Latest news with #OBAMACARE
Time of India
01-05-2025
- Health
- Time of India
Republicans weigh cuts to Medicaid that could dramatically affect millions
Washington: President Donald Trump 's fellow Republicans in the U.S. Congress are weighing steep cuts to the Medicaid health program as part of a wide-ranging budget package that also would cut taxes and raise spending on defense and border security. That could lead to dramatic changes for one of the biggest U.S. safety-net programs, which provides coverage to 83 million low-income people, according to government figures. Here are some options being considered by Republicans on the House of Representatives Energy and Commerce Committee: REQUIRING RECIPIENTS TO WORK Republicans are divided over how deeply to cut Medicaid, which is jointly funded by the federal government and states. The program cost Washington $618 billion last year and is projected by the Congressional Budget Office to grow 60% over the coming 10 years. But concerns about Medicaid among a dozen House Republicans and several Senate Republicans have prompted Trump and party leaders to assure lawmakers that their measures will not lead to cuts in benefits, though it is not clear what they mean. Republicans broadly support adding a work requirement for adult recipients, arguing that tax dollars should not go to those unwilling to support themselves. While supporters for the program say the expansion to some adult recipients has led to the lowest uninsured rate in U.S. history, leading to better health and economic outcomes for the country as a whole. A Republican proposal in 2023 would have required able-bodied adults between the ages of 19 and 55 who do not have dependents to spend at least 80 hours a month either working or participating in job training or community service. CBO estimated that would reduce federal spending by $109 billion over 10 years by excluding 1.5 million current recipients. Roughly 900,000 would remain covered through their state programs, while 600,000 would become uninsured, CBO said. Analysts say a work requirement could inadvertently force out qualified Medicaid recipients, due to the increased administrative hurdles they would face to prove eligibility. Georgia included a work requirement when it opted into the Obamacare expansion in 2023. According to news reports, relatively few people have signed up as the requirement to prove they are working has complicated enrollment. REDUCE SUPPORT FOR OBAMACARE EXPANSION Medicaid has grown significantly since 2010, when Democratic President Barack Obama's Affordable Care Act, also known as Obamacare, expanded coverage to include childless adults who earn slightly more than poverty wages. The Supreme Court made this expansion optional for states, and 41 have opted in. Republicans fiercely opposed that law and tried repeatedly to repeal it, but many Republican-led states now participate in the Obamacare expansion. Though Republicans have given up on trying to repeal Obamacare, they are discussing ways to roll back support for the Medicaid expansion the law enabled. Roughly 20 million Medicaid recipients are currently covered through the Obamacare expansion. One approach would scale back the federal funding share of the Obamacare expansion from 90% - the level in place now - to levels closer to what Washington provides for the rest of the program, which ranges from 77% to 50%, depending on income levels and other factors in each state. This would require states to shoulder more of the cost themselves, kick people off the program, or both. Even a slight reduction in federal support could cause millions of people losing coverage, as 12 states have "trigger" laws in place that would end or reduce their Obamacare expansions if the federal share of funding changed. Alternatively, Republicans could opt for a "per capita" cap on Obamacare expansion spending to avoid running afoul of those trigger laws. That would limit spending growth based on some metric, such as inflation. The Kaiser Family Foundation estimates that would shift $246 billion in costs to states over the next 10 years, which could prompt some states to drop people from the program. ELIMINATE PROVIDER TAX LOOPHOLE Some states effectively shift more of their costs to the federal government by taxing hospitals and other healthcare providers, then using that money to increase Medicaid payments to those same providers. This maneuver increases a state's total Medicaid spending, qualifying it for additional federal funding. While legal, the practice has been widely criticized as a gimmick or loophole that does not accurately reflect how much money is actually being spent on medical care. Eliminating the provider tax entirely, along with a similar maneuver used by local governments that operate their own hospitals, would save the federal government up to $655 billion over 10 years, according to the nonpartisan Committee for a Responsible Federal Budget. But that would force states to shoulder more of the burden, potentially leading to scaled back coverage. STEP UP VERIFICATION, EXCLUDE NONCITIZENS Though they have yet to formally propose specific Medicaid cuts so far, Republicans have spoken extensively about eliminating "waste, fraud and abuse" in the program. This could take the form of more stringent verification requirements to ensure that nonqualified people are not covered, though those steps could also end up excluding qualified people who may not be able to provide the required paperwork. Republicans could also push to exclude noncitizens who are now covered by Medicaid, amplifying Trump's crackdown on immigrants. Medicaid is currently open to some immigrants who are lawfully present in the country, though many - including green card holders - must wait five years before they can sign up. Undocumented immigrants in the United States are not eligible for coverage. The program also reimburses hospitals for emergency care they provide to immigrants who are not eligible. Several states, including California and New York, have expanded their Medicaid programs further to cover all poor residents regardless of their immigration status, relying on their own money for this purpose, according to KFF. Others cover some immigrant populations, such as children, who are not in the country legally. Eligible noncitizens account for 6 per cent of those enrolled in Medicaid and CHIP, a related health program for children, according to KFF Scott Malone and Aurora Ellis )
