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Medicare expansion TRANSCRIPT: 8/4/20, The Rachel Maddow Show

Guests: Amy Klobuchar, Louann Woodward

CHRIS HAYES, MSNBC HOST: That is the story so far of 2020, amidst the  pandemic and everything else. 

Dale Ho and Vanita Gupta, thank you so much, both of you. That was great. 

That was ALL IN on this Tuesday night. 

I have great news for you. "THE RACHEL MADDOW SHOW" starts right now with  the one and only Rachel Maddow. 

Great to have you back, Rachel. 

RACHEL MADDOW, MSNBC HOST: Thank you very much. It was really nice to be  away. It both felt like a visit to another planet and also like I was only  gone for 30 seconds. 

HAYES:  Yes, exactly. 

MADDOW:  Anyway, thank you, my friend. Appreciate it. 

And thanks to you at home for being with us this hour. It was great to have  a few days off. 

I want to say thanks in particular to my dear friends, my very beloved and  respected colleagues Ali Velshi and Nicolle Wallace for pinch hitting for  me. I want to thank my staff for keeping THE RACHEL MADDOW SHOW going with  all cylinders firing while I was away and those guest hosts were here in my  seat. And that`s to all of you guys for not minding too much for when I  need to go turn off my brain for six days and not be here. So it was  really, really nice and a real privilege to have that time. I am grateful  for it.

But I am back, and, honestly, now coming back to this news day, now I am  more than ready to turn my brain off again, because, you know, you come  back, you know, just -- I will just say, here`s the thing that should  never, ever, ever, ever, ever happen from the White House. Not only should  this never happen from the White House, it should never happen anywhere  anyone is in any position of supposed authority. 

I mean, what happened today shouldn`t happen from a White House podium, but  it also, like, shouldn`t happen from a teacher`s desk. It shouldn`t happen  from the voice of a cop giving you a parking ticket. It shouldn`t happen  from a PA announcement at a supermarket about which car has its lights on  in the parking lot. 

This shouldn`t come from anybody who purports to be giving you actual  information from any position of purported authority. But here it was today  from the mouth of the president of the United States. Him -- just winging  it, just making it up as he goes along because who cares, right? 

(BEGIN VIDEO CLIP)

DONALD TRUMP, PRESIDENT OF THE UNITED STATES:  The United States stands  ready to assist Lebanon. I have a very good relationship with the people of  Lebanon and we will be there to help. It looks like a terrible attack. 

(END VIDEO CLIP)

MADDOW:  It looks like a terrible attack? What? It was an attack? Said the  president?

I mean, the news today out of Lebanon is absolutely terrifying, right? This  huge, huge blast in the densely-packed city of Beirut. At least dozens of  people killed, thousands of people known to be injured. A significant area  of that big and important city just decimated. 

It was an attack? The president today speaking from the White House podium  called this a, quote, terrible attack. 

To be clear, before the president said that today from the White House,  there had been no public indication at all that this was an attack. That  this was some sort of terrorist or military assaults on the city of Beirut.  I mean, when the president of the United States speaking from the White  House podium says "this is an attack," that`s a huge piece of news. That`s  a huge deal. That`s, like, announcing the start of a war kind of news from  the mouth of the president of the United States. 

Except with this president, nah, turns out, grain of salt, he makes stuff  up. He didn`t know if it was an attack. Even when he was saying it`s an  attack, he didn`t know. He was just spitballing-ish. 

(BEGIN VIDEO CLIP)

REPORTER:  I just want to follow up before I ask the coronavirus question  on Lebanon. You called this an attack. Are you confident that this was an  attack and not an accident? 

TRUMP:  Well, it would seem like it. 

(END VIDEO CLIP)

MADDOW:  It would seem like it. I mean, it seemed like it. 

When I announced that huge blast in Lebanon today was a terrible attack, I  was just, you know -- seems like maybe. Don`t listen to me on stuff like  this. I really do make things up and then blurt them up as they occur to  me. 

I mean, it is very nice to have had a few days away. It is nice to be back  from a week`s vacation. Nothing got better while I was gone. That was  absolutely atrocious today at the White House. 

I mean, what other president did stuff like that? This one does that as a  matter of course. Over the course of the week that I was gone, though, I  think that we have a natural -- whether you`re on optimist or a pessimist,  I think we have a natural human inclination to believe that longstanding  problems that require fixing eventually over time get worked on and start  to get fixed, even if progress is slow and halting. 

It doesn`t work that way with this administration. I mean, over the course  of the week that I was gone, in fact, I think the coronavirus response from  the president, from this White House actually got worse. I mean, the weird  attacks and conspiracy theories about Anthony Fauci, about the nation`s top  infectious disease doctor, those absolutely have continued apace, if  anything, they appear to have accelerated over the past week. 

