he's explaining why he's opposed to the One Big, Beautiful Bill, and it all has to do with the cuts to Medicaid, where he says, twenty six billion dollars cut to North Carolina. I think it's over the next ten years. And this is now breaking the promise of President Trump that nobody is going to lose their health insurance. And I would point out Medicaid is non health insurance. It is a program. When the White House richer is advising the President are not telling him that the effect of this bill is to. Break a promise. And you know, the last time I saw a promise broken around healthcare with respect to my friends on the other side of the aisle, is when somebody said, if you like your health care, you could keep it, If you like your doctor, you could keep it. We found out that wasn't true. That made me. The second Republican Speaker of the House since the Civil War, Ladies and gentlemen, because we betrayed the promise to the American people. Two years later, three years later, it actually made me a US senator because in twenty ten it had just been proposed, and just anticipation of what was going to happen was enough to have a sea change election. The swhipt Republicans. Into the majority for the second time in one hundred years. Now Republicans are about to make a mistake on healthcare and betraying a promise. It is inescapable that. This bill, in. Its current form will betray the very promise that Donald J. Trump made in the Oval office or in the Cabinet room when I was there with Finance, where he said we can go after waste, fraud and abuse on any programs. Now, those amateurs that are advising him, not doctor Oz, I'm talking about White House healthcare experts, refused to tell him that those instructions that were to eliminate waste, fraud and abuse, all of a sudden eliminates a government program that's called the provider tax. We have morphed a legal construct that admittedly has been abused and should be eliminated. And to waste fraud and abuse, money laundering. Read the code. Look at how long it's been there. I was Speaker of the House. I refused to do it. When I left North Carolina, I said we're not going to do a provider tax. I left it at two and a half percent, now six mistake on the part of the leadership. And frankly, I know my friends are probably going to think I'm a little bit crazy here, but I actually passed a lot. It made it illegal to expand Medicaid. Why did I do that because I was convinced someday we would be here and I would have rather found a way to get more people on Medicaid at the standard f map than having this ninety ten match and watching it disappear and taking away desperately needed healthcare. So, mister President, over the course of the evening, I may look for an opportunity to speak again, but I'm telling the President that you have been misinformed. You supporting the Senate mark will hurt people who are eligible and qualified for Medicaid. I love the work requirement, I love the other reforms in this bill. They are necessary, and I appreciate the leadership of the House for putting it in there. In fact, I like the work. Of the House so much that I wouldn't be having to do this speech if we simply started with. The house mark. I've talked with my colleagues in North Carolina. I know that we can do that, and I believe that we can make sure that we do not break the promise of Donald J. Trump that he's made to the people who are on Medicaid today, mister President, but what we're doing because we've got a view on an artificial deadline on July fourth, that means nothing but another date in time. We could take the time to get this right if we lay down the house mark of the Medicaid bill and fix it. And I know that my friend in Kylleade from New Hampshire, I jumped in front of her. So I'm only going to take another minute or two. But mister President, we owe it to the States to do the work to understand how. These proposals affect them. How hard is that? I did it? How hard is it? How hard is it to. Sit down and ask the Medicaid Office, ask the legislative staff, ask the Independent. Hospital Association what the impact is. If there's no negative impact, what's wrong with daylight? What's wrong with actually understanding what this bill does, Mister President. I know what it does because I spent a career implementing complex systems. And then I had the privilege of being Speaker of the House, and I implement a limited government setting. And since I've been here, I've focused on bills and what's their implementation from the cradle until they're fully implemented. Mister President, we owe. It to the American people, and I owe it to the people of North Carolina to withhold my affirmative vote until it's demonstrated to me that we've done our homework. We're going to make sure that we fulfill the promise, and then we can feel I can feel good about a bill that I'm willing to vote for, but until that time, I will be withholding my vote. All right, So here is my hot take, not really hot, it's like a it's like a mid the lukewarm take, which is isn't this what US senators were supposed to originally be doing, right before the US Senate was turned into a popularly elected body. They were appointed US senators in the constitution original they were appointed by the state legislatures and to advocate for those state legislative bodies and to advocate for the states. And that's what I thought when I heard Tellis's speech. Regardless of the merits of what he's saying, he's taking a position that is in defense of and protective of the state legislative bodies. I just thought, like, huh, hadn't seen that in a while, actually ever in my lifetime. Here's a great idea. Yep, how about making an escape to a really special and secluded getaway in western North Carolina. Just a quick drive up the mountain and Cabins of Ashville is your connection. Whether you're celebrating an anniversary, a honeymoon, maybe you want to plan a memorable proposal, or get family and friends together for a big old reunion, Cabins of Ashville has the ideal spot for you where you can reconnect with your loved ones and the things that truly matter. Nestled within the