Yahoo
30-04-2025
- Health
- Yahoo
Explainer-Republicans weigh cuts to Medicaid that could dramatically affect millions
By Andy Sullivan WASHINGTON (Reuters) -President Donald Trump's fellow Republicans in the U.S. Congress are weighing steep cuts to the Medicaid health program as part of a wide-ranging budget package that also would cut taxes and raise spending on defense and border security. That could lead to dramatic changes for one of the biggest U.S. safety-net programs, which provides coverage to 83 million low-income people, according to government figures. Here are some options being considered by Republicans on the House of Representatives Energy and Commerce Committee: REQUIRING RECIPIENTS TO WORK Republicans are divided over how deeply to cut Medicaid, which is jointly funded by the federal government and states. The program cost Washington $618 billion last year and is projected by the Congressional Budget Office to grow 60% over the coming 10 years. But concerns about Medicaid among a dozen House Republicans and several Senate Republicans have prompted Trump and party leaders to assure lawmakers that their measures will not lead to cuts in benefits, though it is not clear what they mean. Republicans broadly support adding a work requirement for adult recipients, arguing that tax dollars should not go to those unwilling to support themselves. While supporters for the program say the expansion to some adult recipients has led to the lowest uninsured rate in U.S. history, leading to better health and economic outcomes for the country as a whole. A Republican proposal in 2023 would have required able-bodied adults between the ages of 19 and 55 who do not have dependents to spend at least 80 hours a month either working or participating in job training or community service. CBO estimated that would reduce federal spending by $109 billion over 10 years by excluding 1.5 million current recipients. Roughly 900,000 would remain covered through their state programs, while 600,000 would become uninsured, CBO said. Analysts say a work requirement could inadvertently force out qualified Medicaid recipients, due to the increased administrative hurdles they would face to prove eligibility. Georgia included a work requirement when it opted into the Obamacare expansion in 2023. According to news reports, relatively few people have signed up as the requirement to prove they are working has complicated enrollment. REDUCE SUPPORT FOR OBAMACARE EXPANSION Medicaid has grown significantly since 2010, when Democratic President Barack Obama's Affordable Care Act, also known as Obamacare, expanded coverage to include childless adults who earn slightly more than poverty wages. The Supreme Court made this expansion optional for states, and 41 have opted in. Republicans fiercely opposed that law and tried repeatedly to repeal it, but many Republican-led states now participate in the Obamacare expansion. Though Republicans have given up on trying to repeal Obamacare, they are discussing ways to roll back support for the Medicaid expansion the law enabled. Roughly 20 million Medicaid recipients are currently covered through the Obamacare expansion. One approach would scale back the federal funding share of the Obamacare expansion from 90% - the level in place now - to levels closer to what Washington provides for the rest of the program, which ranges from 77% to 50%, depending on income levels and other factors in each state. This would require states to shoulder more of the cost themselves, kick people off the program, or both. Even a slight reduction in federal support could cause millions of people losing coverage, as 12 states have "trigger" laws in place that would end or reduce their Obamacare expansions if the federal share of funding changed. Alternatively, Republicans could opt for a "per capita" cap on Obamacare expansion spending to avoid running afoul of those trigger laws. That would limit spending growth based on some metric, such as inflation. The Kaiser Family Foundation estimates that would shift $246 billion in costs to states over the next 10 years, which could prompt some states to drop people from the program. ELIMINATE PROVIDER TAX LOOPHOLE Some states effectively shift more of their costs to the federal government by taxing hospitals and other healthcare providers, then using that money to increase Medicaid payments to those same providers. This maneuver increases a state's total Medicaid spending, qualifying it for additional federal funding. While legal, the practice has been widely criticized as a gimmick or loophole that does not accurately reflect how much money is actually being spent on medical care. Eliminating the provider tax entirely, along with a similar maneuver used by local governments that operate their own hospitals, would save the federal government up to $655 billion over 10 years, according to the nonpartisan Committee for a Responsible Federal Budget. But that would force states to shoulder more of the burden, potentially leading to scaled back coverage. STEP UP VERIFICATION, EXCLUDE NONCITIZENS Though they have yet to formally propose specific Medicaid cuts so far, Republicans have spoken extensively about eliminating "waste, fraud and abuse" in the program. This could take the form of more stringent verification requirements to ensure that nonqualified people are not covered, though those steps could also end up excluding qualified people who may not be able to provide the required paperwork. Republicans could also push to exclude noncitizens who are now covered by Medicaid, amplifying Trump's crackdown on immigrants. Medicaid is currently open to some immigrants who are lawfully present in the country, though many - including green card holders - must wait five years before they can sign up. Undocumented immigrants in the United States are not eligible for coverage. The program also reimburses hospitals for emergency care they provide to immigrants who are not eligible. Several states, including California and New York, have expanded their Medicaid programs further to cover all poor residents regardless of their immigration status, relying on their own money for this purpose, according to KFF. Others cover some immigrant populations, such as children, who are not in the country legally. Eligible noncitizens account for 6% of those enrolled in Medicaid and CHIP, a related health program for children, according to KFF.