But now, in the past week, those attacks have also extended to the White  House`s hand-picked COVID chief, Dr. Deborah dirks. She`s now getting the  same treatment. 

And with over 157,000 Americans dead, with us steaming toward 5 million  infections, millions more infections than any other country on earth, the  increasing chaos and incoherence and incompetence at the White House  matters in life and death terms. I mean, it matters for the overall numbers  of Americans dead and sick and unemployed and infected and scared. 

It also matters to every single American family that right now is trying to  figure out if they`re going to be working, and if their kids are going to  be in school. I mean, here`s Dr. Deborah Birx. Like her or don`t, right?  She`s the head doctor on the White House`s coronavirus task force response  team. 

Here is Dr. Deborah Birx on CNN`s "State of the Union" on Sunday. Quote: If  you have a high caseload and active community spread, we are asking people  to distance learn at this moment, so we can get this epidemic under  control.

She`s saying, if you have a lot of cases, if you have the active spread of  the virus in your state, well, school buildings should stay closed for now  and kids should keep doing distance learning until that high caseload is  brought down, until active community spread is stopped. This is not like a  mandate from Dr. Birx or anything, but she`s explaining this as a clear,  scientifically grounded principle for how we should think about whether  schools can open, how we should think about what criteria should be used to  make decisions about schools opening, right? 

This is her telling us how we should think about schools and whether or not  kids are going to be remote learning in an ongoing way or whether they can  actually go to a physical school building. You can`t open schools unless  your case numbers are way down and the spread of the virus is under control  in your state. That`s Dr. Deborah Birx speaking, you would think, on behalf  of the White House. 

But then here`s the president at 11:30 last night, all caps: open the  schools! And that`s his reasoned, scientifically-based argument. Open the  schools!  

So that`s what we`ve got as American policy on coronavirus and schools.  Good luck, every family in America who is agonizing over this. Good luck  and God bless. This is the president who we have for this time. 

I mean, your kids will never again be the age that they are now. They will  never again be this age going into this grade, thinking about this time in  their education. But there will always have been this president at this  time in their lives, right? Screaming into the void, open the schools! Even  as his own coronavirus coordinator tells the public that we cannot do that  until it`s safe, and here`s why. 

And this kind of mishegoss should, you know, shape your view of who we have  elected president in this country, but it also just makes a real difference  in terms of the way we live and the way we try to handle this and the way  we try to save lives or not. I mean, having bad, incoherent, increasingly  insane leadership on this subject screws things up materially in ways large  and small every single day, right? 

And every single day is a new 1,000 deaths in this country. Every single  day is a new 50,000-plus cases. Having bad leadership messes things up.  Having confused leadership messes things up. 

Take, for example, the great state of Tennessee. The same Dr. Deborah Birx  from the White House has advised Tennessee that looking at their numbers  and looking at how things are going, they should climb back down on some of  their reopening decisions. She has advised Tennessee that they should close  bars, that they should limit indoor dining at restaurants. 

But, you know, if you run the state of Tennessee, why would you think that  you should listen to the top doctor tapped to lead the coronavirus response  for the nation? I mean, president picked her for that job and he doesn`t  listen to her. He`s now publicly dragging her, the way he`s publicly  dragging Dr. Fauci. 

Frankly, in Tennessee, following his lead, Republican U.S. Senate  candidates are competing with each other during their primary process as to  who can rip Dr. Fauci with the worst insults and who can more effusively  promote that malaria drug the president is still inexplicably saying is a  cure for coronavirus, even though it is not a cure for coronavirus.

And so, if you`re governor of Tennessee, how do you look at that? Well,  turns out the way you look at that is who cares if Dr. Deborah Birx says  Tennessee should close the bars and roll back indoor dining, right? Why  would you think you should follow that advice, even though it`s coming from  the top doctor in the coronavirus response hand-picked to that job by the  president? 

And so, Governor Bill Lee of Tennessee hard that advice from Dr. Deborah  Birx and said, no, no, you think I should close down the bars and limit  indoor dining? No, I`m not going to do it. I don`t want to so I`m not going  to. And who`s to tell him any different? Really, who`s to tell him? 

I should tell you that Tennessee had a 139 percent rise in coronavirus  cases over the month of July. But now it`s August, so now maybe August will  be great. About two weeks ago, the Trump administration, specifically the  part of the administration that regulates nursing homes, an agency called  CMS, they announced that they would be requiring weekly testing for all  nursing home staff, weekly testing for all nursing home staff in any state  where the positivity rate was over 5 percent. 

