Millions of Americans could lose their Medicaid coverage under Republican plans to vastly cut federal spending.
Lawmakers on the House Committee on Energy and Commerce, which has jurisdiction over Medicaid, are mulling over changes to the health care insurance program that benefits more than 70 million Americans nationwide.
Committee Republicans have found at least $880 billion in spending cuts, largely to Medicaid, to help cover the cost of $4.5 trillion in tax breaks wanted by President Donald Trump.
Why It Matters
Millions of Americans—particularly low-income individuals, the elderly, and immigrants living in the country without legal status—are at risk of losing access to Medicaid under the proposed legislation. According to estimates from the nonpartisan Congressional Budget Office, the bill in its current form would lead to 10.3 million people losing some coverage and 7.6 million people going uninsured.
What To Know
A slew of changes are on the way if the current proposed bill is successful. Not all of these changes would come into force immediately upon the bill’s passage, but all changes would be implemented within the coming decade.
Low-Income Adults
One of the main reforms is introducing new work requirements. Able-bodied adults aged under 65 without dependents will be required to engage in a minimum of 80 hours of paid work or 80 hours of “community engagement”—such as voluntary work. Exceptions will be made for pregnant women and in cases of short-term hardship. This could particularly impact those who have irregular employment.
There will also be new co-pays for those earning over a certain threshold. Medicaid recipients who make more than 100 percent of the federal poverty level—which is around $32,000 a year for a family of four—would be required to pay an out-of-pocket cost of $35 for some services. Fees would not apply to emergency room visits, prenatal care, pediatric visits or primary care checkups.
Illegal Immigrants
The proposed bill also includes provisions aimed at immigrants without legal status. Contained in the bill is a 10-percentage point reduction in the federal funding allocated to states—such as New York or California—that permit illegal immigrants to enroll in Medicaid.
Stricter immigration checks would also be implemented if the bill passes.
Jemal Countess/Getty Images for Protect Our Care
Abortion and Gender Care
Medicaid funds will also be prohibited from being paid to Planned Parenthood, while federal matching funds will also be prohibited for “gender transition procedures”—including puberty blockers, hormone treatments and surgeries—for individuals under the age of 18 enrolled in the program.
Eligibility Checks
The bill also mandates states to conduct Medicaid eligibility redeterminations at least every six months for adults covered under the Medicaid expansion, up from the current annual check. Such administrative burdens could cause people to lose coverage simply due to paperwork delays or logistical obstacles, critics have argued.
What People Are Saying
Representative Brett Guthrie of Kentucky, the GOP chairman of the Energy and Commerce Committee, said: “Savings like these allow us to use this bill to renew the Trump tax cuts and keep Republicans’ promise to hardworking middle-class families.”
House Speaker Mike Johnson said: “Medicaid is intended, remember, as a safety net for young pregnant mothers and the elderly and disabled and vulnerable populations, not for young able-bodied men without dependents. Those are the kinds of people we’re taking off the program.”
Representative Frank Pallone of New Jersey, the top Democrat on the panel, said: “In no uncertain terms, millions of Americans will lose their health care coverage.
“Hospitals will close, seniors will not be able to access the care they need, and premiums will rise for millions of people if this bill passes.”
Darbin Wofford, deputy director of health care at Third Way, a center-left think tank, previously told Newsweek in an emailed statement: ” No matter how Republicans try to spin it, this bill means major cuts to the Medicaid program.
“This package will mean millions of people losing their coverage and exploding our medical debt crisis, all to pay for tax cuts for the wealthy.”
What Happens Next
The bill needs to win over nearly every Republican on the floor of the narrowly divided House. If it passes, it will then be considered in the Senate.