Medicaid cuts move closer to reality

The House Budget Committee will meet Friday in the next step toward passage of a massive bill that would extend tax cuts, establish new tax breaks and potentially take health coverage from  millions of Americans.

Earlier this week, Republicans on the House Energy and Commerce Committee advanced legislation containing cuts to Medicaid and health care provisions. The bill now heads to the Budget Committee, which will combine it with legislation from other committees that are advancing the Trump administration’s priorities.

Republicans in Congress are trying to come up with ways to offset $880 billion in spending cuts over a decade to fund a domestic policy bill that would include extending the tax cuts in the 2017 Tax Cuts and Jobs Act. Reports estimate that as much as $600 billion of those spending cuts could come from federal health care programs.

The Congressional Budget Office estimates that 5.7 Americans could lose their Affordable Care Act coverage by 2034 over the proposed changes. In addition, proposed changes to Medicaid could lead to 8 million losing coverage over the next decade.

The Medicaid-related provisions included in the Energy and Commerce Committee’s proposed legislation include:

• Establishing work requirements on able-bodied Medicaid recipients. The proposed bill would require recipients to be employed, attend classes or training, or perform “community engagement” for a minimum of 80 hours a month to maintain coverage. This provision will take effect in January 2029.
• Restricting subsidies on the ACA marketplace for those who lose Medicaid coverage as a result of not complying with work requirements. Subsidies are currently available for those with annual incomes between 100% and 400% of federal poverty level.
• Requiring patient co-pays for Medicaid enrollees with incomes up to 130% to 138% of the federal poverty level— around $35,000 a year for a family of three.

Preliminary estimates by the CBO suggest that the health provisions, including those related to Medicaid, could reduce the federal deficit by $715 billion over 10 years.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at susan.rupe@innfeedback.com.