Congress is moving forward with next year’s budget, but Medicaid, the most controversial program in the Chopping Bloc, is causing a rift within the Republican Party.
Earlier this year, Congress passed a budget blueprint that includes billions of dollars in federal spending. But as lawmakers bring out details of their spending plans, changes to popular government-funded healthcare programs are looming.
Republicans are rushing to find creative ways to make budget cuts they voted for without hindering Medicaid.
So far, flooring options — increasing eligibility and labor requirements and limiting immigrant access — would have a dramatic impact on Medicaid, even as Republicans brand their vision to tackle the “waste, fraud and abuse” used by Trump administration officials who are downing federal departments and programs.
“It’s about strengthening Medicaid for those who need it by eliminating fraud, waste, abuse and more. This is a major issue with the program, including the removal of illegal aliens,” the GOP said at a press conference Tuesday.
Other options considered by lawmakers include significantly reducing how much money the federal government will give to states that have expanded Medicaid coverage under the Affordable Care Act. According to an analysis by the Robert Wood Johnson Foundation, if the minimum threshold is eliminated, California could lose as much as $156.5 billion in federal funds for the program over the next decade.
“Nationals can’t really raise such incomes in general,” said Kathy Hempstead, senior policy director at the foundation. “What the state does is to raise some revenue, but we have to start cutting services.”
Johnson showed on Tuesday that he had left that consideration.
Still, advocates warn that if other options close eligibility, millions of people qualifying for the program will be incorrectly at a disadvantage.
The passed budget meeting included an order from the House Energy and Commerce Committee that governs spending on Medicaid, cutting $880 billion over a decade. The nonpartisan Congressional Budget Office says levels of reduction are only possible by reducing Medicaid.
In a letter to committee leaders on Wednesday, the CBO outlined how changes in the federal government in Medicaid could lead to a downsizing of the program.
The state is expected to spend more on Medicaid, reduce payment rates to healthcare providers, limit the benefits of options, and reduce enrollment.
Last week, the committee postponed a planned meeting on the bill over continued differences of opinion among its members. Matt Hardman, the state director for protecting California, saw the delay as a partial victory.
“They clearly realize that they have big problems in their hands. They have a lot of vulnerable members,” Hardman said. “If I thought this was a completed transaction, they wouldn’t have pushed this back.”
However, Johnson dismissed the idea that the postponement was “snagged” and after meeting with President Trump over the weekend, he reviewed the numbers and decided, “it makes sense to pause for a week… to make it right.” The speaker said he still aims to pass the budget by the anniversary.
In the meantime, Johnson is competing for members from the far-right side of the party, supporting Medicaid and other Republicans in reimbursement and reform.
Twelve members representing high-Medicaid districts, including California Rep. David Valadao (R-Hanford) and Young Kim (R-Anaheim Hills), wrote letters to House leaders last month, warning that Medicaid would put their Hardwon district at risk in future elections.
“We cannot and cannot support the final settlement bill, which includes reducing Medicaid compensation for vulnerable groups,” the letter read, adding that lawmakers are supporting program reform. “It’s a responsibility that communities like us will win us a majority and fulfill our promises.”
Valadao told Politico that he has texted and met with council colleagues regularly to work on alternative solutions. Varadao has a serious incentive to save the program. He represents the California area, which has the highest percentage of Medicaid recipients, and lost his seat in Congress in 2017 after voting to repeal the Affordable Care Act.
His office refused to interview this article.
Protests to preserve Medicaid have wiped out the country for weeks. The United Nations of service employees, which many U.S. care workers live, have organized several demonstrations outside the Republican Congressional office in recent weeks, including Kim.
“I see an incredible amount of energy about this,” Hardman said. “I don’t think I’ve seen anything big directly since the pandemic on legislative issues.”
Rep. Debbie Dingel (D-Mich.), a member of the Energy and Commerce Committee, told reporters Tuesday that he was hearing from members of the district that rely on Medicaid to maintain healthcare.
“Medicaid is a lifeline. It keeps children healthy, helps parents work, and cares for seniors in nursing homes,” Dingel said. “The American people can’t afford Medicaid cuts, especially as the economy has crashed around them due to President Trump.”
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