Latest news with #AffordableCareAct
The Hill
2 hours ago
- Politics
- The Hill
Johnson says 4.8 million Americans won't lose Medicaid access ‘unless they choose to do so'
Speaker Mike Johnson (R-La.) doubled down on his claim that there won't be Medicaid cuts in President Trump's 'big, beautiful bill,' despite projections that millions of low-income individuals would lose health insurance as a result of the bill. Johnson, during an appearance on NBC's 'Meet the Press,' pushed back on independent projections that the bill would lead to 4.8 million who would lose coverage because of work requirements, saying they won't lose it 'unless they choose to do so.' 'Those 4.8 million people will not lose their Medicaid unless they choose to do so,' he told host Kristen Welker. 'You're telling me that you're going to require the able-bodied — these young men, for example, okay — to only work or volunteer in their community for 20 hours a week, and that's too cumbersome for them? I'm not buying it. The American people are not buying it.' He added that the people who are complaining about losing their coverage are doing so 'because they can't fulfill the paperwork,' noting that the policy follows 'common sense.' 'When people work, when able-bodied young men work, it's good for them, for their dignity, their purpose, and it's good for the community,' he said. 'If you can't find a job, then volunteer in your community for 20 hours, and you will meet the requirement.' The proposed Medicaid and health care reforms would require states to impose work requirements on childless adults aged 19-64 to be eligible for Medicaid. It also aims to shorten the open enrollment period for the Affordable Care Act, among other changes. The reforms are key components of the bill, which the House Energy and Commerce Committee crafted after being tasked with finding more than $800 billion in savings over a decade. Those portions of the GOP proposal would save $625 billion over 10 years, according to the CBO. Johnson said that the bill 'strengthens' Medicaid and said what they are doing is 'an important and frankly heroic thing.' 'It's intended for young, you know, single, pregnant women and the disabled and the elderly,' he said. 'But what's happening right now is you have a lot of people, for example, young men, able bodied workers, who are on Medicaid. They're not working when they can.' His comments are just the latest assertion from Johnson that the bill won't threaten Medicaid coverage for people who need it. However, the bill is hitting some roadblocks for Republican lawmakers, who are finding themselves enveloped in criticism at their town halls.
Axios
2 days ago
- Business
- Axios
How the GOP megabill may roll back the Affordable Care Act
The massive Republican budget bill working its way through Congress has mostly drawn attention for its tax cuts and Medicaid changes. But it would also take steps to significantly roll back coverage under the Affordable Care Act, with echoes of the 2017 repeal-replace debate. Why it matters: The bill that passed the House before Memorial Day includes an overhaul of ACA marketplaces that would result in coverage losses for millions of Americans and savings to help cover the cost of extending President Trump's tax cuts. It comes after a growth spurt that saw ACA marketplace enrollment reach new highs, with more than 24 million people enrolling for 2025, according to KFF. The House's changes would likely reverse that trend, unless the Senate goes in a different direction when it picks up the bill next week. Driving the news: The changes are not as sweeping as the 2017 effort at repealing the law, but many of them erect barriers to enrollment that supporters say are aimed at fighting fraud. Brian Blase, president of Paragon Health Institute and a health official in Trump's first administration, said Republicans are focusing on rolling back Biden-era expansions "that have led to massive fraud and inefficiency." The CBO estimates the ACA marketplace-related provisions would lead to about 3 million more people becoming uninsured. Cynthia Cox, a vice president at KFF, said while the changes "sound very technical" in nature, taken together "the implications are that it will be much harder for people to sign up for ACA marketplace plans." What's inside: The bill would end automatic reenrollment in ACA plans for people getting subsidies, instead requiring them to proactively reenroll and resubmit information on their incomes for verification. It would also prevent enrollees from provisionally receiving ACA subsidies in instances where extra eligibility checks are needed, which can take months. If people wound up making more income than they had estimated for a given year, the bill removes the cap on the amount of ACA subsidies they would have to repay to the government. Some