Latest news with #EnergyandCommerceCommittee
Yahoo
22-05-2025
- Business
- Yahoo
House GOP's Medicaid revisions aim to please hard-liners
House Republicans made substantial changes to the Medicaid portion of the GOP megabill in amendments unveiled Wednesday night, including accelerating work requirements and paying states not to expand the program under the Affordable Care Act. The proposal will move up the start date of Medicaid work requirements from Jan. 1, 2029, to Dec. 31, 2026, in a concession to conservative hard-liners who have been pushing for deeper cuts to the program. The work requirements included in the previous bill would yield nearly $280 billion in savings, according to congressional scorekeepers — the most of any policy under the House Energy and Commerce Committee's jurisdiction. The new accelerated timeline could lead to additional savings of tens of billions of dollars but also result in even more people losing coverage. GOP moderates have not raised significant concerns about implementing them more quickly. The new bill does not include controversial changes hard-liners had pushed for that would alter the federal share of spending in the joint federal-state Medicaid program. Moderates had balked, arguing they would cut too deep into benefits, and House Speaker Mike Johnson had ruled out those changes. But in other sops for conservatives, the revisions would expand the criteria for states that could lose a portion of their federal payments if they offer coverage to undocumented people. It also moves to bar coverage of gender-affirming care for adults under the program, not just minors as previously proposed. The Congressional Budget Office estimated that a previous iteration of the bill could lead to 7.6 million people who had Medicaid going uninsured, and millions more from the the Affordable Care Act marketplace also losing coverage. Those coverage losses are expected to be higher with this new version. The Energy and Commerce portion of the bill has been estimated to save nearly a trillion dollars over a decade. The new amendments would make another notable change to Medicaid -— one that hard-liners hope would incentivize states to not to expand their programs under the ACA after the legislation goes into effect. The wonky measures would give states a financial incentive not to expand coverage to people with higher incomes than traditional enrollees, though still near the poverty line. The policy would make higher payments to providers like hospitals for uncompensated care. Hard-liners, particularly Rep. Chip Roy of Texas, pushed for the provision to be in the bill during a White House meeting with President Donald Trump Wednesday afternoon, according to three people with direct knowledge of the meeting. One senior GOP aide described the provision as 'a small Medicaid tweak' that would give the hard-liners a reason to support the bill, along with several other minor changes. Notably, they did not secure any further changes to the Medicaid state provider tax, which moderates had held firm against. Rep. Ralph Norman of South Carolina said in a brief interview Wednesday night he was happy with the meeting and that 'there were some good things from the White House.' Another Republican lawmaker said hard-liners would chiefly tout the accelerated Medicaid work requirements, the expansion change and a newly accelerated phase-out of clean-energy tax credits. In a major departure, the bill would fund cost-sharing reduction payments to insurers on Obamacare's insurance exchanges. The policy would offer subsidies to insurers that would, in turn, help reduce premiums and co-pays for patients. Trump ended this practice in his first administration, saying it constituted a bailout to the insurance industry. But the nonpartisan Congressional Budget Office estimated at that time that ending the payments would cost hundreds of billions of dollars over a decade. Bringing the policy back could provide savings. Rachael Bade contributed to this report.
Politico
22-05-2025
- Business
- Politico
House GOP's Medicaid revisions aim to please hard-liners
House Republicans made substantial changes to the Medicaid portion of the GOP megabill in amendments unveiled Wednesday night, including accelerating work requirements and paying states not to expand the program under the Affordable Care Act. The proposal will move up the start date of Medicaid work requirements from Jan. 1, 2029, to Dec. 31, 2026, in a concession to conservative hard-liners who have been pushing for deeper cuts to the program. The work requirements included in the previous bill would yield nearly $280 billion in savings, according to congressional scorekeepers — the most of any policy under the House Energy and Commerce Committee's jurisdiction. The new accelerated timeline could lead to additional savings of tens of billions of dollars but also result in even more people losing coverage. GOP moderates have not raised significant concerns about implementing them more quickly. The new bill does not include controversial changes hard-liners had pushed for that would alter the federal share of spending in the joint federal-state Medicaid program. Moderates had balked, arguing they would cut too deep into benefits, and House Speaker Mike Johnson had ruled out those changes. But in other sops for conservatives, the revisions would expand the criteria for states that could lose a portion of their federal payments if they offer coverage to undocumented people. It also moves to bar coverage of gender-affirming care for adults under the program, not just minors as previously proposed. The Congressional Budget Office estimated