breath taking fourteen thousand acres of the Pisga National Forest, their cabins offer a serene escape in the heart of the Blue Ridge Mountains. Centrally located between Asheville and the entrance of the Great Smoky Mountain National Park. It's the perfect balance of seclusion and proximity to all the local attractions, with hot tubs, fireplaces, air conditioning, smart TVs, Wi Fi, grills, outdoor tables and your own private covered porch. Choose from thirteen cabins, six cottages, two villas, and a great lodge with eleven king sized bedrooms. Cabins of Ashville has the ideal spot for you for any Asian and they have pet friendly accommodations. Call or text eight two eight three six seven seventy sixty eight or check out all there is to offer at Cabins of Aashville dot com and make memories that'll last a lifetime. I have a message from the hell Yan on Twitter who says, if Tillis is retiring, why the strong stand? It makes me think. It makes me think he's compromised. Yeah. Like, I try not to assume motive of you know, of people, but I, you know, if he was looking to secure a spot at some lobbying firm on behalf of the healthcare industry, I suspect this would play very well for that audience. But I don't know. We'll see, we shall see. Let me get back to this piece at National res View by Jeremy Nigohosi nigohos Niosi. I don't know how to pronounce it. It's a very weird nigho niho hosien ni hoo ho hoosian. Anyway, it's called the explosive growth of Medicaid calls for significant reforms. He says states have strong incentives to game Medicaid because the federal government is footing the bill. Because states manage enrollment and reimbursement policies, the federal government does not have the means to verify state claims about their costs. Consequently, states develop new and creative funding mechanisms to exploit the system. For example, over the past ten years, states expanded a scheme wherein they imposed taxes on hospitals, nursing facilities, and other providers that serve Medicaid patients. I suspect this is called the provider tax cuts, right, So they provide, they impose taxes on these hospitals, and then they kick back the money to those providers via higher Medicaid reimbursements, and the states pocket the nine dollars in matching funds Washington sends, even though the dollar from the state gets paid back to its source, negating the tax altogether. States have found ways to take the federal money and have offload the costs and Perhaps that's exactly why North Carolina Republicans finally caved and expanded Medicaid. They figured out we could do this too, he says, And this is where Congress has a major reform opportunity. In May, the House passed its budget package that they dubbed the One Big Beautiful Bill Act. The largest spending reductions in the bill are targeted at limiting the recent expansion of Medicaid and the creative accounting that the states have been using to draw in federal money. While the House bill merely freezes the use of the provider tax gimmick in the future, the Senate bill is more restrictive, rolling back state's ability to employ it to the same three and a half percent threshold that President Obama endorsed in a budget he submitted to Congress what ten years ago. This is what Tillis has mad about. It's that the Senate bill is more restrictive rather than just freezing it. I think Tilla said at six percent, at least in North Carolina, the Senate bill rolls it back to three and a half percent. While some may believe the large matching funds that the federal government provides for state Medicaid spending may be at risk. In fact, the states can maintain the federal funding by shifting the tax from the providers to corporations in general, individuals, or any other part of their tax base. So the states are going to have to solve this, and that's what Tillos was complaining about. Also in that floor speech, the cost to ensure each Medicaid beneficiary has increased by twelve percent since twenty nineteen, so that's what five years, so a little bit more than two percent each year. The cost to ensure each Medicaid beneficiary gone up twelve percent, but the federal government is currently footing the entirety of that increase. The state spending per beneficiary has actually dropped by two percent over the same period. States are contributing a smaller percentage of their budgets today than they were in twenty twelve when Obamacare passed, So this is a massive offloading of the call lost to the federal government by the states, yet the states administer the program. Meanwhile, he says the amount sent from Washington has increased actual Medicaid spending last year twenty twenty four, actual Medicaid spending six hundred eighteen billion dollars, which, this may come as a surprise, was about one hundred billion more than projected, because, of course it's always more than projected. It's always more than projected. Given the growing size of the federal government's debt and the large and growing drag that servicing that debt will place on government programs in the future, Congress must oblige the states to pay more, or force the states to pay more for any program they want to expand. The Senate's more ambitious approach is the one that Congress should take. This is again, according to this guy Jeremy nae Egosi in the Googojo Sian something Anyway at Nationalreview dot com. Right, if states want to as North Carolina just finally caved in and did, if they want to expand Medicaid, and they want to include people that are able bodied, that can be working but don't work. Although part of this Senate one big beautiful bill does have a work requirement in it, as it should, because again, the original intent for Medicaid was not to provide universal health coverage for all Americans and even non Americans to some degree. Right, you've got you got a really clear line here, and the Republicans used to understand this at the state level, but then they flipped, and I suspect it was because the pressure from the health care industry. That's my suspicion. Because they saw there was a trough of money that the Feds were filling up and they said, we