Medicaid enrollees fear losing health coverage if Congress enacts work requirements
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition.
Strickland, who's unable to work due to her condition, chafed when she learned that the U.S. House has passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people.
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Winnipeg Free Press
11 hours ago
- Winnipeg Free Press
The GOP's big bill would bring changes to Medicaid for millions
WASHINGTON (AP) — Republican Sen. Josh Hawley has been clear about his red line as the Senate takes up the GOP's One Big Beautiful Bill Act: no Medicaid cuts. But what, exactly, would be a cut? Hawley and other Republicans acknowledge that the main cost-saving provision in the bill – new work requirements on able-bodied adults who receive health care through the Medicaid program — would cause millions of people to lose their coverage. All told, estimates are 10.9 million fewer people would have health coverage under the bill's proposed changes to Medicaid and the Affordable Care Act. That includes some 8 million fewer in the Medicaid program, including 5.2 million dropping off because of the new eligibility requirements. 'I know that will reduce the number of people on Medicaid,' Hawley told a small scrum of reporters in the hallways at the Capitol. 'But I'm for that because I want people who are able bodied but not working to work.' Hawley and other Republicans are walking a politically fine line on how to reduce federal spending on Medicaid while also promising to protect a program that serves some 80 million Americans and is popular with the public. As the party pushes ahead on President Donald Trump' s priority package, Republicans insist they are not cutting the vital safety net program but simply rooting out what they call waste, fraud and abuse. Whether that argument lands with voters could go a long way toward determining whether Trump's bill ultimately ends up boosting — or dragging down — Republicans as they campaign for reelection next year. Republicans say that it's wrong to call the reductions in health care coverage 'cuts.' Instead, they've characterized the changes as rules that would purge people who are taking advantage of the system and protect it for the most vulnerable who need it most. What's in the bill House Republicans wrote the bill with instructions to find $880 billion in cuts from programs under the purview of the Energy and Commerce Committee, which has a sprawling jurisdiction that includes Medicaid. In the version of the bill that the House passed on a party-line vote last month, the overall cuts ended up exceeding that number. The Kaiser Family Foundation projects that the bill will result in a $793 billion reduction in spending on Medicaid. Additionally, the House Ways & Means Committee, which handles federal tax policy, imposed a freeze on a health care provider tax that many states impose. Critics say the tax improperly boosts federal Medicaid payments to the states, but supporters like Hawley say it's important funding for rural hospitals. 'What we're doing here is an important and, frankly, heroic thing to preserve the program so that it doesn't become insolvent,' Speaker Mike Johnson said on NBC's 'Meet the Press.' House Democratic leader Hakeem Jeffries, meanwhile, has denounced the bill as an 'assault on the healthcare of the American people' and warned years of progress in reducing the number of uninsured people is at risk. Who would lose health coverage The nonpartisan Congressional Budget Office estimates that the GOP's proposed changes to federal health programs would result in 10.9 million fewer people having health care coverage. Nearly 8 million fewer people would be enrolled in Medicaid by 2034 under the legislation, the CBO found, including 5.2 million people who would lose coverage due to the proposed work requirements. It said 1.4 million immigrants without legal status would lose coverage in state programs. The new Medicaid requirements would apply to nondisabled adults under age 65 who are not caretakers or parents, with some exceptions. The bill passed by the U.S. House stipulates that those eligible would need to work, take classes, or record community service for 80 hours per month. The Kaiser Family Foundation notes that more than 90% of people enrolled in Medicaid already meet those criteria. The legislation also penalizes states that fund health insurance for immigrants who have not confirmed their immigration status, and the CBO expects that those states will stop funding Medicaid for those immigrants altogether. Why Republicans want Medicaid changes Republicans have cited what they call the out-of-control spending in federal programs to explain their rationale for the changes proposed in the legislation. 'What we are trying to do in the One Big Beautiful Bill is ensuring that limited resources are protected for pregnant women, for children, for seniors, for individuals with disabilities,' said Rep. Erin Houchin, R-Ind., in a speech on the House floor. Senate Majority Whip John Barrasso argued that Medicaid recipients who are not working spend their time watching television and playing video games rather than looking for employment. Republicans also criticize the CBO itself, the congressional scorekeeper, questioning whether its projections are accurate. The CBO score for decades has been providing non-partisan analysis of legislation and budgetary matters. Its staff is prohibited from making political contributions and is currently led by a former economic adviser for the George W. Bush administration. What polling shows While Republicans argue that their signature legislation delivers on Trump's 2024 campaign promises, health care isn't one of the president's strongest issues with Americans. Most U.S. adults, 56%, disapproved of how Trump was handling health care policy in CNN polling from March. And according to AP VoteCast, about 6 in 10 voters in the November election said they wanted the government 'more involved' in ensuring that Americans have health care coverage. Only about 2 in 10 wanted the government less involved in this, and about 2 in 10 said its involvement was about right. Half of American adults said they expected the Trump administration's policies to increase their family's health care costs, according to a May poll from KFF, and about 6 in 10 believed those policies would weaken Medicaid. If the federal government significantly reduced Medicaid spending, about 7 in 10 adults said they worried it would negatively impact nursing homes, hospitals, and other health care providers in their community. For Hawley, the 'bottom lines' are omitting provisions that could cause rural hospitals to close and hardworking citizens to lose their benefits. He and other Republicans are especially concerned about the freeze on the providers' tax in the House's legislation that they warn could hurt rural hospitals. 'Medicaid benefits for people who are working or who are otherwise qualified,' Hawley said. 'I do not want to see them cut.'
