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By Lyle Muller December 17, 2021

Context needed for Grassley comment about Medicare vote

If Your Time is short

• Congress approved raising the federal government’s debt ceiling in December while also extending Medicare funding at current levels for three months.

• Sen. Chuck Grassley, R-Iowa, objected to tying the Medicare extension to the debt ceiling and voted no on the bill, prompting back-and-forth accusations from Grassley’s potential Democrat opponent in the 2022 election and a former Grassley staffer.

• Back-and-forth accusations are common in politics but Abby Finkenauer’s claim that Grassley voted to slash Medicare funding needs context.

Democrats controlling the U.S. Senate with Vice President Kamala Harris’ tie-breaking vote came up with a plan earlier this month to circumvent the Senate’s 60-vote rule for raising the federal government’s debt ceiling: Combine in one bill a procedural vote saving Medicare from automatic funding cuts for 2022 with the unusual authorization of a one-time only Senate majority vote to raise the federal government’s debt limit.

It’s a move journalist Lindsey McPherson called in a Dec. 13 Roll Call story "an age-old Washington trick for must-pass legislation that requires bipartisan support: Pair the thing the minority hates with something they support and hope they feel the good outweighs the bad."

The legislation passed 59 to 35, with 10 Republicans voting yes and six senators not voting. 

The ploy didn’t pass muster for Sen. Chuck Grassley, R-Iowa, though, who voted against the legislation. Grassley said he opposed the part that authorized raising the debt ceiling without a 60-vote Senate approval. That brought a response from Democrat Abby Finkenauer, the former U.S. representative from Iowa running in 2022 for the seat Grassley holds. Finkenauer tweeted on Dec. 9:

"It’s not surprising that @ChuckGrassley would fight to preserve the filibuster while voting to slash Medicare, but it’s sure as heck not acceptable. D.C. hasn’t been working for DECADES and this guy is the problem."

Michael Zona, former spokesman for the Senate Finance Committee and Grassley when Grassley led that committee, saw the tweet and responded

"Another day, another lie. Grassley explicitly stated he supported the Medicare policies. Honesty isn’t Abby’s strong suit. Abby accomplished nothing in the House and now she has opinions about how the Senate should operate. I’m gathering humility isn’t her strong suit either."

Finkenauer’s campaign staff called foul, saying Zona unfairly accused Finkenauer of lying. Zona told PolitiFact Iowa he was referring specifically to the assertion that Grassley voted to slash Medicare, so we looked at the record.

Political rhetoric galore

Defining political opponents’ actions in ways that provoke negative emotion also is an age-old Washington trick, practiced in abundance in a town whose major industry is influencing others to take preferred actions on behalf of the public. With this approach, failing to vote yes on a bill that stops automatic Medicare funding cuts gets defined as a vote that allows Medicare cuts.

Republicans voting no included Sen. Joni Ernst, R-Iowa. "It’s a bad position to be in. I don’t like being put in this position," Ernst told Roll Call’s McPherson. "But, you know, Medicare is important.

Republicans voting no on this legislation thought they had something to gain: pinning the blame for raising the federal government’s debt ceiling but also high spending on Democrats, even though raising the ceiling authorizes the government to pay existing bills, not take on new spending.

Grassley said in a prepared statement that he objected to authorizing a procedural vote without the Senate’s 60-vote requirement to increase the debt ceiling in an otherwise non-controversial bill. 

"I support the health care-specific provisions reflected in the Medicare extenders package, which the Senate will soon take up, that would prevent cuts and changes to Medicare providers," he said, referring to an upcoming procedural vote on extending legislation. "In fact, I supported an amendment that would have provided for a clean Medicare extender package." 

Grassley had joined Sen. Lindsey Graham, R-South Carolina, Ernst and 19 other senators on Dec. 8 in support of an amendment that would have eliminated the last portion from the legislation. That portion – Section 8 –  contained the language giving the Senate authority to expedite through Dec. 31 a vote on raising the debt limit a non-specified amount by using a joint resolution, which would allow a simple majority vote instead of a 60-vote majority to pass. The amendment failed.

"Had the bill not included the debt ceiling provision, Sen. Grassley would have supported it," Grassley’s communications director Taylor Foy wrote in an email to PolitiFact Iowa.

Foy sent a list of 16 legislative bills Grassley supports that provide Medicare access and health care benefits. Grassley sponsored some of them, including the Rural Health Clinic Protection Act that was part of legislation signed into law in April that also spared Medicare for nine months of automatic 2% spending cuts. The latest action stops cuts for three months. Medicare was headed for a 2% sequestration cut on Jan. 1 and a mid-January 4% cut in Medicare provider payments. 

"Sen. Grassley supports the 60 vote threshold to reach finality on legislation, which forces bipartisanship and collaboration on proposals being considered during the normal course of action in the Senate," Foy wrote. "But, that wasn’t his chief concern regarding the process in this particular instance. His procedural concern here is that a supposed ‘one-time’ change of the Senate rules (whether related to vote thresholds or not) rarely results in a one-off event, and tactics to sidestep the Senate’s standing rules are often repeated once the precedent is set."

Christian Slater, Finkenauer’s campaign communications director, countered in a PolitiFact Iowa interview that Finkenauer was on solid ground and not lying about Grassley’s vote. The legislation before the Senate specifically protected Medicare funding from being cut, and Grassley voted against it, he said.

"It doesn’t matter what you theoretically support — you voted to cut Medicare," Slater said.