Well, that`s about 2/3 of all U.S. states now. And so what that means in  practical terms is that there are thousands of nursing homes in the United  States, in the more than 30 states where the positivity rate is over 5  percent, thousands of nursing homes that per the Trump administration are  supposed to be testing all of their staff every week. And the Trump  administration says we are requiring you to do so. 

Thousands of nursing homes in more than 30 states, how many -- how many of  them do you think are weekly testing their staff right now? How`s that  going? We are nowhere near to get every nursing home in every one of those  states the capacity to test their staff every week, but the Trump  administration says they`re requiring that.

Saying that they`re requiring that is apparently the Trump administration`s  plan for stopping tens of thousands more Americans from dying in nursing  homes, right? That`s -- that`s their plan, to say that they`re requiring  that. Which is about as realistic as me fly home from this studio on the  back of a giant, you know, rainbow sequined unicorn. I`m just say that what  I`m going to do. 

That`s -- saying that you`re requiring something that can`t be done and  you`re not facilitating so that it can happen doesn`t count as a plan.  That`s a myth. That`s a lie. 

It`s the absence of a plan. It takes up the space where a plan should be.  So instead nothing happens. 

In Mississippi, teachers in Mississippi are calling for schools in that  state to stay on distance learning only until the state`s positivity rate  is under that same threshold, as the nursing homes rule. They want 5  percent positivity or less in Mississippi before they open up school  buildings in that state. They want 5 percent or less. 

Mississippi`s positivity rate is currently more than quadruple that.  Mississippi`s positivity rate right now is currently over 20 percent. It`s  the worst in the country. 

Nevertheless, Mississippi`s Republican Governor Tate Reeves has just  announced that even though he is now willing for there to be a statewide  mask rule, that was just announced today, he said there still won`t be a  statewide delay in school openings, even with positivity rates over 20  percent. I mean, the state`s teachers, the head of the University of  Mississippi Medical Center have been calling for that statewide delay, but  at least now he says, no, not willing to do that in Mississippi. 

He`s decided, instead, he will tell students over grade seven in eight  specific different counties that they should delay school by two weeks  because that sounds like data? I mean, but, anyway, he`s making it up on  his own. Who`s to tell him different? If he got advice from the White House  on this, even the president wouldn`t tell him to follow White House advice.  White House advice comes from doctors and the president likes dragging the  doctors for political effect. 

I will tell you, among Mississippi`s problems right now is not just that  they`re approaching the highest per capita infection rate in the nation and  their positivity rate is over 20 percent and their biggest hospitals are  full already and they have been full for weeks now. Among Mississippi`s  problems right now is that so many Mississippi residents are dying so fast  right now that the morgues in the state are overtopped. 

See the headline in "The Daily Beast." morgues are overflowing in  Mississippi and coroners are terrified. The head of the University of  Mississippi medical center is going to join us live tonight in just a few  minutes. I`m very much looking forward to that conversation.

But, you know, it`s not, I mean, I singled out Tennessee and Mississippi  there. Even states in other parts of the country that have done relatively  well over the last weeks and months, Massachusetts, for example.

Massachusetts brought its case numbers way, way, way down from what had  been a scary peak in late April, but in Massachusetts, numbers have started  going back up as the state has opened back up. And, yeah, the positivity  rate in Michigan right now is roughly 1/10 the rate they`ve got in  Mississippi, but the trend is in the wrong direction. It is starting to go  back up. Positivity numbers are starting to rise. Case numbers are starting  to rise. 

Anecdotal information about hospitalization suggests that the uptick in  hospitalizations in Massachusetts is starting to become systematic as well.  And so, epidemiologists in the state of Massachusetts are now telling that  state`s Republican Governor Charlie Baker that he should go back to what  works. He should go back to the so-called phase 2 operations the state was  under before when the case numbers were being held very low and slow and  Massachusetts look like a model for the nation. Go back to that. 

Since Governor Baker said, no, I want to move forward and go to phase 3  with indoor dining and all the rest of it, well, that`s when the numbers  have started going back up, so why would you stick with that? 

One expert from Boston University School of Public Health telling the  "Boston Globe," quote, I would back up to the last level the governor had  that we know worked. Somewhere between that and where we are is the sweet  spot. Level two worked. Level three didn`t work. 

Right. When your case numbers are going up, your positivity rates going up,  your hospitalizations and death numbers are going to follow that  trajectory, too. If that`s the trend line you`re on, it means what you`re  doing isn`t working. You have to do something else. 

If you had been doing well before and now you stopped doing well, go back  to what you were doing when you were doing well. It`s not rocket science.  We don`t have a cure. The only interventions we have are the simple dumb,  hard things that we fight over. Masks, and social distance, and keeping the  schools closed and keeping workplaces closed and having rules about  gatherings. That`s all we`ve got. 