legal immigrants would also be cut off from ACA subsidies, including people granted asylum and those in their five-year waiting period to be eligible for Medicaid. What they're saying: In a letter to Congress, patient groups pointed to the various barriers as "unprecedented and onerous requirements to access health coverage" that would have "a devastating impact on people's ability to access and afford private insurance coverage." The letter was signed by groups including the American Cancer Society Cancer Action Network, American Diabetes Association and American Lung Association. Between the lines: A last-minute addition to the bill would also make a technical but important change that increases government payments to insurers in ACA marketplaces. That would have the effect of reducing the subsidies that help people afford premiums and save the government money, by reducing the benchmark silver premiums that are used to set the subsidy amounts. Democrats are concerned that if Congress also allows enhanced ACA subsidies to expire at the end of this year, the combined effect would be even higher premium increases for enrollees next year. Insurers that already are planning their premium rates for next year say the Republican funding changes are throwing uncertainty into the mix. "Disruption in the individual market could also result in much higher premiums," the trade group AHIP warned in a statement on the bill. The big picture: Blase said changes like ending automatic reenrollment are needed to increase checks that ensure people are not claiming higher subsidies than they're entitled to. "I think what happened during the Biden years led to massive fraud and improper spending, and that needs to be rolled back," he said. Cox said another way to address fraud would be to target shady insurance brokers, rather than enrollees themselves. She estimated that marketplace enrollment could fall by roughly one third from all the changes together.
Yahoo
2 days ago
- Business
- Yahoo
Unpacking rumors that DOGE and RFK Jr. found 8M people fraudulently enrolled in Medicaid
In May 2025, a claim spread online that the Department of Government Efficiency (DOGE) in the U.S. discovered 8 million people fraudulently enrolled in Medicaid, the government health insurance program for low-income people. While U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. claimed that 8 million people are on Medicaid because of "fraud, waste and abuse," and that DOGE helped determine this, there is no evidence backing up the claim that this number originated from DOGE's work. However, the Congressional Budget Office did estimate that approximately 7.6 million or 7.7 million people would lose Medicaid coverage under U.S. President Donald Trump's "One Big Beautiful Bill Act," which appears to be where Kennedy's numbers come from. Kennedy also claimed, as did many people online, that of the 8 million, 1 million are enrolled in Medicaid in multiple states, about 1 million enrollees are immigrants in the country illegally and another million are enrolled in plans under both Medicaid and the Affordable Care Act. However, there is no publicly available documented proof of the double enrollment numbers — for both multiple states and multiple plans — and the enrollees who do not have legal immigration status are on Medicaid through state-sanctioned and -funded programming, not federal funding. In mid-2025, a rumor circulated online that the Department of Government Efficiency (DOGE) found 8 million people fraudulently enrolled in Medicaid, the government health insurance program for low-income people. The claim spread primarily on Facebook but could also be found on X. Snopes readers also searched the website for information on the claims about Medicaid fraud and DOGE. "DOGE drops the facts, and RFK Jr. confirms it — 8 million people are on Medicaid who shouldn't be," many of the posts read. The text from the post above appears to be copypasta, or misinformation in the form of copied and pasted text, as it reads word-for-word the same in many of the claims reviewed by Snopes. U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. did allege that 8 million people on Medicaid would be affected by the administration's efforts to cut "fraud, waste and abuse" in the program. However, there is no evidence that DOGE made this discovery — nor did Kennedy provide any proof for his claim. In fact, the number appears to come from preliminary estimates by the Congressional Budget Office on how many people may lose health insurance coverage if Trump's massive legislative budget package — called the "One Big Beautiful Bill Act" — becomes law without undergoing any changes. Furthermore, Kennedy's claim that these 8 million people represent "fraud, waste and abuse" is in part a matter of opinion, not fact. Asked via email whether