that a previous iteration of the bill could lead to 7.6 million people who had Medicaid going uninsured, and millions more from the the Affordable Care Act marketplace also losing coverage. Those coverage losses are expected to be higher with this new version. The Energy and Commerce portion of the bill has been estimated to save nearly a trillion dollars over a decade. The new amendments would make another notable change to Medicaid -— one that hard-liners hope would incentivize states to not to expand their programs under the ACA after the legislation goes into effect. The wonky measures would give states a financial incentive not to expand coverage to people with higher incomes than traditional enrollees, though still near the poverty line. The policy would make higher payments to providers like hospitals for uncompensated care. Hard-liners, particularly Rep. Chip Roy of Texas, pushed for the provision to be in the bill during a White House meeting with President Donald Trump Wednesday afternoon, according to three people with direct knowledge of the meeting. One senior GOP aide described the provision as 'a small Medicaid tweak' that would give the hard-liners a reason to support the bill, along with several other minor changes. Notably, they did not secure any further changes to the Medicaid state provider tax, which moderates had held firm against. Rep. Ralph Norman of South Carolina said in a brief interview Wednesday night he was happy with the meeting and that 'there were some good things from the White House.' Another Republican lawmaker said hard-liners would chiefly tout the accelerated Medicaid work requirements, the expansion change and a newly accelerated phase-out of clean-energy tax credits. In a major departure, the bill would fund cost-sharing reduction payments to insurers on Obamacare's insurance exchanges. The policy would offer subsidies to insurers that would, in turn, help reduce premiums and co-pays for patients. Trump ended this practice in his first administration, saying it constituted a bailout to the insurance industry. But the nonpartisan Congressional Budget Office estimated at that time that ending the payments would cost hundreds of billions of dollars over a decade. Bringing the policy back could provide savings. Rachael Bade contributed reporting.
Yahoo
19-05-2025
- Business
- Yahoo
Major sticking points unresolved as Johnson races to push Trump's massive policy bill through House by Thursday
House Republican leaders are still trying to resolve major internal battles over President Donald Trump's massive domestic policy bill even as Speaker Mike Johnson is engaged in last-ditch negotiations to win over GOP members' conflicting demands before an expected floor vote later this week. Among the major issues that are still unresolved: The timeframe over when new Medicaid work requirements would kick in, whether to change the federal-state cost sharing program for Medicaid, when green energy tax credits would be phased out and how much Americans can deduct from the state and local taxes they pay. There are also big questions: How much the sweeping bill will add to the deficit and how many Americans would lose access to benefits like Medicaid and food stamps — since the non-partisan Congressional Budget Office has yet to release an official estimate on the bill's impact to the debt and the economy. House GOP leadership aides said Monday morning that key decisions have not been finalized even though Johnson wants the bill passed out of his chamber by Thursday. 'Everything is in plan all the way until the end,' said one leadership aide, noting the talks are 'extremely difficult' given the narrowness of the majority and the diversity of the demands. But aides contended that '95%' of the bill had been agreed to among House Republicans. The bill calls for first-time work requirements for Medicaid beneficiaries to be implemented by 2029, but GOP hardliners are demanding that timeframe be moved up — something that is causing angst among more moderate members. Moreover, some of the hardliners want to pare back the amount of money the federal government pays into state-run Medicaid programs, a change that moderates have long resisted. Moving up the start date of Medicaid's work requirements would boost the amount of savings in the bill, but it would also strip coverage from more people, experts say. Currently, the Energy and Commerce Committee's Medicaid provisions are expected to reduce spending by $625 billion but leave 7.6 million more people uninsured by 2034, according to preliminary estimates from the Congressional Budget Office released by the GOP. The work requirement proposal accounts for nearly half the savings, at $300 billion. Some of the more moderate GOP members are also demanding an increase of the proposed $30,000 cap on the amount taxpayers can deduct on state and local taxes they pay — a push that would increase the price tag but also cause a revolt on the right. A source involved in the so-called SALT negotiations told CNN Monday morning that the issue had not been resolved, and they had not heard much on where leadership was going on it. Asked for an update on where leadership had left things over the last 24 hours, the source responded with a cricket emoji. Johnson is expected to continue talks Monday with his members as they negotiate final changes to the bill before the House Rules Committee meets at 1 a.m. on Wednesday for a key vote to advance the package to the full House. At that meeting, an amendment would be added to the bill to make the changes to win over holdouts in his conference. CNN's Tami Luhby contributed to this report.