It`s not rocket science. But you do the things that work, and when your  numbers show you that new things that you`re trying don`t work, you stop  doing them. But, you know, who`s to tell you what to do? Who`s to say? 

If you even got advice from the top doctor working at the White House on  these issues, should you follow their advice? She was picked for the job by  the president. The president says she`s terrible now and is disparaging her  and dragging her for political effect, so do you listen to her? Who`s to  tell you what to do? Do you listen to the president? 

That said, in 91 days, we all get to decide if the guy who`s currently in  charge of how we`re responding to this epidemic should stay in the job for  four more years or if Democratic candidate Joe Biden would do better at  this. It`s honestly hard to know what it will be like for a president to  stand for re-election with 200,000 dead Americans as a key metric from his  first term, while he asks for a second term. 

But we`re going to talk tonight about how some of that is going to work and  some of what we can see coming down the pike. And a lot of it is very  worrying, in terms of the institutions of our democracy and what we count  on to keep us a constitutional republic. 

We`re going to be talking tonight, for example, about what appears to be  one sort of shocking sign that the White House doesn`t expect President  Trump to be here for a second term. Back in April, the administration went  to Congress and told them that because of COVID, they were going to need  some more time to get the census done. Instead of basically finishing up  the census and turning in the results of it by the end of this year, they  wanted a few months` extension, an extension into next spring, to be able  to get the thing done and compiled. 

And it honestly makes sense. The census is a huge undertaking, right?  You`re trying to count over 300 million people. It involves huge numbers of  people doing tons of shoe leather work. 

And lots of its offices were closed for months because of the pandemic. So  it makes sense that they would need some extra time to finish it up. 

The associate director for the 2020 census recently did a briefing where he  said there was definitely not enough time for the Census Bureau to get this  thing done properly on the original schedule, unavoidably because of COVID  and so, yeah, they needed the extension. 

But now, a sudden about-face, a sudden U-turn from the Trump administration, because I think they just realized what that means if  they`re going to take that extension that they asked for. The  administration has suddenly just announced that they`re not only going to  take that extra time they asked for, they`re actually going to wrap up the  whole census thing early. They`re going to stop the count a month early. 

They`re going to stop the count altogether actually next month. Which on  its surface is a little bizarre, right? I mean, they`ve already said  they`re crunched, they`re not going to get this done without extra time to  complete it because of the pandemic. 

As Vanita Gupta points out, she was just on with Chris Hayes tonight here  on MSNBC. She was the head of the civil rights division at the Justice  Department in the Obama administration. She points out that the census is  calling it quits early, even as their response rate right now is the lowest  it`s ever been. 

At this point in the process, they have counted fewer of us than ever  before, at this point in the process. And so, why would they cut off the  counting early? They would not only need that extension, they would need to  scale up what they`re planning on doing, so why would they be cutting it  back, right? 

On the surface, it makes no sense. If you actually want to count everyone  in the country, you need the extra time, and they should not only be taking  the extension, they certainly shouldn`t be stopping work early. I mean, the  census is supposed to count everyone in the country. If that`s what you  want to do, what the Trump administration is doing right now makes no  sense. 

If, however, they`re not really interested in counting the whole country,  and if specifically they`re not interested in counting the people who are  hardest to count -- poor people, minorities, marginalized populations,  people who move a lot, people who are in homeless shelters, people who are  hard to find -- if the Trump administration doesn`t really want to count  those people because maybe they don`t want those people to be counted, they  don`t want, for example, all the consequences of those people being  counted, which include federal funding for places where those people live,  right? Getting congressional seats apportioned to places where those people  live. 

If, for example, you`d be happier with those people never getting counted  at all, well, then cutting off the count early will conveniently cut out  the people who get counted last, the people who are hardest to count,  hardest to find, people hardest to lock down in terms of getting a census  response. 

But in terms of this decision being made late by the Trump administration,  I think they`ve also realized that by wrapping this thing up early, right,  rather than taking the extension that they were going to, by wrapping this  thing up early, that also means they`re going to be handing over the census  data to the president who is in office this term. Not the one who will be  in office next spring. 

Under the deadline they had previously asked Congress for, they`d be  handing over the data to the White House in the spring, which happens to be  after the next inauguration. Now by walking away from that plan, which they  themselves said they needed because of COVID, now the data will be sent to  the president by the end of this year. Not next spring when Joe Biden very  well could be in the oval office. 

As Vanita Gupta puts it in her "Washington Post" op-ed today, quote, in the  event that President Trump does not serve a second term, cutting the census  short would ensure that decisions about congressional apportionment are  made under his presidency, not the Biden presidency that may be in effect  by next spring. 