DOGE could be credited for this, White House spokesperson Harrison Fields requested Snopes provide an example of the claim. Snopes provided this post from a Facebook account titled, "Donald Trump For President," to which Fields said the White House would not comment on unofficial Republican accounts. After clarifying that the claim spread widely online and may have originated from Kennedy, we did not hear back. We also reached out to DOGE and await a response. The Department of Health and Human Services did not return a request for more information on where Kennedy's numbers came from. As first reported by The Wall Street Journal and later confirmed by the Centers for Medicare and Medicaid Services on Feb. 5, 2025, officials granted DOGE access to Medicaid systems in its widespread search for fraud. On May 14, 2025, Kennedy said during a committee hearing that "because of DOGE," the agency found 8 million people on Medicaid who would be affected by cuts made for reasons of "fraud, waste and abuse." However, if DOGE did make this discovery, they did not appear to make any public announcement about it. The public face of DOGE, tech billionaire Elon Musk, often makes major announcements through his X page — and a search for "Medicaid" on his X profile returned no results concerning 8 million fraudulent enrollees. DOGE similarly uses X for public statements, and a search of its page for "Medicaid" also returned no relevant results as of this writing. Musk did claim in an X post on Feb. 10, 2025, without providing evidence, that the "magnitude of fraud in federal entitlements," including Medicaid, "exceeds the combined sum of every private scam you've ever heard by FAR." This post did not include hard data or any supposed number of fraudulent enrollees. DOGE releases dollar amounts of its purported savings on its website, but there was not a section for the number of people that the agency supposedly caught committing fraud as of this writing. No reputable news outlets have credited this supposed discovery to DOGE as of publication, and if the claim were true — or if Musk even claimed it was — it would certainly make news. Kennedy's comments during the May 14 committee hearing were in reference to cuts that would be made to Medicaid under the One Big Beautiful Bill Act. Here is the full exchange between Kennedy and Rep. Josh Harder, D-Calif.; see 1:53:00 (emphasis ours): KENNEDY: The cuts to Medicaid are for fraud, waste and abuse, and I'll tell you what that means. It means because of DOGE — and it's about 8 million people who would be affected — because of DOGE, we were able to determine that there are a million people who are claiming Medicaid from multiple states. That's illegal. It's theft. You're not allowed to do that. There are another million people who are collecting both under Obamacare and — HARDER: Mr. Secretary. That has nothing to do with the budget that is actually being proposed — KENNEDY: These are the only cuts that are being made. These are the only cuts that are being made to Medicaid. HARDER: That's not true. KENNEDY: Yes it is. There are another million illegal aliens. We announced the law yesterday, we're not going to pay illegal aliens anymore. The first public reference available of this "8 million" number appears to be a May 11 preliminary estimate from the nonpartisan Congressional Budget Office (CBO), which found that "at least" 7.7 million people may lose health insurance coverage by 2034 if the "One Big Beautiful Bill Act" became law without undergoing any changes. An updated May 18, 2025, estimate from CBO, available for download here (go to the "Title IV — Commerce and Energy" tab after downloading and scroll to the very end), said "the number of people without health insurance would increase by 8.6 million in 2034," with 7.6 million of that number attributable to Medicaid cuts and another 1 million attributable to the Affordable Care Act. CBO cautioned that it has not yet completed "estimates for effects on spending subject to appropriation and estimates of the effects of interactions among titles of the legislation," meaning these numbers are subject to change. The One Big Beautiful Bill Act has also undergone changes since being passed by the House of Representatives on May 22, 2025, and is likely to undergo even more changes once it reaches debate in the Senate. It must pass both chambers and be signed by Trump in order to become law. Kennedy's explanation as to why the 8 million who would be cut from Medicaid represent "waste, fraud and abuse" largely matches with the text from the copypasta, seen below: Over 1 million are double-dipping, illegally getting Medicaid from two different states. Another 1.4 million are undocumented immigrants — and they're being handed benefits funded by your tax dollars. On top of that, another million are