Yahoo
18-05-2025
- Health
- Yahoo
Concerns rise over medical coverage losses from ‘big, beautiful bill'
Doctors, patients and health experts are bracing for massive coverage losses as House Republicans are poised to impose Medicaid work requirements as part of the 'big, beautiful bill' encompassing many of President Trump's legislative priorities. They are warning that a blizzard of red tape and administrative hurdles will strip people of needed health care. The requirements would apply to everyone aged 19 to 64, with certain exceptions. States wouldn't be able to waive them. According to partial estimates released by Republicans on the Energy and Commerce Committee, nearly 5 million people would lose Medicaid coverage. GOP lawmakers say they are fine with those consequences, even those who have said they oppose cutting Medicaid benefits, because the requirements will only target the 'able-bodied' people who should be working but choose not to. 'I like work requirements,' said Rep. Don Bacon (R-Neb.). 'People that are able-bodied, mentally healthy and all that should be working if you're working age. Able-bodied people still get Medicaid, but you should be looking for work, trying to improve your skills or working. And I think most Americans want that.' Groups such as the disabled, pregnant women and people who are in prison or rehabilitation centers would be exempt from the requirements. Those people, Republicans say, are the truly needy. But someone who qualifies would need to prove they are exempt, which would require submitting the correct forms and documentation — in the correct order — at the time they apply for Medicaid and after they are already enrolled. GOP leaders even seem likely to move up the start date for the work requirements. That accelerated time frame would front-load much of the savings, but also the coverage losses, meaning millions of people could be losing Medicaid in the run-up to the 2028 presidential election. Work requirements currently account for the largest savings in the health portion of the legislation: about $301 billion over seven years. Those savings come from removing millions of people from coverage, and there is no provision in the legislation to connect them with jobs or other sources of coverage. 'It's not like they're saving money by reducing costs or making people healthier. If the feds are saving money, it's because the states are spending it or people aren't getting health care. I mean, there's no magic efficiency in these proposals,' said Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities, a left-leaning think tank. Georgia is currently the only state with a Medicaid work requirement. It's part of the state's partial Medicaid expansion; people who earn up to the federal poverty level can be eligible for coverage, but only if they complete the requirements. Tanisha Corporal, 47, of Atlanta, is a social worker who needed health insurance after her nonprofit job ended last summer. She said she submitted an application three times over the digital portal, only to have her file disappear. She appealed; her appeal was denied. 'I would email, wouldn't get responses. Or I'd get, like, very short responses that were not clear, or were not true,' she said of her experience trying to navigate the state's verification system. She eventually spoke up during public comments about the program, and her application was finally approved in March. During those months, she went without insurance. She postponed an annual mammogram she gets because of a family history of breast cancer. Her college-aged son dislocated his finger and was scared to go to the doctor because of the cost. She eventually paid the bill after her application for Medicaid was approved retroactively. Opponents of work requirements say stories like Tanisha's will be the norm nationwide if the legislation passes. 'What I believe you're doing, not intentionally, is figuring out every way possible for them not to qualify, either because they can't fill out the paperwork [or] they don't know how to do it,' Energy and Commerce ranking member Frank Pallone Jr. (D-N.J.) said in the early morning hours Wednesday, as the committee was slogging through a marathon session to debate and advance the provisions. According to health policy research group KFF, there is no epidemic of nonworking adults on Medicaid. According to a KFF analysis, nearly two-thirds of the 26.1 million adults ages 19-64 covered by Medicaid in 2023 were working; nearly 3 in 10 were not working because of caregiving responsibilities, illness or disability, or due to school attendance. 'We're talking about low-income people to begin with, often with very complicated lives. You know, shifting hours, if they're in part-time work, shifting jobs. So, you know, any of those folks could, could easily fall through the cracks,' said Larry Levitt, vice president of health policy at KFF. Work requirements also represent a major cost shift to states. According to the Georgia Budget and Policy Institute, spending on upgrades to Georgia's online eligibility and enrollment system represents the largest proportion of total program costs. It was almost five times higher than spending on health care benefits for enrollees. The legislation would provide $100 million for states to implement registration and enrollment verification — spread across 40 states and D.C. that expanded Medicaid. Work requirements have been a central feature of the Republican vision of turning Medicaid into a welfare program for the disabled and most in need, rather than a health insurance program. During the first Trump administration, the Department of Health and Human Services actively encouraged states to apply for waivers to institute them. Officials at the time argued that work requirements were a pathway out of poverty. Arkansas was the only state to implement a work requirement. The program began in 2018 but was struck down by a federal judge in 2019. In just the first five months, more than 18,000 people lost coverage. Only a very small share regained coverage the next year. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
