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Daily Mail
9 hours ago
- Health
- Daily Mail
How Trump's pride and joy is set to cause 13,000 preventable deaths... are you at risk?
Health experts are sounding the alarm over the president's One Big Beautiful Bill, estimating the proposed cuts to government-funded health insurance could lead to the needless deaths of thousands. The bill, which is expected to be passed July 4, would slash Medicaid coverage, reimbursement and funding by $793 billion over 10 years, as well as implement restrictive requirements for benefits. This gutting of the federal insurance program is estimated to have big implications for the 71 million people enrolled in Medicaid. Now, an in-depth study led by Dr Adam Gaffney, an assistant professor of medicine at Harvard Medical School, concluded it could undermine the coverage, financial well-being, medical care, and health of low-income Americans, resulting in up to 12,600 medically preventable deaths annually. And an even higher mounting death toll would occur off the back of necessary healthcare services being reduced for vulnerable populations. This could include, for instance, those battling chronic conditions like heart disease, HIV, and cancer, who rely on regular, low-cost medication and treatment. Supporters of the bill say it will cut taxes, help boost the economy and increase take-home pay. But critics argue the bill primarily benefits the wealthy and could lead to increased national debt. The researchers warn: 'Today, despite its many shortcomings, Medicaid enjoys wide support from the electorate and serves as the foundation of the nation's health care safety net. 'The cuts under consideration, intended to offset the cost of tax cuts that would predominantly benefit wealthier Americans, would strip care from millions and likely lead to thousands of medically preventable deaths.' Researchers identified six potential Medicaid cuts that the House of Representatives ' Budget Committee estimates would each reduce the federal government's Medicaid outlays by at least $100billion over 10 years. They include reduction of the Medicaid matching floor; reduced funding of the Affordable Care Act's Medicaid Expansion; Medicaid per capita caps; Medicaid work requirements; reduced Medicaid provider taxes; and repeal of the Biden-era Medicaid eligibility rule. 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, which expanded eligibility and created a national minimum income threshold. The team also assessed the overall effects of the current House bill, which includes three of the six options along with multiple smaller policy changes, such as shortening the duration of Medicaid's retroactive coverage and increasing cost-sharing for some Medicaid enrollees. The researchers project that individually, these six Medicaid cuts would lead to an annual increase of between 651 and 12,626 medically preventable deaths. These cuts would increase the number of uninsured Americans by between 600,000 and 3.9 million, and the annual number of people foregoing needed medical care will range from 129,060 to 838,890. It could lead to 1.9 million people losing their personal doctor, 1.3 million foregoing needed medications and 380,270 women going without a mammogram. The authors assert that policy makers should weigh the likely health and financial harms to patients and providers of reducing Medicaid expenditures against the desirability of tax reductions, which would benefit mostly wealthy Americans. Under the current proposal, childless adults without disabilities who want Medicaid coverage would have to prove that they had worked, volunteered or attended school for 80 hours in the month enrolling. But if you have a medically diagnosed illness or disability that prevents you from working, you may be exempt from Medicaid work requirements. This exemption falls under the category of being 'medically frail' or having 'special medical needs'. Many details of the bill have yet to be ironed out, leaving beneficiaries with a host of unknowns and causing worry that their illnesses might not be enough to exempt them from the work requirements. Advocates and sick and disabled enrollees also worry 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. A tracking poll conducted by health policy research firm Kaiser Fund Foundation in May found that the enrollees come from across the political spectrum, including those who voted for Trump. About one-fourth are Republicans; roughly one-third are Democrats. The poll found that about seven 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. Republicans have suggested a work requirement similar to the conditions for the Supplemental Nutrition Assistance Program - food stamps. Those ages 16 to 59 must work or volunteer at least 80 hours a month if they are not in school, caring for a child under age six, disabled, pregnant or homeless. Republicans say, however, the requirement could motivate people to find employment — maybe even a job that comes with health insurance. Other cuts on the table include a proposal to change TO the federal government's reimbursement, which would shift the costs to states, forcing them to make tough choices about who or what they cover. Joan Alker, executive director of the Georgetown Center for Children and Families, SAID: 'People still have health care needs even if you cut their coverage. Their health care needs are not going to go away.'