Slater had a list, too, of votes Grassley took in 2012 and 2013 on proposals by then U.S. Rep. Paul Ryan, R-Wisconsin, to cut federal spending. The 2012 budget proposal, which failed 41 to 58, capped Medicare beneficiary payments for people under the age of 55 at 2012 levels, with annual, inflationary adjustments. Democrats said then that Republicans voted to end Medicare, earning PolitiFact’s 2011 Lie of the Year designation, although PolitiFact noted that Democrats’ assertion that the Republican plan would privatize Medicare was Mostly True.

Slater cited that privatization attempt as a bid to cut Medicare funding. He cited Grassley votes to revisit the Ryan budget proposal in 2012 and also a 2013 Grassley vote on an involved budget amendment to bring down proposed fiscal 2014 spending, revise spending levels for fiscal 2013 and set federal budget levels through 2023. 

That budget amendment was tied to a Ryan budget proposal to rein in the federal spending growth rate and included a Medicare policy that would have given seniors the option of using subsidies to buy private health insurance. The moves failed in the Democrat-controlled Senate.

This time around, Grassley voted against legislation that, had his side prevailed, would have resulted in automatic cuts to Medicare funding unless further action were taken.

Why? Because of budget sequestration, the method by which federal funding is cut automatically under the Budget Control Act of 2011 that allows spending caps if spending exceeds congressional appropriations.

Words matter

Zona countered by referring to the 2021 Medicare and debt ceiling legislation’s words. For Finkenauer’s assertion to be true, Zona said, the legislation would have had to state specifically that Medicare was being slashed. It does not use those words, he said.

"There was never a vote to cut Medicare funding, or to slash it," Zona, who is out of government now and spokesman and senior vice president at a public affairs company, Bullpen Strategy, told PolitiFact Iowa in an interview. He followed up in an email, writing that Grassley delivered as chairman of the Senate Finance Committee expanded Medicare benefits to "tens of millions of Americans."

Our ruling

Finkenauer said Grassley’s vote against the combined Medicare extension and debt ceiling meant voting to slash Medicare. Is Finkenauer lying, as Zona tweeted?

She is correct about Grassley declining to vote in this instance to stave off a pending Medicare funding cut and, for that matter, about wanting to preserve the Senate’s 60-vote rule. But the legislation did not specifically call for slashing Medicare funding — if a 2% cut fits the definition of slashing — or close the door on finding another way to avoid cutting Medicare funding.

The exchange between Finkenauer and Grassley is just the latest example of the two parties forcing their opponents to vote on combinations of measures that force them to choose between voting for something they don’t like, or voting against something they do. If they pursue the latter course, it can be weaponized into campaign attacks. Both parties do this regularly.

Figuring out how Congress works through various pieces of legislation and how debate is carried out in a political dispute like this benefits from having context. We rate Finkenauer’s statement to be Half True.

Our Sources

U.S. Congress, S.610 – Protecting Medicare and American Farmers from Sequester Cuts Act text and roll call vote

Roll Call, "Medicare cuts scare helps put debt limit bill on fast track," by Lindsey McPherson, Dec. 13, 2021

Joseph Zeballos-Roig tweet, Dec. 9, 2021

Abby Finkenauer tweet, Dec. 9, 2021

Michael Zona tweet, Dec. 9, 2021

Chuck Grassley statement on extending Medicare and the debt limit vote, Dec. 9, 2021

Phone interview and email exchanges with Christian Slater, Dec. 15, 2021

Phone interview and email exchanges with Michael Zona, Dec. 15, 2021

Email exchanges with Taylor Foy, Dec. 15, 2021

U.S. Department of Treasury debt limit description

The Hill, "House approves bill to ease passage of debt limit hike," by Cristina Marcos and Mike Lillis, Dec. 7, 2021

U.S. Congress, S.1844 – Lowering Medicare Premiums and Prescription Drug Costs Act

U.S. Congress, H.R.5099 – Lowering Medicare Premiums and Prescription Drug Costs Act

U.S. Congress, S.935 – Rural Health Clinic Protection Act

U.S. Congress, H.Con.Res.112 – Establishing the budget for the United States Government for fiscal year 2013 and setting forth appropriate budgetary levels for fiscal years 2014 through 2022 text and vote

U.S. Congress,  S.Con.Res.44 – A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2013 and setting forth the appropriate budgetary levels for fiscal years 2014 through 2022 text and vote

U.S. Congress, S.Amdt.433 to S.Con.Res.8 — An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023, text and vote

U.S. Congress, S.Amdt.243 to S.Con.Res.8, text 

U.S. Congress, H.R.1868 – To prevent across-the-board direct spending cuts, and for other purposes, text and vote

U.S. House, "Summary of the Budget Control Act of 2011," Aug. 3, 2011 

Center on Budget and Policy Priorities; "Senator Lee’s Budget Would Sharply Cut Social Security, Medicare, Other Programs While Making Tax System Less Progressive;" by Paul N. Van de Water; May 16, 2012

Text of Amendments; Congressional Record Vol. 159, No. 42, (Senate – March 21, 2013)

U.S. News and World Report, "Congress Moves Forward on Debt Ceiling Deal to Avert Default," by Lisa Hagen, Dec. 7, 2021

Politico, "Ryan budget: Challenge to W.H., DOA;" by Jonathan Allen and David Nather, March 12, 2013

Congressional Budget Office, Sequestration

American Hospital Association news release, Dec. 9, 2021

American Academy of Physical Medicine and Rehabilitation news release, Dec. 9, 2021

PolitiFact, "Lie of the Year 2011: ‘Republicans voted to end Medicare,’ " by Bill Adair and Angie Drobnic Holan, Dec. 20, 2011

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Context needed for Grassley comment about Medicare vote

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