need to get us some of that. And here's how you do this mechanism, this creative mechanism that we see other states doing, and you can offload more the costs to the Feds, and the hospitals and the industry get to keep more money too, and then the state can actually lower its contribution to Medicaid. You know, stories are powerful. They help us make sense of things, to understand experiences. Stories connect us to the people of our past while transcending generations. They help us process the meaning of life. And our stories are told through images and videos. Preserve your stories with Creative Video started in nineteen ninety seven and Minhill, North Carolina. It was the first company to provide this valuable service, converting images, photos and videos into high quality produced slide shows, videos and albums. The trusted, talented and dedicated team at Creative Video will go over all of the details with you to create a perfect project. Satisfaction guaranteed. Drop them off in person or mail them. They'll be ready in a week or two. Memorial videos for your loved ones, videos for rehearsal, dinners, weddings, graduations, Christmas, family vacations, birthdays, or just your family stories, all told through images. That's what your photos and videos are. They are your life told through the eyes of everyone around you and all who came before you, and they will tell others to come who you are. Visit creative video dot com. So after Tom Tillis makes his announcement that he will not be supporting moving forward with the One Big Beautiful Bill because of his concerns over the Medicaid funding cuts to the States, Donald Trump takes to the truth social it's a mean truth, or because it's not a tweet anymore. They used to be mean tweets, but now they're not tweets. They're not even tweets on x anymore. They're I guess now they're just mean posts. Anyway, Trump said, quote numerous people have come forward wanting to run in the primary against Senator Tom. He put that in quotes for some reason. I don't know why, because that's Senator Tom Tillis. That's that that doesn't need the scare quotes. But Senator Tom Tillis, I will be meeting with them over the coming weeks looking for someone who will properly represent the great people of North Carolina and so importantly the United States of America. Thank you for your attention to this matter. So that starts. So that starts the pylon, the social media pylon. That was at. Seven one pm on Saturday. Two hours later, two and a half hours later, Trump is out with a longer post. Looks like Senator Tom Tillis, as usual, wants to tell the nation that he's giving them a sixty eight percent tax increase as opposed to the biggest tax cut in American history. At the same time, he is unable to understand the importance of debt extension, which Republicans gave to the Democrats just prior to the November fifth election because of its significance and how important it was for the future of the USA. Sadly, the Democrat politicians probably won't reciprocate on a debt extension because they're nasty people who actually hate our country. Tillis is also willing to throw the very important tobacco industry in North Carolina. Quote out the window, end quote for reasons nobody seems to understand. He loves China made windmills that will cost a fortune, ruin the landscape and produce the most expensive energy on Earth. I can't believe that the great people of North Carolina, a state that I love and I won all three times, and a state that I just brought back with money, blood, sweat and tears from the recent tragic floods when Sleepy Joe let them drown right up until the end of that administration without doing anything. I was given an A plus rating for the job we did in bringing it back, and Tillis, despite being a Republican, was missing in action North Carolina. I'm not taking a breath here because he doesn't ever. There's no period anywhere in this entire rant. It's just complete stream of consciousness here. Lots of dashes though, but no periods. North Carolina will not allow one of their senators to grandstand in order to get some publicity for himself for a possible but very difficult re election. America wants reduced taxes, including no tax on tip tips, no tax on overtime, and no tax on social security, interest deductions on cars, border security, a strong military, and a bill which is great for our farmers, manufacturers, and employment in general. A bunch of random commas in there. Tom Tillis is making a big mistake for America and the wonderful people of North Carolina. That was at ninety eight pm. Then after midnight, three hours later tonight we saw a great victory in the Senate with a great, big, beautiful bill. But it wouldn't have happened without the fantastic work of Senator Rick Scott, Senator Mike Lee, Senator Ron Johnson, Senator Cynthia Loomis. They, along with all of the other Republican patriots who voted for the bill, are people truly love our country. As President of the USA, I am proud of all of them and look forward to working with them to grow our economy, reduce wasteful spending, secure our border, fight for our military and veterans, ensure that a medicaid system helps those who truly needed, protect our Second Amendment, and so much more. God bless America, and make America great again. And then he said later, Tom Tillis has hurt the great people of North Carolina. Even on the catastrophic flooding, nothing was done to help until I took office. Then a miracle took place. Tillis is a talker and a complainer, not a doer. He's even worse than rand Faucy Paul. And then Tillis says he's not going to run for reelection, and he says, great news, Senator Tom Tillis will not be seeking reelection. All right, that'll do it for this episode. Thank you so much for listening. I could not do the show without your support and the support of the businesses that advertise on the podcast, so if you'd like, please support them too and tell them you heard it here. You can also become a patron at my Patreon page or go to thepetecleanershow dot com. Again, thank you so much for listening, and don't break anything while I'm gone.