An inflated pig with the message “Medicaid Is Not A Piggy Financial institution For Billionaires” is stationed at a rally opposing Home Republicans Tax Proposal previous to the ultimate Home Vote on Capitol Hill on Could 21, 2025 in Washington, D.C.
Jemal Countess | Getty Photos Leisure | Getty Photos
Whereas some Medicaid cuts proposed in Republicans’ One Massive Stunning Invoice Act had been rejected by the Senate parliamentarian on Thursday, different reforms to this system that would have an effect on people’ entry to protection had been left untouched.
The Senate parliamentarian rejected proposed adjustments geared toward capping states’ supplier taxes, that are used to assist fund states’ Medicaid expenditures. The Senate provision reduces the protected harbor restrict in growth states and places a moratorium on any new supplier taxes in all states.
But different components of the proposed Medicaid cuts — together with new work requirements of 80 hours monthly and extra frequent redetermination evaluations each six months — made it previous the Senate referee.
“The Senate invoice, just like the Home invoice, contains deep cuts to Medicaid and different well being applications, and is deeply dangerous, whether or not or not these provisions keep in or out,” mentioned Allison Orris, senior fellow and director of Medicaid coverage on the Middle on Funds and Coverage Priorities.
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The Home model of the One Massive Stunning Invoice Act would cut back federal Medicaid spending by nearly $800 billion, in accordance with estimates from the Congressional Funds Workplace.
Republican lawmakers are pushing to go the invoice by way of funds reconciliation, an expedited legislative course of that requires a easy majority vote. This week, the Senate parliamentarian evaluated whether or not the proposal complies with the Byrd rule, which prohibits the inclusion of adjustments which might be extraneous to the funds.
Whereas the Senate parliamentarian’s choices imply sure provisions can not keep in as written, that leaves room for lawmakers to vary the language of the proposal or make different changes.
How Medicaid supplier taxes might have an effect on protection
Medicaid supplier taxes provide a method for states to lift cash for the non-federal share of funding towards this system, Orris mentioned. If states are restricted on how they’ll try this, the federal authorities will spend much less on Medicaid, she mentioned.
The CBO scores a discount in supplier taxes as a Medicaid lower, Orris mentioned, as a result of it’s assumed states won’t be able to switch that income.
In response to restrictions on supplier taxes, states may make choices that may end in folks shedding Medicaid protection, Orris mentioned. Primarily based on the Home model of the invoice, the CBO has estimated round 400,000 folks may lose Medicaid protection based mostly on the proposed adjustments to supplier taxes, she mentioned.
Some Republican lawmakers have expressed issues that the adjustments to the supplier taxes would hurt rural hospitals financially and immediate them to reduce services or close.
Along with Medicaid supplier taxes, the Senate parliamentarian additionally rejected proposals to make certain immigrants who usually are not residents ineligible for Medicaid protection.
About 7.8 million folks might lose Medicaid coverage based mostly on each the Home model of the “huge lovely” invoice and Reasonably priced Care Act adjustments together with expiring subsidies and rule adjustments proposed by the Trump administration, in accordance with Washington, D.C.-based assume tank Third Method.
In a recent report, Third Method discovered the funds invoice might improve medical debt by $50 billion — a 15% rise over right this moment’s $340 billion in unpaid money owed.