illegally enrolled in both Medicaid and Obamacare. Not all of these numbers are available in public documents, making it impossible to check every claim made here, so let's start by looking at the claim that is possible to fact-check. The claim that 1.4 million immigrants in the country illegally are on Medicaid comes from the May 18, 2025, CBO estimate (emphasis ours): Included in that 8.6 million total are an estimated 1.4 million people without verified citizenship, nationality, or satisfactory immigration status who, if section 41110 were enacted, would no longer be covered in state-only funded programs in 2034. While such immigrants are largely ineligible for federal health insurance, Medicaid is a joint state and federal program — and some states offer Medicaid or Medicaid-like benefits to people without legal immigration status using state funds, which is what CBO references. Thus, legally speaking, those immigrants who enroll through state-sanctioned Medicaid programs aren't committing fraud or abuse. (On the federal spending level, noncitizen immigrants — both with and without legal authorization — can be eligible for emergency Medicaid services, but the government doesn't keep track of an immigrant's legal status when collecting data on emergency Medicaid usage, making it impossible to tell how many undocumented immigrants have benefited from these services, per a 2024 letter sent to U.S. representatives.) As for the claim that 1 million enrollees are "double-dipping" into Medicaid from two different states, that is both illegal and a legitimate issue, according to a 2022 audit by the Department of Health and Human Services' Office of the Inspector General. (See Page 2 under "Federal Requirements" for the law on receiving benefits in two different states.) However, this audit found that the total number of beneficiaries concurrently enrolled in two different states was 327,497 as of August 2020; in August 2019, it was 208,254 (see pages 14 and 15). Thus, the most recent numbers available as of this writing aren't close to 1 million (see the first summary page). It is possible that the number of "double-dippers" has increased to 1 million, but that number isn't publicly available as of this writing. Finally, Snopes could not find any data on the number of people who are enrolled in both Obamacare, formally known as the Affordable Care Act, and Medicaid. However, in 2016, the federal government did crack down on duplicate enrollments, per a New York Times story; in that report, Judith Solomon, then-vice president of the progressive Center on Budget and Policy Priorities, said there is not really a benefit to "double-dipping" into both insurance plans. Eligibility for either ACA plans or Medicaid can change based on a person's or family's income level or other factors, meaning Americans often find themselves swapping between the two types of plans. The federal government provides a guide online for ending one form of coverage or the other, as overlap between the two is common; the IRS also provides tax guidance on overlapping coverage. Here's the math: According to the copypasta, 8 million people are fraudulently on Medicaid — 1.4 million of whom are immigrants in the country illegally, 1 million who are double-dipping into Medicaid in multiple states and an additional 1 million on plans under both Medicaid and Obamacare. That totals 3.4 million, meaning there are 4.6 million people unaccounted for. During the May 14 committee hearing, Kennedy said about 4.8 million people cut from Medicaid under the One Big Beautiful Bill Act would become ineligible because they aren't employed. "The last category is adults who are able-bodied, who refuse to look for a job, to volunteer, to get a job or to show — to take a part-time job," Kennedy said (at 1:54:25). Multiple Republican lawmakers also cited this number during a May 13 House committee hearing; at least one attributed it to CBO — but if this is a CBO estimate, it has not yet been released publicly. Snopes reached out to several Republican lawmakers who shared the number in the hearing to ask for documented proof and await their reply. CBO would not share its estimate or related documents with Snopes. To summarize, there is no public evidence, aside from Kennedy's claim, that DOGE deserves credit for the alleged discovery of 8 million people fraudulently on Medicaid. The numbers and categories of supposedly fraudulent enrollees from the post come from either Kennedy, who did not provide proof, or estimates by the Congressional Budget Office. While enrollment in multiple states or multiple plans is a legitimate issue, it's unclear if the numbers shared are accurate. Furthermore, the 1.4 million immigrants in the country illegally on Medicaid — as estimated by CBO — are on the program through state funding, not federal. "Affordable Care Act - Return Preparer Best Practices." Internal Revenue Service, 7 Apr. 2016, Accessed 21 May 2025. Broder, Tanya. "Health Care Coverage (Maps)." NILC, 16 Oct. 2024, Accessed 21 May 2025. "CMS Statement on Collaboration with DOGE | CMS." 5 Feb. 2025, Accessed 21 May 2025. Congressional Budget Office. Subject: E&c Reconciliation Recommendations. 