State-by-state report by Dems projects millions could lose Medicaid coverage

BY: JENNIFER SHUTT

WASHINGTON — A report released Thursday by Democrats details how many people in each state would lose access to Medicaid if Republicans in Congress were to cut the program by one-third — a scenario some GOP lawmakers have floated as an option to help pay for tax cuts, though one so sweeping it would struggle to get the votes needed to become law.

The Joint Economic Committee – Minority report, shared first with States Newsroom, projects that 25 million people throughout the country would lose access to Medicaid if Republicans were to enact a law cutting funding to the health care program for lower income Americans by one-third.

Among them, 3 million would be rural residents and 10 million would be children. Additionally, 1 in 5 seniors could lose Medicaid coverage of their nursing home care, according to the report.

The state-by-state breakdown in the JEC report shows that California, Florida, Illinois, New York and Texas would have the highest numbers of residents harmed by the potential cuts. Each of those states could have more than 1 million residents potentially kicked off the program.

The Joint Economic Committee includes members of both chambers of Congress and both political parties. It's designed "to review economic conditions and to recommend improvements in economic policy," according to its website.

New Hampshire Democratic Sen. Maggie Hassan, ranking member on the Joint Economic Committee, said in a statement that House Republicans' plans "could take health care away from up to 25 million Americans."

"This new Joint Economic Committee analysis sheds light on the number of people who could lose health care coverage because of President Trump and Congressional Republicans — and the devastating impacts that their budget could have specifically on the ability of children, seniors, and people living in rural areas across the country to access health care," Hassan said.

$880 billion in spending cuts

Republicans in Congress are trying to figure out how to pass several of their core policy goals, including extending the 2017 tax law, through the budget reconciliation process.

The House approved a budget resolution in late February that would clear the way for lawmakers to increase the deficit by as much as $4.5 trillion to accomplish their tax goals. But that budget resolution also proposes several committees find savings, including the Energy and Commerce Committee.

That panel, tasked with finding at least $880 billion in spending cuts, oversees several federal programs, including Medicare and Medicaid.

Republicans and President Donald Trump have been clear they will not be touching the Medicare program, which provides health insurance for retired Americans and some people with disabilities.

But GOP lawmakers are debating how exactly to find savings in the Medicaid program, though they could face intense blowback given how many of their own voters rely on the program for health care. Medicaid is a joint federal-state program that helps cover medical costs for some people with limited incomes.

Republicans in Congress cannot actually advance a reconciliation bill until after the House and Senate agree to adopt the same budget resolution, which has yet to happen.

Senate two-bill plan

The Senate voted in mid-February to approve its own budget resolution that proposes a two-bill strategy for enacting Republican campaign promises.

Under the Senate budget resolution, which House leaders have vowed not to take up, Congress would first pass a bill to boost defense and border security spending by hundreds of billions of dollars as well as remaking the country's energy policy.

The Senate strategy would then have Congress adopt a second budget resolution later this year, setting up a pathway for Republicans to extend the 2017 tax law.

The Senate is expected to take up the House's budget resolution at some point and make changes to the document, though when exactly they'll do that is an open-ended question. The budget resolution would then have to go back to the House for final approval.

CBO report

The Joint Economic Committee – Minority report made public Thursday came out just one day after the nonpartisan Congressional Budget Office released a letter detailing how much federal funding the House Energy and Commerce Committee oversees.

CBO Director Phillip L. Swagel wrote that the letter was in response to a request from House Budget Committee ranking member Brendan F. Boyle, D-Pa., and Energy and Commerce Committee ranking member Frank Pallone, D-N.J.

The Energy and Commerce Committee, Swagel wrote, oversees $8.8 trillion in spending over the 10-year budget window when Medicare spending is excluded, which is what Boyle and Pallone requested.

Of that total, $8.2 trillion, or 93%, goes toward Medicaid, Swagel wrote.

The Energy and Commerce Committee, which House Republicans expect to find at least $880 billion in spending cuts, oversees just $381 billion over the 10‑year budget window that doesn't go toward Medicaid or the Children's Health Insurance Program, or CHIP.

Those CBO numbers would indicate that if Republicans stick to the goals in the House budget resolution, which very well could change in the Senate, they would likely have to cut hundreds of billions of dollars from Medicaid.