Reuters
30-04-2025
- Health
- Reuters
Explainer: Republicans weigh cuts to Medicaid that could dramatically affect millions
WASHINGTON, April 30 (Reuters) - President Donald Trump 's fellow Republicans in the U.S. Congress are weighing steep cuts to the Medicaid health program as part of a wide-ranging budget package that also would cut taxes and raise spending on defense and border security. That could lead to dramatic changes for one of the biggest U.S. safety-net programs, which provides coverage to 83 million low-income people, according to government figures. Here are some options being considered by Republicans on the House of Representatives Energy and Commerce Committee: here. REQUIRING RECIPIENTS TO WORK Republicans are divided over how deeply to cut Medicaid, which is jointly funded by the federal government and states. The program cost Washington $618 billion last year and is projected by the Congressional Budget Office to grow 60% over the coming 10 years. But concerns about Medicaid among a dozen House Republicans and several Senate Republicans have prompted Trump and party leaders to assure lawmakers that their measures will not lead to cuts in benefits, though it is not clear what they mean. Republicans broadly support adding a work requirement for adult recipients, arguing that tax dollars should not go to those unwilling to support themselves. While supporters for the program say the expansion to some adult recipients has led to the lowest uninsured rate in U.S. history, leading to better health and economic outcomes for the country as a whole. A Republican proposal in 2023 would have required able-bodied adults between the ages of 19 and 55 who do not have dependents to spend at least 80 hours a month either working or participating in job training or community service. CBO estimated that would reduce federal spending by $109 billion over 10 years by excluding 1.5 million current recipients. Roughly 900,000 would remain covered through their state programs, while 600,000 would become uninsured, CBO said. Analysts say a work requirement could inadvertently force out qualified Medicaid recipients, due to the increased administrative hurdles they would face to prove eligibility. Georgia included a work requirement when it opted into the Obamacare expansion in 2023. According to news reports,, opens new tab relatively few, opens new tab people have signed up as the requirement to prove they are working has complicated enrollment. REDUCE SUPPORT FOR OBAMACARE EXPANSION Medicaid has grown significantly since 2010, when Democratic President Barack Obama's Affordable Care Act, also known as Obamacare, expanded coverage to include childless adults who earn slightly more than poverty wages. The Supreme Court made this expansion optional for states, and 41 have opted in. Republicans fiercely opposed that law and tried repeatedly to repeal it, but many Republican-led states now participate in the Obamacare expansion. Though Republicans have given up on trying to repeal Obamacare, they are discussing ways to roll back support for the Medicaid expansion the law enabled. Roughly 20 million Medicaid recipients are currently covered through the Obamacare expansion. One approach would scale back the federal funding share of the Obamacare expansion from 90% - the level in place now - to levels closer to what Washington provides for the rest of the program, which ranges from 77% to 50%, depending on income levels and other factors in each state. This would require states to shoulder more of the cost themselves, kick people off the program, or both. Even a slight reduction in federal support could cause millions of people losing coverage, as 12 states have "trigger" laws in place that would end or reduce their Obamacare expansions if the federal share of funding changed. Alternatively, Republicans could opt for a "per capita" cap on Obamacare expansion spending to avoid running afoul of those trigger laws. That would limit spending growth based on some metric, such as inflation. The Kaiser Family Foundation estimates that would shift $246 billion in costs to states over the next 10 years, which could prompt some states to drop people from the program. ELIMINATE PROVIDER TAX LOOPHOLE Some states effectively shift more of their costs to the federal government by taxing hospitals and other healthcare providers, then using that money to increase Medicaid payments to those same providers. This maneuver increases a state's total Medicaid spending, qualifying it for additional federal funding. While legal, the practice has been widely criticized as a gimmick or loophole that does not accurately reflect how much money is actually being spent on medical care. Eliminating the provider tax entirely, along with a similar maneuver used by local governments that operate their own hospitals, would save the federal government up to $655 billion over 10 years, according to the nonpartisan