11 May 2025, Accessed 23 May 2025. DOGE. "DOGE: Department of Government Efficiency." DOGE: Department of Government Efficiency, Accessed 21 May 2025. "Doge 8 Million People on Medicaid - Google Search." 2024, Accessed 21 May 2025. Dorning, Courtney, et al. "DOGE Sets Its Sights on Medicare and Medicaid." NPR, 10 Feb. 2025, Accessed 21 May 2025. "Estimated Budgetary Effects of a Bill to Provide for Reconciliation pursuant to Title II of H. Con. Res. 14, the One Big Beautiful Bill Act." Congressional Budget Office, 20 May 2025, Accessed 23 May 2025. "From:DOGE Medicaid - Search / X." 21 May 2025, Accessed 21 May 2025. "From:elonmusk Medicaid - Search / X." 21 May 2025, Accessed 21 May 2025. Grimm, Christi. " NEARLY ALL STATES MADE CAPITATION PAYMENTS for BENEFICIARIES WHO WERE CONCURRENTLY ENROLLED in a MEDICAID MANAGED CARE PROGRAM in TWO STATES." Sept. 2022, Accessed 21 May 2025. House Appropriations Committee. "Budget Hearing – U.S. Department of Health and Human Services." YouTube, 16 May 2025, Accessed 23 May 2025. House Committee on Energy and Commerce. "Full Committee Markup of Budget Reconciliation Text Part 1." 13 May 2025, Accessed 23 May 2025. MACPAC. "Overview of the Affordable Care Act and Medicaid : MACPAC." 31 Mar. 2022, Accessed 21 May 2025. Mathews, Anna Wilde, and Liz Essley Whyte. "DOGE Aides Search Medicare Agency Payment Systems for Fraud." Wall Street Journal, 5 Feb. 2025, Accessed 21 May 2025. Musk, Elon. "At This Point, I Am 100% Certain That the Magnitude of the Fraud in Federal Entitlements (Social Security, Medicare, Medicaid, Welfare, Disability, Etc) Exceeds the Combined Sum of Every Private Scam You've Ever Heard by FAR. It's Not Even Close." X (Formerly Twitter), 10 Feb. 2025, Accessed 21 May 2025. Pear, Robert. "U.S. Officials Move to End Duplicate Health Care Coverage." The New York Times, 19 Aug. 2016, Accessed 21 May 2025. "Press Room." Accessed 21 May 2025. Snopes Staff. "Copypasta." Snopes, 21 Aug. 2019, Accessed 21 May 2025. Swagel, Phillip. "Re: Emergency Medicaid Services for Certain Non-U.S. Nationals ." 2024, Accessed 21 May 2025. "Take Action When You Have Marketplace Coverage along with Medicaid or CHIP Coverage." Accessed 21 May 2025. USAGov. "How to Get Insurance through the ACA Health Insurance Marketplace | USAGov." 6 Dec. 2023, Accessed 21 May 2025.
Yahoo
2 days ago
- Business
- Yahoo
Ohio's Cleveland Clinic faces questions over booming subsidies
A medical exam room. File photo from Federal officials are raising questions about exploding drug discounts under a program meant to fund services for low-income patients, and Ohio's Cleveland Clinic is at the center of some of them. Over a 38-month period ending in June 2023, the massive nonprofit hospital received nearly $1 billion from the program. However, the clinic didn't cut drug prices for any of its low-income patients, instead plowing the money into its general budget. Officials at the clinic told congressional investigators that they used the money in other ways to help poor patients. Yet in 2023, the nonprofit hospital had enough money to pay 22 of its executives more than $1 million and another 30 over $500,000 — and still finish the year with nearly $1 billion in 'net income.' A private business would call that 'profit.' For its part, the clinic pointed out that its operating income was much smaller than that, and that it spent almost as much on free or discounted care in 2023. Cleveland Clinic was one of two hospitals to come under scrutiny as part of a U.S. Senate investigation of a drug-discounting program known as 340B. It requires drugmakers who want to sell their products to Medicaid patients to also sell them to qualifying hospitals and clinics at deep, legally defined discounts. The hospitals and clinics then sell them at much higher prices and pocket the difference — notionally, to provide care to people who can't afford it. When it was created in 1992, 340B was intended to free up money and make federal resources go further for providers who cared for a heavy mix of low-income and underinsured patients. But after the Affordable Care Act passed in 2010 and the 340B rules were changed, the amount of discounts provided under the program exploded — from $5 billion a year to nearly $67 billion in 2023. That's not free money, and the discounts to 340B providers are made up by other payers — including the poor, said Antonio Ciaccia, a Columbus-based drug-pricing analyst. As the amount of that money grew 13-fold in as many years, the Senate Health, Education, Labor, and Pensions Committee wanted to know whether 340B was really fulfilling the program's goal to 'stretch scarce Federal resources as far as possible.' The multi-year investigation focused on two hospitals. 