Hospital groups say the GOP budget resolution would cut Medicaid coverage to millions and further hurt struggling providers.
The budget resolution released late Sunday includes at least $715 billion in cuts to Medicaid, a federal program that shares costs with states for healthcare coverage for low income families and for long-term care.
"Over 70 million Americans depend on Medicaid for care from the doctor's office to the hospital to the nursing home, and critical providers in between," said Chip Kahn, president and CEO of Federation of American Hospitals. "Congressional Republicans and President Trump rightly pledged to protect Medicaid benefits and coverage – this bill fails that test," Khan said.
If passed, the bill would threaten the ability of the nation's financially struggling hospitals to maintain services, according to Rick Pollack, American Hospital Association president and CEO.
"The magnitude of the proposals contained in the Energy and Commerce reconciliation text represents a devastating blow to the health and well-being of our nation's most vulnerable citizens and communities. There is no avoiding the real-life consequences they will create for hospitals serving our most vulnerable and hard-working families," Pollack said.
The nonpartisan Congressional Budget Office found that the health provisions in the bill would cause at least 8.6 million Americans to lose coverage.
The House Committee on Energy and Commerce will be marking up its portion of the resolution called "One Big, Beautiful Bill" starting at 2 p.m. Tuesday, May 13.
The committee would then vote on whether to pass the bill's amendments to the full House.
Republican leaders want to pass the measure in the House by Memorial Day, according to The Wall Street Journal.
WHY THIS MATTERS
The budget resolution calls for at least $715 billion in cuts to Medicaid but it also affects the Affordable Care Act by "addressing waste, fraud and abuse," and would reportedly require those in the ACA marketplace to pay up to $1,000 in out-of-pocket costs.
It ends the long-term care staffing mandates put forward by the Biden administration.
Medicaid, not Medicare, pays for most long-term care, said Nicole Jorwic, chief program officer, Caring Across Generations, who spoke on a press call on Monday.
The bill curbs climate change and green energy initiatives and gives $500 million for AI and information technology modernization.
On Medicaid, the bill doesn't go far enough for some conservative Republicans, according to the WSJ. It doesn't lower the minimum share the federal government contributes to Medicaid in each state or cap per-person federal spending, the report said.
Also, according to the WSJ, the proposal would clamp down on states' use of special tax arrangements to pay their share of Medicaid costs and would freeze, at current rates, arrangements known as "provider taxes."
Here's how the bill would change current Medicaid coverage and policy:
- Medicaid recipients would be subject to work requirements.
- They would be required to re-enroll in Medicaid twice a year, instead of the current once a year.
- The proposal would require recipients making more than 100% of the federal poverty level, or $15,650 for a single adult, to pay 5% of their income for healthcare, with the exception of primary, prenatal, pediatric and emergency care.
- It would curb federal funds for facilities that provide abortion services or gender transition for minors.
- It would prohibit individuals without verified citizenship or nationality, or satisfactory immigration status from receiving benefits. This includes DACA, or Deferred Action for Childhood Arrivals, according to participants in Monday's press call.
It doesn't just cut Medicaid, it guts Medicaid, said Anthony Wright, executive director of Families USA, which held the press call.
Behavioral health would be affected, said Monique Stanton, president and CEO of the Michigan League for Public Policy.
There's no way states can absorb the federal reductions, call participants said. In New Jersey, the bill would slash $2 billion to $10 billion a year from the state's Medicaid program, said Laura Waddell, Health Care Program Director, New Jersey Citizen Action.
THE LARGER TREND
House Energy and Commerce Committee Chairman Congressman Brett Guthrie (KY-02), a Republican, said Sunday in an op-ed for the WSJ that the budget reconciliation bill is common sense.
"When President Trump took the podium for his Second Inaugural Address, he promised a 'revolution of common sense' that would launch a generation of growth, health and prosperity. Today, our country faces numerous threats to that goal. Medicaid waste and abuse threatens the well-being of America's most vulnerable as the looming expiration of important 2017 tax reforms throws a shadow over U.S. industry.
"This reconciliation legislation will help raise federal revenue and limit government spending to what actually helps Americans. We will raise $88 billion by reauthorizing the Federal Communications Commission's spectrum auction authority and provide resources to modernize federal information-technology systems. Both are crucial for maintaining and expanding U.S. technological leadership.
"Without Republican solutions, Washington risks a complete collapse of Medicaid. Even with these simple steps to eliminate waste and abuse, Medicaid spending will continue to rise every year for the foreseeable future."
Energy and Commerce Health Subcommittee Ranking Member Diana DeGette (CO-01), a Democrat, said: "House Republicans are terrified the American people will learn the details of their plan to gut Medicaid, so they want to pass this monstrosity of a bill less than 48 hours after making the bill public to distract and mislead their constituents. They want to kick at least 8.6 million Americans off their healthcare to pay for tax cuts for billionaires, and that is exactly what this bill will do. House Republicans are so laser-focused on pleasing Trump, they are willing to make their constituents' lives harder and healthcare more expensive."
"Throughout the markup for this legislation, I will call out Republicans for their disgraceful policies, force votes on amendments to protect Medicaid, and stand up to their brazen disregard for their constituents' well-being while they pad the pockets of billionaires like Elon Musk."
Email the writer: SMorse@himss.org