BREAKING: Republicans Pass Spending Bill with Dramatic Potential Medicaid Cuts
On a party-line vote on Feb. 25, Republicans in the House of Representatives passed a continuing resolution to keep the federal government running, that involves massive potential cuts to the Medicaid program. The bill also fails to match the provisions of the Senate CR passed last week.
As the Washington Post’s Jacob Bogage and Marianna Sotomayor wrote on Tuesday evening, “House Republicans narrowly approved a framework Tuesday for President Donald Trump’s legislative agenda, setting off a sprint with the Senate to reshape the tax code, implement strict new immigration policy, drill for new energy resources and spend billions on national defense. The bill, which passed 217 to 215, would allow Congress’s GOP majorities to bypass a Democratic Senate filibuster through what’s known as the budget reconciliation process, but Republicans still face significant challenges before they can pass what Trump has taken to calling his “big, beautiful bill.” The House and Senate must agree on competing approaches, even though both chambers have now passed their own versions of the legislation.” All of those supporting the bill were Republicans; only one Republican voted with the Democrats to oppose it.
Importantly, the Post reporters wrote, “Some tensions within the GOP were on display Tuesday. Conservative hard-liners and moderates alike threatened to buck Speaker Mike Johnson (R-Louisiana) and sink the budget. Moderates fear its $2 trillion in spending cuts will force the GOP to slash Medicaid benefits, a political third rail in toss-up districts, but hard-liners say budget cuts don’t go far enough. The Senate had already passed its own budget resolution under the assumption that House Republicans would falter.”
As The Hill’s Mychael Schnell and Emily Brooks wrote on Tuesday evening, “Republicans are looking to use a process known as budget reconciliation to enact Trump’s priorities, which would allow the party to circumvent Democratic opposition in the Senate. The House’s resolution lays out a $1.5 trillion floor for spending cuts across committees with a target of $2 trillion, puts a $4.5 trillion ceiling on the deficit impact of any GOP plan to extend Trump’s 2017 tax cuts, and includes $300 billion in additional spending for the border and defense and a $4 trillion debt limit increase,” they wrote.
Further, Schnell and Brooks wrote, “In addition to the fiscal conservative holdouts, GOP leaders also had to win over moderates concerned about potential cuts to Medicaid in the ultimate Trump agenda bill. The resolution directs the Energy and Commerce Committee — which has jurisdiction over Medicaid — to find at least $880 billion in cuts, a figure that some lawmakers said could not be reached without significant slashes to the social safety net program. That notion sparked worries among centrists. But after several conversations with leadership, they softened their stances. ‘I’m in a better place [than] where I was yesterday,’ Rep. Juan Ciscomani (R-Ariz.), who represents a purple district, said Tuesday morning. Leadership, for its part, has rejected the notion that the bill will prompt significant Medicaid cuts. Johnson for weeks has said the conference just wants to root out “fraud, waste and abuse” in the program. Top lawmakers amped up that messaging on Tuesday.”
Speaker Johnson told reporters on Tuesday morning, “Do a word search for yourself. It doesn’t even mention Medicaid in the bill, so that’s an important point.”
But, The Hill reporters noted, “Skepticism, however, remains high that the conference will be able to achieve those levels without significant changes to the social safety net program, signaling the headwinds House GOP leaders will face as they work to craft the bill in the coming weeks and months.”
Per that, the Post reporters quoted Rep. Jeff Van Drew (R-N.J.), formerly a Democrat, who “said he called Trump on Monday to tell the president to reinforce his pledge not to cut Medicaid. ‘Don’t touch seniors’ Medicare, and don’t cut Medicaid, because it isn’t just for lazy welfare people. It’s for real people,’ Van Drew said late Monday. ‘That’s the new Republican Party, a populist party, a party of working people, a party of blue-collar people.’”
Meanwhile, the New York Times’s Catie Edmonson, Andrew Duehren, Maya C. Miller, and Robert Jimison, wrote on Tuesday evening that “The blueprint sets the contours for the legislation that House Republicans will now turn to writing. It puts a $4.5 trillion upper limit on the size of any tax cuts over the next 10 years, but does not dictate which taxes should be reduced, a complex and politically tricky question of its own that could take months to sort out. It also calls for slashing $2 trillion in spending over the same period, without specifying which programs should be cut, though top Republicans have targeted Medicaid and food aid programs for poor Americans. And it directs increases of about $300 billion for border enforcement and defense programs, alongside a $4 trillion increase in the debt limit. The resolution,” they wrote, “ties together the lower taxes and spending cuts. If House Republicans ultimately find less than $2 trillion in spending to eliminate, the allowance for tax cuts will shrink by the amount of the shortfall. That means the budget for the tax cut could ultimately drop to $4 trillion if Republicans cut only $1.5 trillion in spending — the floor set in the outline.”