'These hospitals were selected for this investigation as a result of media reports alleging abuse of the 340B Program, such as hospitals cutting services to underserved populations and expanding into affluent areas to increase reimbursement rates and subsequent revenue under the 340B Program,' the committee report, which was released last month, said. The other hospital chain, Cincinnati-based Bon Secours Mercy Health, will be the subject of a separate story. Regarding Cleveland Clinic, the Senate report referred to a 2022 Wall Street Journal story. It said the hospital didn't admit enough Medicaid and low-income patients to qualify under the original 340B rules. But under a quirk in the new rules, it was allowed in as a 'rural-referral center' even though it's headquartered in the middle of a big city. In analyzing the data the submitted by Cleveland Clinic, the Senate committee found that between April 2020 and June 2023, the hospital chain received $934 million in benefit from the 340B program. Yet, even though the reason for the program's existence is to support care for people who can't do so themselves, Cleveland Clinic didn't use those funds to directly defray patients' drug costs. 'Cleveland Clinic… explained that it does not pass 340B discounts directly to patients because 'there is no dollar-for-dollar, pass-on requirement to patients under the 340B statute' and the statute 'was intentionally left general to provide safety-net providers with latitude on how they use their savings in the ever-changing health care industry,'' the report said. Instead, Cleveland Clinic said it 'applies its 340B benefit 'to the health system's overall operating expenses and revenues in order to offset the cost of providing health care services to the communities [it] serve[s] and to maintain and invest in programs that enhance patient services and access to care.'' Cleveland Clinic said it didn't track the 340B millions after putting them in the revenue pot. But it said it spends huge amounts underwriting care for low-income Ohioans. In 2023, it provided $261 million in free or discounted care to more than 110,000 patients, a spokeswoman said on background. The clinic is the leading provider of Medicaid services, charity care and mental health services in Ohio, she said. She also pointed out that in 2024, Cleveland Clinic had an operating margin of $276 million, while it spent $261 million discounting care a year earlier. However, that excludes income the tax-exempt nonprofit makes from its sizable investments. When you include that, Cleveland Clinic made $911 million in net income in 2023, Healthcare Dive reported. Also, those narrow operating margins come after paying out hefty salaries. According to Cleveland Clinic's 2023 IRS Form 990, President and CEO Tom Mihaljevic was paid $7 million. That was more than 100 times Ohio's median household income for that year. In all, more than 50 of the top decision-makers at Cleveland Clinic made more than $500,000 as they set and enacted a budget subsidized by hundreds of millions of 340B dollars that are notionally meant to support charity care. 'Cleveland Clinic sets executive compensation in accordance with the process developed by the IRS to ensure that such compensation is determined in a fair and impartial manner taking relevant comparative data into account,' the clinic's spokeswoman said. In its response to the Senate report, Cleveland Clinic claimed the 340B program doesn't cost taxpayers. 'As the cost of providing healthcare continues to rise, the 340B program helps us save resources that would have otherwise been spent on purchasing medications but instead can be directed to providing care, at no additional taxpayer expense,' it said. However, just as others have to pay the taxes nonprofits don't, drugmakers don't simply absorb the tens of billions in discounts they're required to give under the 340B program, said Ciaccia, the drug pricing analyst. In fact, many of the low-income patients the program is supposed to benefit help pay for it. That's because those with private insurance — or who are uninsured — don't pay for drugs on the basis of 340B discounts. They have to pay based on the inflated prices the clinic and its contracted pharmacies charge in order to generate the program's income. Everyone with employer-based insurance also pays because those plans also don't get the 340B discount — or in some cases even a slice of manufacturer rebates they might get in non-340B pharmacy transactions, Ciaccia said. And, as with so many other things, increased insurance costs are usually passed on to consumers. Ciaccia added that as with rebates, mandatory 340B discounts give drugmakers an incentive to increase the list prices of drugs — increases that are felt most acutely by those who are least able to pay. 