So, I mean, what this looks like is that the White House thinks President  Trump is going to lose or at least they`re hedging their bets. And that  means cutting the census short from even what they said they needed. Thus  making sure that it`s Trump who will get the census data before Biden is  sworn in in January, so it will be Trump who can proclaim, census looks  good to me. And he can proclaim who has been counted where and which states  get additional congressional seats and which states lose them based on who  was counted and who was left out. 

It was the Trump administration itself that said they couldn`t get it done  in time. Now they`re like screw it, let`s not get it done in time and let`s  get this thing sealed and done before Biden gets here. At least Republicans  can grab extra seats in Congress that way, from a deliberately bad count.  That seems fair. Let`s do it that way. 

There are primaries under way today in Michigan, in Missouri, Arizona,  Kansas, Washington state. There are worries in those states tonight and  around the country right now and for the next 91 days about whether the  COVID necessity of mail-in ballots is another thing the president and his  administration could be messing with. Could try to mess with to try to keep  him and keep Republicans in office. 

New York state prosecutors have just told the courts they need action on  their subpoenas for the president`s financial records because of their  investigation into what they reference as, quote, extensive and protracted  criminal conduct at the Trump Organization. The president just told "Axios"  in this bizarre Jonathan Swan interview you`ve seen played all day that  150,000 Americans dead. 

He says, quote, it is what it is. A thousand Americans dying a day, he  says, ah, that`s the best we can do. I mean, he also got up at the White  House briefing room today and said, hey, look, Lebanon was just attacked. A  terrible attack. 

But, you know, he makes things up. Ninety-one days until the election, far  fewer than that before you and everyone you know starts voting by mail --  here we go -- all at once, everything all at once. 

Lots to get to tonight. Senator Amy Klobuchar is going to join us next. Do  stay with us. 

(COMMERCIAL BREAK)

MADDOW:  We`ve been watching the president`s efforts to undermine the  November election playing out before our eyes for months now. We have the  worst coronavirus epidemic on earth. Keeping Americans safe, therefore,  means that as many Americans as possible need to not crowd together in  polling places November or any other time. People instead should vote by  mail. 

And so, of course, the president has discouraged people from voting by  mail. He`s backed efforts to make it harder to vote by mail. He`s been  constantly promoting this lie that mail voting is rife with fraud. He`s now  put in a new postmaster general who is deliberately slowing down the mail  at the Postal Service, which means, of course, that means ballots maybe  won`t be delivered on time. 

I mean, as strategies go, it`s unsubtle. If you`re a president who thinks  you might not be able to win more votes in an election, you just create as  much smoke and chaos around that election as you can, use the control that  you have in the government to make the election less fair and maybe you`ll  be able to hold on to power somehow by claiming the election is tainted,  even if you loss. 

But if you are an administration or a political party that was starting to  worry that that plan might not work, if you wanted to try to lock in a  certain amount of political power for yourself for years to come,  regardless of what happens in November, well, then the first thing you  would probably think of to try to do that would be to mess with the census.

The census every ten years tries to count every person living in the U.S.  and where in the U.S. they live. That count is done this year. Every ten  years, 2010 -- it was 2000, 2010, 2020. 

The count that`s done this year will be used to determine America`s  political representation for years to come. How many members of Congress  every state gets for the next decade. It`s all based on how many people  live where and the fact that they get counted. 

Well, now, the census bureau has suddenly announced that it`s cutting its  count short. It will potentially miss millions of people who historically  have been the hardest to reach. Those people tend to be poor people, people  of color, immigrants and people who live in blue cities and blue states. 

So a flawed census count could help Republicans increase their  representation in Congress simply by not counting ton office people who  tend to live in Democratic districts, which is a neat trick.

Just to be safe, the Census Bureau has also announced that instead of  submitting their final numbers to the White House next April when Joe Biden  potentially could be president, they will submit them earlier than they  planned to do. They now say they`ll submit those numbers on December 31st,  so no matter how flawed the count, it will be Donald Trump who is still  there in the Oval Office to sign off on their work, even if his election  plans don`t work out. 

The next few months are going to be a wild ride, both in terms of the  election, but also, of course, what comes after. 

Joining us now, I`m delighted to say, is Senator Amy Klobuchar, Democrat of  Minnesota. 

Senator Klobuchar, it`s been too long. Thanks so much for being here  tonight. 

SEN. AMY KLOBUCHAR (D-MN): Well, thanks, Rachel. It`s great to be on. 

I can see you`ve done a lot of thinking over your time off and had much to  say, and, of course, you come back the day we`re yet into more shenanigans  are announced with the census. 

And I will say they`ve tried and failed several times. Remember the  citizenship question? When they tried to put that and the court pushed back  on that. 

Then, recently, the president has talked about not counting all people, but  just counting citizens and, of course, that is not what the law says. And  now, we get to the day. And what they`re trying to do here, of course, is  to lock in the Trump numbers on the census when, in fact, we have one of  the lowest numbers, as Vanita pointed out, in recent history of people  responding. People still have to respond. 

