States Subject to Major Medicaid Reductions Are Led by Republican Governors
On July 3, Phil Galewitz wrote for KFF Health News that red-state governors are saying little publicly about what President Trump’s tax and spending legislation does to healthcare, even as they face reductions that will punch multibillion-dollar holes in their respective states’ budgets. “The last time a Republican-controlled Congress and President Donald Trump moved to slash Medicaid spending, in 2017, a key political force stood in their way: GOP governors.” This time it is different.
“Some of the biggest health cuts in the legislation Trump calls the 'One Big Beautiful Bill' are achieved through new policies that would reduce enrollment by imposing more paperwork demands on enrollees, including a requirement that many prove they’re working. Those policies would affect only states that expanded Medicaid to more low-income people under the Affordable Care Act. Nineteen of those states are led by Republican governors,” Galewitz explained.
Furthermore, Galewitz stated, “Their silence on the bill’s health measures is giving political cover to GOP lawmakers from their states as they seek to cut Medicaid coverage for millions of people who gained it within the last decade.”
“In addition to the work requirement, the biggest Medicaid cuts in the bill stem from its restrictions on provider taxes — levies that states impose on hospitals, nursing homes, and other health care institutions to help increase their federal reimbursement. Much of the additional money is then returned to the healthcare providers in the form of higher payments for their Medicaid patients.”
“It’s been surprising that red-state governors, particularly those in Medicaid expansion states, haven’t spoken out against Medicaid cuts,” said Larry Levitt, executive vice president for health policy at KFF, in a statement. “Republican governors were a potent political force in the failed 2017 effort to repeal and replace the ACA, including Medicaid expansion.”
“We are in a crisis, “Bruce Siegel, MD, MPH, president and CEO of America’s Essential Hospitals, said in a statement. “Millions of Americans will see their health care coverage vanish through burdensome Medicaid work requirements and other eligibility changes throughout the bill. Hospitals across the country have been destabilized, affecting their ability to serve patients and their communities.”
The Association of American Medical Colleges (AAMC) also released a statement on the final U.S. House passage of the reconciliation bill: “Massive cuts to Medicaid and changes to state health insurance marketplace exchanges will lead to tens of millions of people losing much-needed healthcare coverage.”