'In recent years, the list prices for drugs have arguably exploded, creating greater and greater pressure for government programs, employers, and sick patients to access medicines — not through actual affordable prices — but instead through negotiated or mandated discounts off of those bloated prices,' Ciaccia said. 'Programs like 340B double down on our system's addiction to discounts, pressuring the list prices of medicines higher. But instead of passing those discounts through, the end payer gets stuck with a bloated tab at the pharmacy counter. One way or another, the bill always comes due.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
3 days ago
- Business
- Yahoo
Opinion: Budget bill highlights how Washington lacks a sense of irony
I'm old enough to remember when Republican President Ronald Reagan, during his 1988 State of the Union Address, dropped a heavy stack of papers, comprising that year's budgeting megabill, next to the podium. He declared that 'Congress shouldn't send another one,' because he would not sign it. He got a rare bipartisan standing ovation for that. Many of you are old enough to remember when former House Speaker Nancy Pelosi said of the Affordable Care Act, 'We have to pass the bill so that you can find out what is in it.' Her next sentence clarified that she meant the bill could be understood best 'away from the fog of the controversy.' But that first sentence soon became a political rallying cry for some Republicans upset with the passage of a bill so large no one could properly digest it. Times change. This is a much more hyper-partisan period in history. It's apparently so partisan that party faithful don't get the irony. Today's proposed budget — another megabill totaling more than 1,000 pages — is being pushed by a Republican president. He apparently doesn't mind how big and heavy it is. Republican Rep. Thomas Massie of Kentucky posted a plaintive plea on X last week before the House voted: 'Shouldn't we take more than a few hours to read a bill this big and this consequential?' Was he implying we may have to pass it to see what's in it? So far, we know it makes changes to Medicaid, extends the tax cuts enacted during the first Trump term, removes some tax credits for clean energy and increases spending for border security. A measure to eliminate taxes on tips passed the Senate separately on a unanimous vote and is now awaiting action in the House. We also know that, taken together, these would add $3.8 trillion over 10 years to the rapidly growing national debt, according to Congressional Budget Office estimates. A lot of tips probably already don't get reported as income, but the Peter G. Peterson Foundation estimates the no-tax bill on tips would cost $110 billion over 10 years, even though it's limited to people earning less than $160,000. That may not be much in a Washington where deficits run in the trillions, but it's still moving in the wrong direction. But the bill doesn't stop there. It would bar states from regulating artificial intelligence for 10 years. Utah has been a leader in passing laws that protect its people from malicious AI, including its use for mental health services. But the budget bill tells states to repeal all such laws. It also would curtail the federal courts' power to hold government personnel in contempt for disobeying judicial orders — an ominous provision given the number of Trump actions courts have found to be illegal. It's a rule Republicans may quickly regret the next time a Democrat takes control of the White House. The '80s are long gone. We no longer have Reagan and his eye-catching stack of budget bills. Everything's electronic these days, anyway. But we do have Elon Musk, the DOGE slasher, who told CBS News he doesn't like what he's seeing. 'I was disappointed to see the massive spending bill, frankly, which increases the budget deficit, not just decreases it, and undermines the work that the DOGE team is doing,' he said, adding this interesting observation: 'I think a bill can be big or it can be beautiful, but I don't know if it can be both.' Strip away the PR, and budgets are statements about priorities. That's true whether it's your household budget or that of a stamp-collecting club. By that measure, this bill speaks loudly and with increasing clarity as it awaits Senate action. But what its size and breadth say about a representative government's deliberative process, and what its totality says about overspending, are causes for concern. So is its implied message about political parties and the fluidity of principles. I'm guessing Mr. Reagan would not be amused.