I did it today, Rachel. It took five minutes. Because I was afraid you`d  ask me if I didn`t. Census.gov. It`s really simple to do so everyone should  go do it when your show is over. 

But we need the time. And you don`t just tell all these people running the  census, guess what? We pulled it back a month. But I`m here with a  solution. 

The HEROES Act that passed the House, it`s been sitting on Mitch  McConnell`s desk for over two months, that we`re valiantly working every  day to get passed in the Senate. It actually contains an extension that  would extend it four more months because of the pandemic so we can get  people, especially on our tribal reservations, people of color, people who  have historically who haven`t been counted to be able to be counted. And  that`s what I think we should do, is to negotiate and get that provision in  a final bill. 

MADDOW:  It feels like such a profoundly cynical and partisan thing to  deliberately undercount the hardest people to count and to deliberately  move their own goal posts. It was the Trump administration that said they  needed more time to get this done rather than cutting it short so that they  can get these numbers to President Trump instead of a potential President  Biden. 

But that`s what it looks like from the outside. Do you feel like your  Republican colleagues in the Senate get that this is the wrong thing to do,  in terms of the census, just in terms of this being an effort with  integrity? 

KLOBUCHAR:  You know how they haven`t stood up. Time and time again, they  don`t stand up. And they`ve had one day to hear this. I`ll be talking to  them about it tomorrow. 

But I think beyond that, you have started to see some cracks when it comes  to, say, voting. And that you`ve seen -- you were just talking about with  the vote by mail. Trump is on one side. But you`ve got Republican  governors, Republican secretaries of state. 

Roy Blunt has been working with me on this pushing to say, hey, no matter  what Donald Trump says on his Twitter feed, people are going to vote by  mail. They`re doing it at rates of 60 percent to 70 percent. In the state  of Maryland in the GOP primary, over 95 percent of the people voted by  mail. 

It is happening before our eyes. So we need to make sure the states have  the resources that they need, and that`s what we`re also pushing for right  now. 

And it`s not just vote by mail. You know, if the president doesn`t want to  do vote by mail, even though he`s done it himself in the comfort of 1600  Pennsylvania Avenue, while people in Milwaukee stood in the rain in  homemade masks and in garbage bags just trying to exercise their right to  vote -- hey, some of this money is going to go big time to training poll  workers so people aren`t vulnerable, to sanitizing poll places, to make  sure polling locations are open early so that people are able to vote when  there`s less people congregating. 

We have to help the states on this. The Republicans know it and that`s what  I`m really focused on right now, in addition to this census issue. 

MADDOW:  Let me ask if you share some of the concerns that have been voiced  about what`s happening at the postal service. Obviously, the president has  installed a new postmaster general. I wasn`t speaking hyperbolically. He  has actually instituted policies that has deliberately slowed down the mail  process, which has alarmed a lot of people inside that agency. 

Are you worried that the president is messing with the postal service in a  way that could materially affect our ability to successfully vote by mail  nationwide? 

KLOBUCHAR: Completely. 

And let me make the case again to my Republican colleagues, which we will  be making, four of us, including Senator Schumer and Senator Gary Peters  actually sent a letter to the postal -- postmaster general asking a bunch  of questions about this because, yeah, this is going to be about ballots,  but it is also about people`s medications. 

During the pandemic, more and more people are getting their lifesaving  medications by mail. If they mess with stuff like this, they are literally  going to mess with people`s lives. I know as a result of this that Senator  Schumer and Speaker Pelosi I believe are going to be meeting with him and  asking these questions, because as we work, again, on this very important  HEROES Act, we have got to make sure that there`s also funding for the  Postal Service, because it`s not just the funding that`s an issue. It`s the  rules he`s put in place that has resulted in people getting delays in all  over their mail. Not just their ballots, all of their mail. 

MADDOW:  Senator Amy Klobuchar of Minnesota, it is great to see you. Thank  you so much for joining us tonight. 

KLOBUCHAR:  Good to see you, Rachel. 

MADDOW:  I missed talking to you. I hope you`ll come back soon. 

KLOBUCHAR:  Oh, I will be back very soon. Thanks, Rachel. 

MADDOW:  All right. Thanks, Senator. 

All right. Much more to come here tonight. Do stay with us. 

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

GOV. TATE REEVES (R), MISSISSIPPI:  We have to be very smart about  convincing Mississippians that wearing a mask is the right thing to do. And  I understand that a lot of you think we can just snap our finger and, all  of a sudden, 100 percent of the people will comply and everything will be  great. 