18-05-2025
- Health
- The Hill
Concerns rise over medical coverage losses from ‘big, beautiful bill'
Doctors, patients and health experts are bracing for massive coverage losses as House Republicans are poised to impose Medicaid work requirements as part of the 'Big, Beautiful Bill.' They are warning that a blizzard of red tape and administrative hurdles will strip people of needed healthcare. The requirements would apply to everyone aged 19 to 64, with certain exceptions. States wouldn't be able to waive them. According to partial estimates released by Republicans on the Energy and Commerce Committee, nearly 5 million people would lose Medicaid coverage. GOP lawmakers say they are fine with those consequences, even those who have said they oppose cutting Medicaid benefits, because the requirements will only target the 'able-bodied' people who should be working but choose not to. 'I like work requirements,' said Rep. Don Bacon (R-Neb.). 'People that are able-bodied, mentally healthy, and all that should be working if you're working age. Able-bodied people still get Medicaid, but you should be looking for work, trying to improve your skills or working. And I think most Americans want that.' Groups such as the disabled, pregnant women and people who are in prison or rehabilitation centers would be exempt from the requirements. Those people, Republicans say, are the truly needy. But someone who qualifies would need to prove they are exempt, which would require submitting the correct forms and documentation—in the correct order—at the time they apply for Medicaid and after they are already enrolled. GOP leaders even seem likely to move up the start date for the work requirements. That accelerated time frame would front-load much of the savings, but also the coverage losses, meaning millions of people could be losing Medicaid in the runup to the 2028 presidential election. Work requirements currently account for the largest savings in the health portion of the legislation; about $301 billion over seven years. Those savings come from removing millions of people from coverage, and there is no provision in the legislation to connect them with jobs or other sources of coverage. 'It's not like they're saving money by reducing costs or making people healthier. If the feds are saving money, it's because the states are spending it or people aren't getting health care. I mean, there's no magic efficiency in these proposals,' said Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities, a left-leaning think tank. Georgia is currently the only state with a Medicaid work requirement. It's part of the state's partial Medicaid expansion; people who earn up to the federal poverty level can be eligible for coverage, but only if they complete the requirements. Tanisha Corporal, 47, of Atlanta, is a social worker who needed health insurance after her non-profit job ended last summer. She said she submitted an application three times over the digital portal, only to have her file disappear. She appealed; her appeal was denied. 'I would email, wouldn't get responses. Or I'd get, like, very short responses that were not were not clear, or were not true,' she said of her experience trying to navigate the state's verification system. She eventually spoke up during public comments about the program, and her application was finally approved in March. During those months, she went without insurance. She postponed an annual mammogram she gets because of a family history of breast cancer. Her college-aged son dislocated his finger and was scared to go to the doctor because of the cost. She eventually paid the bill after her application for Medicaid was approved retroactively. Opponents of work requirements say stories like Tanisha's will be the norm nationwide if the legislation passes. 'What I believe you're doing, not intentionally, is figuring out every way possible for them not to qualify, either because they can't fill out the paperwork [or] they don't know how to do it,' Energy and Commerce ranking member Frank Pallone Jr. (D-N.J.) said in the early morning hours Wednesday, as the committee was slogging through a marathon session to debate and advance the provisions. According to health policy research group KFF, there is no epidemic of non-working adults on Medicaid. According to a KFF analysis, nearly two-thirds of the 26.1 million adults ages 19-64 covered by Medicaid in 2023 were working; nearly three in ten were not working because of caregiving responsibilities, illness or disability, or due to school attendance. 'We're talking about low-income people to begin with, often with very complicated lives. You know, shifting hours, if they're in part-time work, shifting jobs. So, you know, any of those folks could, could easily fall through the cracks,' said Larry Levitt, vice president of health policy at KFF. Work requirements also represent a major cost shift to states. According to the Georgia Budget & Policy Institute, spending on upgrades to Georgia's online eligibility and enrollment system represents the largest proportion of total program costs. It was almost five times higher than spending on healthcare benefits for enrollees. The legislation would provide $100 million for states to implement registration and enrollment verification — spread across 40 states and D.C. that expanded Medicaid. Work requirements have been a central feature of the Republican vision of turning Medicaid into a welfare program for the disabled and most in need, rather than a health insurance program. During the first Trump administration, the Department of Health and Human Services actively encouraged states to apply for waivers to institute them. Officials at the time argued that work requirements were a pathway out of poverty. Arkansas was the only state to implement a work requirement. The program began in 2018 but was struck down by a federal judge in 2019. In just the first five months, more than 18,000 people lost coverage. Only a very small share regained coverage the next year.