Toronto Star
18 hours ago
- Toronto Star
Medicaid enrollees fear losing health coverage if Congress enacts work requirements
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition. Strickland, who's unable to work due to her condition, chafed when she learned that the U.S. House has passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people.
Winnipeg Free Press
18 hours ago
- Winnipeg Free Press
Medicaid enrollees fear losing health coverage if Congress enacts work requirements
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition. Strickland, who's unable to work due to her condition, chafed when she learned that the U.S. House has passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people. 'What sense does that make?' she asked. 'What about the people who can't work but can't afford a doctor?' The measure is part of the version of President Donald Trump's 'Big Beautiful' bill that cleared the House last month and is now up for consideration in the Senate. Trump is seeking to have it passed by July 4. The bill as it stands would cut taxes and government spending — and also upend portions of the nation's social safety net. For proponents, the ideas behind the work requirement are simple: Crack down on fraud and stand on the principle that taxpayer-provided health coverage isn't for those who can work but aren't. The measure includes exceptions for those who are under 19 or over 64, those with disabilities, pregnant women, main caregivers for young children, people recently released from prisons or jails — or during certain emergencies. It would apply only to adults who receive Medicaid through expansions that 40 states chose to undertake as part of the 2010 health insurance overhaul. Many details of how the changes would work would be developed later, leaving several unknowns and causing anxiety among recipients who worry that their illnesses might not be enough to exempt them. Advocates and sick and disabled enrollees worry — based largely on their past experience — that even those who might be exempted from work requirements under the law could still lose benefits because of increased or hard-to-meet paperwork mandates. Benefits can be difficult to navigate even without a work requirement Strickland, a 44-year-old former server, cook and construction worker who lives in Fairmont, North Carolina, said she could not afford to go to a doctor for years because she wasn't able to work. She finally received a letter this month saying she would receive Medicaid coverage, she said. 'It's already kind of tough to get on Medicaid,' said Strickland, who has lived in a tent and times and subsisted on nonperishable food thrown out by stores. 'If they make it harder to get on, they're not going to be helping.' Steve Furman is concerned that his 43-year-old son, who has autism, could lose coverage. The bill the House adopted would require Medicaid enrollees to show that they work, volunteer or go to school at least 80 hours a month to continue to qualify. A disability exception would likely apply to Furman's son, who previously worked in an eyeglasses plant in Illinois for 15 years despite behavioral issues that may have gotten him fired elsewhere. Furman said government bureaucracies are already impossible for his son to navigate, even with help. It took him a year to help get his son onto Arizona's Medicaid system when they moved to Scottsdale in 2022, and it took time to set up food benefits. But he and his wife, who are retired, say they don't have the means to support his son fully. 'Should I expect the government to take care of him?' he asked. 'I don't know, but I do expect them to have humanity.' There's broad reliance on Medicaid for health coverage About 71 million adults are enrolled in Medicaid now. And most of them — around 92% — are working, caregiving, attending school or disabled. Earlier estimates of the budget bill from the Congressional Budget Office found that about 5 million people stand to lose coverage. A KFF tracking poll conducted in May found that the enrollees come from across the political spectrum. About one-fourth are Republicans; roughly one-third are Democrats. The poll found that about 7 in 10 adults are worried that federal spending reductions on Medicaid will lead to more uninsured people and would strain health care providers in their area. About half said they were worried reductions would hurt the ability of them or their family to get and pay for health care. Amaya Diana, an analyst at KFF, points to work requirements launched in Arkansas and Georgia as keeping people off Medicaid without increasing employment. Amber Bellazaire, a policy analyst at the Michigan League for Public Policy, said the process to verify that Medicaid enrollees meet the work requirements could be a key reason people would be denied or lose eligibility. 'Massive coverage losses just due to an administrative burden rather than ineligibility is a significant concern,' she said. One KFF poll respondent, Virginia Bell, a retiree in Starkville, Mississippi, said she's seen sick family members struggle to get onto Medicaid, including one who died recently without coverage. She said she doesn't mind a work requirement for those who are able — but worries about how that would be sorted out. 'It's kind of hard to determine who needs it and who doesn't need it,' she said. Some people don't if they might lose coverage with a work requirement Lexy Mealing, 54 of Westbury, New York, who was first diagnosed with breast cancer in 2021 and underwent a double mastectomy and reconstruction surgeries, said she fears she may lose the medical benefits she has come to rely on, though people with 'serious or complex' medical conditions could be granted exceptions. She now works about 15 hours a week in 'gig' jobs but isn't sure she can work more as she deals with the physical and mental toll of the cancer. Mealing, who used to work as a medical receptionist in a pediatric neurosurgeon's office before her diagnosis and now volunteers for the American Cancer Society, went on Medicaid after going on short-term disability. 'I can't even imagine going through treatments right now and surgeries and the uncertainty of just not being able to work and not have health insurance,' she said. Felix White, who has Type I diabetes, first qualified for Medicaid after losing his job as a computer programmer several years ago. The Oreland, Pennsylvania, man has been looking for a job, but finds that at 61, it's hard to land one. Medicaid, meanwhile, pays for a continuous glucose monitor and insulin and funded foot surgeries last year, including one that kept him in the hospital for 12 days. 'There's no way I could have afforded that,' he said. 'I would have lost my foot and probably died.' ___ Associated Press writer Susan Haigh in Hartford, Connecticut contributed to this article.