Some of you believe that if I will just opine that the statewide mask  mandate is the right thing to do that the virus will go away. Just like  when we sheltered in place for three weeks in April, the virus didn`t go  away. 

(END VIDEO CLIP)

MADDOW:  Mississippi Governor Tate Reeves speaking just over a week ago,  talking about why a statewide mask mandate was not needed in Mississippi.

Well, in the eight days since he made those comments, Governor Reeves has  now had a change of heart. Today, he announced a new executive order  mandating masks throughout that state. He also announced that he`ll delay  certain school openings, but not for all that many students and not for all  that long. 

Today, Mississippi`s top health official ordered anyone who tests positive  for coronavirus to immediately self-isolate or risk being subjected to  fines or even jail time. Mississippi has the second highest number of new  cases per capita in the country right now, behind only Florida, but they`re  gaining fast. New daily infections in Mississippi have roughly doubled over  the past month. Researchers expect that the state will overtake Florida and  claim the top spot in the coming days. The top spot being the state with  the highest infection rate in the United States. 

We`re starting to see record daily death tolls in Mississippi, hospitals  that are not only under strain right now. Many hospitals have been under  strain for weeks, which takes an immeasurable toll on the staff of those  hospitals. 

Here`s the head of the University of Mississippi`s Medical Center. 

(BEGIN AUDIO CLIP)

DR. LOUANN WOODWARD, VICE CHANCELLOR, UNIVERSITY OF MISSISSIPPI MEDICAL  CENTER:  Our ICUs are full. I mean, that is the bottom line. We have been  full for several weeks. When other hospitals around the state call us for  help, we`re unable to take their patients. We`ve had to assist a number of  times in having patients transferred actually out of state. 

What we have been doing has not changed the trajectory of our number of  hospitalizations, the number of new cases, et cetera. We need to do  something different. 

(END AUDIO CLIP)

MADDOW:  That is Dr. Louann Woodward. She simultaneously runs the  University of Mississippi Medical Center. She is dean of the University of  Mississippi`s Medical School and she still works as an emergency room  doctor herself. 

Each of those three jobs is something I cannot imagine ever having the  skill or energy to do even for one day, but doing all three of those jobs  at once seems superhuman. Doing all three of those jobs at once in the  middle of a pandemic when your state is on track to be the worst-hit in the  country in terms of cases per capita, that is whatever comes after  superhuman on the number line. 

But Dr. Woodward joins us now. 

Dr. Louann Woodward from the great state of Mississippi. Thank you so much  for taking the time to talk to us tonight. I know you are in demand. 

WOODWARD:  It`s a pleasure. Very glad to talk to you. 

MADDOW:  I`m worried about Mississippi`s case numbers. And what seems to be  on track to be the worst in the country in terms of cases per capita. That  said, there does seem to be some changes happening policy-wise. 

For example, the new mask order effectuated today by the governor. I know  that`s something that you supported. Overall, how worried are you about  your state and do you feel like the right decisions are being made? 

WOODWARD:  I think the right decisions are being made at this point. We do  have a statewide mask mandate in place, effective as of today. We have  taken action from the governor`s standpoint to delay some students` return  back to school, and I think both of those are positive moves in the right  direction. 

The work that we are doing from the Medical Center standpoint, that I`m  doing, that many on my team are doing, and other health care leaders across  the state are doing is to try to really get that message out to the  citizens in Mississippi that we can make a difference in the path that we  are seeing in this pandemic by behavior modification. So we are at a point  where we`re seeing an increased number of cases across the state, increased  hospitalizations, increased deaths. That`s happening statewide. It is also  happening here at our own medical center as well as other large hospitals  in the state. 

And with behavioral modifications, we can change that path that we see out  in front of us. And that`s really what I hope we can accomplish with the  actions that have been taken today. 

MADDOW:  I know that the University of Mississippi Medical Center is really  a flagship medical institution in the state, level 4 trauma center, you do  all the really complicated stuff, transplants and all that kind of stuff.  As other hospitals around the state have come to you for help, have wanted  to ship their patients with complex problems to you, I know that you have  had -- even at that flagship institution -- issues terms of capacity. 

What should we understand at the national level in terms of Mississippi  hospitals and what you have and what you need in terms of beds and in terms  of health care providers to staff those beds? 

WOODWARD:  So, a few points that I would make about that. We are the only  academic medical center in Mississippi, the only tertiary referral center.  The only level 1 trauma, level 4 in ICU. As you said, the only place doing  transplants. 

So for a lot of things like that, at the higher level of care, we are the  only in Mississippi. So it is typically our role to take patients that  other hospitals from outlying areas of the state, particularly the rural  areas, it is our role to take patients that need that higher level of care.  We are very uncomfortable and we are very unhappy when we are not able to  perform that function and that role. 