Yahoo
12-05-2025
- Business
- Yahoo
States bear the brunt of House GOP Medicaid plan
House Republicans opted against some of the most dramatic changes they had been considering for Medicaid, the joint federal-state program covering nearly 80 million Americans. But they are plowing forward with other major initiatives that could leave millions without coverage as the GOP starts laying out key provisions of its party-line domestic policy megabill. The House Energy and Commerce Committee proposal released Sunday night attempts to strike a balance between satiating conservatives' thirst for deep cuts to the program and placating moderates wary of major coverage losses for low-income Americans. It does not include the most controversial ideas, including per-capita caps on federal Medicaid payments to states, but it incorporates new mandates that will likely force states to revamp how they finance their programs or cut benefits. It also includes new work requirements that are expected to lead many people to lose coverage, as well as a new cost-sharing requirement for some beneficiaries in the program, not to exceed five percent of a patient's income. The Energy and Commerce plan also hits on hot-button social issues — proposing, for instance, to cut federal funding for groups like Planned Parenthood and ban the use of Medicaid dollars for gender-affirming care for youth. It also scales back funding from states that use their own funds to offer coverage for undocumented people. 'Democrats will use this as an opportunity to engage in fear-mongering and misrepresent our bill as an attack on Medicaid,' Chair Brett Guthrie (R-Ky.) wrote in a Wall Street Journal op-ed Sunday. 'In reality, it preserves and strengthens Medicaid for children, mothers, people with disabilities and the elderly — for whom the program was designed.' The panel has been tasked with finding $880 billion in savings to help finance a massive portion of the GOP's party-line package of tax cuts and extensions, border security investments, energy policy and more. Committee Republicans have been under significant pressure to make politically difficult cuts to Medicaid as part of that effort. Guthrie told committee Republicans on a call Sunday that the package will create more than $900 billion in savings. Moderate Republicans have been hesitant to make major cuts to the popular safety net program for vulnerable Americans, while fiscal hawks have been angling for transformative 'structural' changes. Democrats and many players in the health care industry, including hospitals — which are major employers in many districts — are expected to fiercely oppose the proposal. "Republican leadership released this bill under cover of night because they don't want people to know their true intentions," Rep. Frank Pallone (D-N.J.), the top Energy and Commerce Democrat, said in a statement. "Taking health care away from children and moms, seniors in nursing homes, and people with disabilities to give tax breaks to people who don't need them is shameful. Democrats have defeated Republican efforts to cut health care before and we can do it again.' Guthrie worked behind the scenes to placate both moderates and conservatives to get to a deal that both sides can live with, but it remains to be seen whether he and his leadership have in fact landed on a winning strategy. Energy and Commerce is scheduled to meet Tuesday at 2 p.m. to debate and advance the bill. One of the largest potential sources of savings will come from a policy curbing states' ability to levy taxes on providers, which could force states to make major changes since the taxes can pay for a state's share of Medicaid costs. The legislation would freeze state provider taxes at their current rates and prohibit them from establishing any new taxes. Conservatives argue that states use the taxes to boost their federal share of Medicaid payments without having to use their own revenue. Doctors and hospitals don't mind because a state can direct the extra funds back to them, making up for the tax hike. Every state except for Alaska relies on a provider tax of some form, an analysis from the research firm KFF found. Last year, 32 percent of states' contributions to Medicaid costs came from other sources such as local government funds and the provider taxes. States cannot levy more than 6 percent of a provider's income and must tax those on and off Medicaid. Some states have already warned Washington about what would happen if they can't levy Medicaid taxes. New Jersey's Medicaid agency released a model of potential changes back in February and would lead to an estimated $2.5 billion in cuts to federal funding. It also will mandate every state to install a work requirement for certain beneficiaries. Able-bodied adults without any dependents would have to work at least 80 hours a month or perform other activities such as community service. It would not apply to pregnant women and only adults from 19 to 64. Tribal members are also exempt as well as those with serious medical conditions. Congress would leave it up to states to verify compliance with the work requirement. The bill would also target state-directed payments, which gives states more power over provider payments and allows some providers to get reimbursed more in line with what commercial insurers pay them. The goal of the payments is to bolster pay rates for providers and encourage them to enter value-based payment arrangements where doctors are paid based on the quality of care delivered. Conservatives have argued there isn't enough transparency in the payments. Here's what else the package would — and wouldn't — do: Non-health care policies: The package would allow the federal government to auction off wireless spectrum in a move that is expected to generate $88 billion, Guthrie said. It would also claw back Biden-era green energy spending, including climate spending under the Inflation Reduction Act. Take on some parts of Medicaid expansion: The package would lower the federal share of payments to states that have expanded Medicaid under the Affordable Care Act if the state allows undocumented immigrants to get Medicaid coverage. It is illegal for undocumented immigrants to get coverage, but several states take on the full amount of coverage without any federal match. Stricter eligibility checks: The legislation would roll back Biden-era rules limiting Medicaid eligibility checks to once annually, allowing them to be made twice a year. Savings would ensue as more are kicked off the rolls. Address cuts to doctor pay in Medicare: Doctors have been angling to reverse payment cuts mandated by a formula that lawmakers on both sides of the aisle say doesn't account for rising costs. The package aims to blunt that. Pharmacy benefit manager reform: The package includes an overhaul of the business practices in Medicaid of the pharmacy intermediaries, which pharmaceutical companies argue have driven up the cost of prescription drugs. PBMs have argued they help negotiate lower drug prices and the reforms would limit their ability to do so. Drug price negotiation: The package would also soften Medicare's new power to negotiate drug prices under the Inflation Reduction Act for certain drugs.