Organizations advocating for healthcare for the disadvantaged released statements on Tuesday evening condemning the Republicans’ bill. “The House Republicans just passed a budget that requires a minimum of $880 billion in health care cuts, which means devastating impacts not just for the 80 million Americans who use Medicaid for their health coverage but will also upend the health care system we all rely on,” said Anthony Wright, executive director of the Washington, D.C.-based Families USA. “Cutting $880 billion from Medicaid will mean millions of Americans losing coverage, hospitals and clinics plunged into budget shortfalls, state budgets thrown into crisis, and health care services we all depend on being scaled back and eliminated. Whether it’s the local hospital that is forced to close its maternity ward or the rural hospitals or long-term care facilities that can no longer keep the doors open, or the emergency room that is overrun and adding hours to their wait times, these Medicaid cuts will be felt by people in every state and congressional district in this country,” he said.
Further, Wright said in the statement, "House Republicans just voted to betray the very voters in working class, rural and other areas that sent Republican leaders to Washington to lower costs, and instead approved a budget that will shred our nation’s social safety net, driving up costs for millions of Americans. House Republicans passed a budget that will take a wrecking ball to our health care system and local economies. This budget would rip away coverage from Americans – including millions of children – who rely on these vital programs to see a doctor or keep food on their table. Many House members said the right thing about how much Medicaid matters and the need to defend health care from cuts but didn't walk the walk when it mattered most. Families USA will continue to fight back against these health cuts, to keep working to protect access to affordable health care for millions of Americans.”
Meanwhile, Margaret A. Murray, CEO of the Washington, D.C.-based Association for Community Plans (ACAP), said in a statement on Tuesday evening that “This is an unfortunate and short-sighted decision by the House. Cuts to Medicaid of the scope contemplated here would force states to restrict eligibility or reduce benefits, leaving families without access to preventive care and treatment – and sticking taxpayers with the bill for the subsequent, higher-intensity care that will inevitably be needed later on.”
What’s more, Murray stated, “We also have grave concerns about the effects these cuts to Medicaid will have on our rural health care system – when Medicaid cuts were previously considered, several rural hospitals warned that they could be at risk of closure, leaving communities without emergency rooms or maternity wards. And taking away the jobs that those facilities create. Cuts of this magnitude to Medicaid funding go far beyond simply cleaning up fraud and waste, and will cut deeply into vital services for children, seniors, veterans, and workers with low incomes. We urge Congress to reconsider the decision laid out here today.”
And Sharon Parrott, president of the Washington, D.C.-based Center on Budget and Policy Priorities, released a statement on Tuesday evening in which she said that “The House Republican budget passed today calls for massive cuts in health coverage, food assistance, and help paying for college, among some other areas, to pay for huge tax giveaways for wealthy households and businesses. This betrays President Trump’s campaign promises to protect families who struggle financially, as well as his specific pledge to not cut Medicaid, which provides health coverage for 72 million people. While raising costs for families and increasing both poverty and the number of people without health coverage, the budget would swell deficits — all to further Republicans’ expensive and skewed tax agenda.”
Further, Parrott said, “Both the House and Senate budgets significantly miss the mark on what should be their basic goals: lowering costs, increasing opportunity, and responsibly addressing our nation’s long-term priorities, including reducing future economic risks associated with high deficits. But the enormity of program cuts called for by the House budget stand as a singular threat to the well-being of people in every state, city, and rural community, threatening to take away their health coverage, make health care more expensive, and make it harder to afford food and college.”
Parrott went on to say that “The Senate should reject the House cuts both now and if Congress ultimately moves ahead with a second budget plan and reconciliation bill this year. The quick math on the House budget shows a stark equation: the cost of extending tax cuts for households with incomes in the top 1 percent — $1.1 trillion through 2034 — equals roughly the same amount as the proposed potential cuts for health coverage under Medicaid and food assistance under the Supplemental Nutrition Assistance Program (SNAP).”
Meanwhile, just hours before the House vote, Rick Pollack, president and CEO of the Washington, D.C.- and Chicago-based American Hospital Association, had released a statement in which he had said that “On behalf of the hospitals, nurses, doctors and those who care for and serve the needs of the 72 million patients that rely on Medicaid, we urge you to consider the implications of hinging the budget reconciliation bill’s fate on removing health care access for millions of our nation's patients. These are hardworking families, children, seniors, veterans, and disabled individuals who rely on essential health care services.”
This is a developing story. Healthcare Innovation will update readers as new developments emerge.