So it has been the case in the last few weeks when, in fact, we have been  unable to accept patients that needed to be transferred here and we had to  work with others to get them taken to hospitals out of the state of  Mississippi. 

MADDOW:  Hmm. 

WOODWARD:  So one point that I think people should recognize is some of our  hospitals in the rural areas of the state do technically have ICU beds. But  you have to realize that all ICU beds are not equal. 

In fact, these patients, the COVID patients, many times need bedside  dialysis and they need other support that is not available at outlying  hospitals that perhaps do have a five or six or ten-bed ICU unit, but they  don`t have the level of care that needs to be provided for these patients. 

Sometimes if you just look at the number of ICU beds available, you don`t  realize that distinction between the level of acuity that a particular  hospital can take care of versus another. 

Another point that I would make for Mississippi is we went into this  pandemic with a few features that were challenging to begin with. We are  number one on a lot of lists that you don`t want to be number one on. We  are number one in the rates of diabetes, hypertension, heart disease,  obesity, stroke, all of these bad things. 

We are also last in the ranking of the states when you look at physicians  per capita. 

So we started out with a population that was sicker than many in the United  States. And we started out with a challenge from our health care workforce  across the spectrum, but particularly physicians. That is not a good place  to start a pandemic. 

The challenges that presented themselves to us due to the pandemic were  layered on top of these chronic challenges that we already recognize and  that we already have to deal with. 

The result of this is, we have many patients that are very sick. We have  many patients that are very sick. We have ICUs around the state that are  full, and we have a workforce that is fatigued. The workforce is doing  everything that they can do, but if you look at all of the physicians, the  nurses, the respiratory therapists, all of the people that are taking care  of patients in the emergency accidents, in the COVID units, in the critical  care units, they are weary. 

MADDOW:  And that weariness is not only a moral challenge to the rest of us  to do what we can in terms of support, it`s a moral challenge to us as a  country to get this under control so that you and your colleagues, among  other things, can get a break from what you have been going through. 

Dr. Louann Woodward, vice chancellor at the University of Mississippi  Medical Center, dean of the University Medical School, practicing emergency  medicine doctor, you wear a lot of hats and your state is in a real  challenge right now. 

Thanks for helping us understand. Please come back soon. We would love to  stay in touch as you go through these challenges. 

WOODWARD:  It was a pleasure. 

MADDOW:  Thank you so much.

All right. We`ll be right back. 

(COMMRECIAL BREAK)

MADDOW:  Here`s something to watch. This is fascinating. I mentioned at the  top of the show we have a bunch of primaries today and tonight, Washington,  Missouri, Kansas. Look at this in Missouri. 

Voters in Missouri are deciding today and tonight whether they`re going to  expand Medicaid, right? Expansion of Medicaid is part of Obamacare, which  is something Republicans are still trying to kill entirely. 

But Missouri voters are voting on whether to do it any way. It could  provide health insurance coverage to over 400,000 people in Missouri, if  they decide to do it. Of course, over the objections of Republican  lawmakers in the state. 

If Missouri voters say, Missouri would become the sixth Republican  controlled state to vote to expand Medicaid at the ballot box just since  Trump has been president. They would follow Oklahoma a few weeks, and  Maine, Nebraska, Idaho. 

As of right now, we`re watching the results come in, in Missouri. It`s  obviously early yet, but if Missouri votes to expand Medicaid, again,  against the wishes of its Republican lawmakers, that will be a huge deal  for hundreds of thousands of people in that state being able to get health  insurance. Results continue to come in. 

Watch this space. 

(COMMERCIAL BREAK)

MADDOW:  That is going to do it for us tonight. It`s good to be back.  Thanks for being here. 

I will tell you, there`s one thing to watch tomorrow morning in the news,  10:00 a.m. Eastern, Sally Yates is scheduled to testify in the Senate, in a  public hearing. She, of course, was deputy attorney general under President  Obama. You may remember she resigned in protest over the Trump Muslim ban. 

She was also the one who came up to the White House in person and warned  the Trump White House that Mike Flynn, the national security adviser, was  secretly talking to the Russian government and lying about it. But 10:00  a.m. tomorrow, Sally Yates will be testify thing that public hearing in the  Senate, as Senate Republicans try to make the Obama administration seem  very bad as a way of trying to make Joe Biden seem very bad, in advance of  the election. 

I have a feeling she will -- she will hold her own. That`s tomorrow morning  10:00 a.m.

We`ll see you again tomorrow night. 

Now, it`s time for "THE LAST WORD," where the great Ali Velshi is in for  Lawrence tonight. 

Ali, my friend, I want to thank you for taking such good care of this show  while I was out last week. You were fantastic. 

                                                                                     THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY  BE UPDATED. END