Committee for a Responsible Federal Budget. But that would force states to shoulder more of the burden, potentially leading to scaled back coverage. STEP UP VERIFICATION, EXCLUDE NONCITIZENS Though they have yet to formally propose specific Medicaid cuts so far, Republicans have spoken extensively about eliminating "waste, fraud and abuse" in the program. This could take the form of more stringent verification requirements to ensure that nonqualified people are not covered, though those steps could also end up excluding qualified people who may not be able to provide the required paperwork. Republicans could also push to exclude noncitizens who are now covered by Medicaid, amplifying Trump's crackdown on immigrants. Medicaid is currently open to some immigrants who are lawfully present in the country, though many - including green card holders - must wait five years before they can sign up. Undocumented immigrants in the United States are not eligible for coverage. The program also reimburses hospitals for emergency care they provide to immigrants who are not eligible. Several states, including California and New York, have expanded their Medicaid programs further to cover all poor residents regardless of their immigration status, relying on their own money for this purpose, according to KFF. Others cover some immigrant populations, such as children, who are not in the country legally. Eligible noncitizens account for 6% of those enrolled in Medicaid and CHIP, a related health program for children, according to KFF.
Politico
11-03-2025
- Health
- Politico
Trump admin takes aim at Obamacare
Presented by the Coalition for Medicare Choices With Ben Leonard OBAMACARE IN THE CROSSHAIRS — The Trump administration released its first major health regulation Monday, proposing policies that would limit Obamacare enrollment, Chelsea and POLITICO's Robert King report. The Centers for Medicare and Medicaid Services' proposed rule, which sets 2026 coverage year policies for the Affordable Care Act, would shorten the annual enrollment period for Obamacare from Nov. 1 to Dec. 15. The previous period stretched to Jan. 15. The rule would also scrap a Biden-era regulation cleared last year that allowed recipients of the Deferred Action for Childhood Arrivals program — which lets young immigrants who were brought to the U.S. illegally when they were children remain in the country — to enroll in Obamacare. The agency proposes stripping this eligibility as part of President Donald Trump's executive order to end the 'taxpayer subsidization of open borders.' Why it matters: The proposed rule illustrates how the Trump administration wants to tighten access to Obamacare's insurance exchanges after enrollment surged and reached record levels during former President Joe Biden's administration. It also builds on the Trump administration's decision to cut funding from nearly $100 million to $10 million for nonprofit 'navigators' that help people find insurance plans. Also in the rule: The administration proposes other changes to Obamacare it says will crack down on improper enrollments, including ending a special monthly enrollment period for people in households earning less than 150 percent of the federal poverty level. The administration's goal is to end a policy that 'allows people to wait to enroll until they become sick instead of promoting continuous enrollment.' It would also remove 'sex trait modifications,' or gender-affirming care, from a list of essential health benefits that Obamacare plans must cover. Key context: Directors of state-run Obamacare exchanges have anticipated a rollback of coverage for DACA recipients for months, preparing to have to quickly reverse coverage that was just granted to the group and encouraging them to access health care while coverage is still available. About 500,000 DACA recipients became eligible for coverage under the Biden administration's expansion last year, though CMS estimated at the time that about 100,000 Dreamers would sign up for coverage. What's next: The Trump administration must still take public comment before it can finalize the rule, a process that can take months. WELCOME TO TUESDAY PULSE. It feels like spring in D.C., and we're not complaining. Send your tips, scoops and feedback to khooper@ and ccirruzzo@ and follow along @Kelhoops and @ChelseaCirruzzo. In Congress GOP AGREES TO DOC PAY — House GOP leadership will resolve pay cuts for doctors treating Medicare patients in Republicans' party-line package supporting President Donald Trump's agenda, Ben reports. In a social media post Monday, Rep. Greg Murphy (R-N.C.), who co-chairs the GOP Doctors Caucus, said that House Speaker Mike Johnson and Majority Leader Steve Scalise would include a fix to the payment cuts — mandated by a formula that lawmakers on both sides of the aisle say doesn't reflect rising costs. Spokespeople for Johnson and Scalise didn't respond to requests for comment. Background: Leadership had previously been open to including the provisions in a stopgap spending bill to keep the government funded after this week, but the pay fix was ultimately not included amid broader concerns among GOP leaders that adding more than standard program extensions would open the door to demands for other policies to be attached. Key context: Supporters of the fix warn the stakes are high for not addressing this issue quickly: Decades of payment reductions in Medicare have put medical practices in difficult financial straits, potentially forcing them to close practices and reduce access to care, doctor groups say. But the price tag of a long-term fix has historically been a barrier to addressing the cuts. FIRST IN PULSE: MEDICAID CAMPAIGN — Left-leaning advocacy group Protect Our Care is launching a $2 million ad buy targeting key House Republicans on preserving Medicaid, Ben reports. The purchase, the largest in a $10 million campaign, consists of television, digital and radio ads featuring a 'lifelong' GOP voter and President Donald Trump supporter urging Republicans not to make cuts to Medicaid. The push comes as Republicans are expected to target the program to help fund Trump's domestic agenda, including tax cuts, border enforcement and energy policy. Moderates have raised concerns about changes leading to cuts in benefits. Among others, the ads will target several California, New York and Pennsylvania Republicans in swing districts, including Reps. Mike Lawler (R-N.Y.) and Young Kim (R-Calif.). FREEDOM CAUCUS' PLEA — A group of ultraconservative lawmakers is pleading with moderate Republicans to not get in the way of making massive cuts to Medicaid, Ben reports. Three prominent members of the House Freedom Caucus said in an op-ed for Fox News on Monday that they're not calling for massive cuts to the safety-net health insurance program but instead calling for reforms that would 'reverse its explosive expansion' that's left Medicaid 'unsustainable.' Freedom Caucus Chair Andy Harris (R-Md.) and members Chip Roy (R-Texas) and Eric Burlison (R-Mo.) argued in the op-ed that while some colleagues may be 'hesitant' about making changes to Medicaid, many of those changes could be phased in to avoid cuts to benefits and help Republicans achieve necessary savings targets. Background: Massive cuts to Medicaid would likely be needed to finance Republicans' party-line bill to enact broad swaths of President Donald Trump's domestic agenda. The budget resolution the House adopted last month would instruct the House Energy and Commerce Committee — which has jurisdiction over Medicaid — to find $880 billion in cuts over a decade. The savings would help to finance the tax, border security and energy bill Republicans want to pass through the filibuster-skirting budget reconciliation process. 'For lawmakers who claim to be on board with cutting the waste, fraud and abuse — and delivering on Trump's historic mandate — this is it,' the Freedom Caucus members wrote. 'Nothing you do in the next two years will come close to the importance of implementing the $880 billion required in savings to programs under the House Energy and Commerce Committee's jurisdiction.' IN THE STATES TARGETING mRNA SHOTS — States are introducing more roadblocks to the use of messenger RNA vaccines, POLITICO's Lauren Gardner reports. Republican policymakers across the country are proposing bills to limit or ban the use of the vaccines based on a mix of medical freedom rhetoric and incorrect assertions of how they work in the body. The proposals represent the latest manifestation of Covid-19 pandemic backlash. Several bills introduced in the Texas Legislature would ban the administration, manufacture or sale of mRNA vaccines there. Legislation in Kentucky would prohibit the use of mRNA vaccines in children under 18. In Idaho, a GOP state senator has proposed a 10-year moratorium on mRNA vaccine administration. Why it matters: Some efforts have failed, but public health experts worry that their existence now could be a bellwether for the future. The efforts come as noted vaccine skeptic Robert F. Kennedy Jr. has taken the reins at HHS and the Trump administration is reportedly weighing whether to pull hundreds of millions of dollars in federal funding to Moderna, the maker of one of the most-used Covid shots, to develop a human bird flu vaccine as that disease spreads among animals and occasionally infects people. 'People laugh at this,' said Dr. Amesh Adalja of the Johns Hopkins Center for Health Security, 'but then five years from now more legislatures are doing it, and it becomes real.' WHAT WE'RE READING ProPublica's Annie Waldman and Lisa Song report on certain topics that will get extra scrutiny at the National Cancer Institute under the new HHS secretary. POLITICO's Meredith Lee Hill reports on House GOP leaders' alarm over the Senate's delay in advancing their budget plan.
