Congressional lawmakers are facing tricky arithmetic as they hammer out a budget plan to finance President Donald Trump鈥檚 agenda.
Republicans need to free up roughly $4 trillion to pay for renewing Trump鈥檚 2017 tax cuts, which expire at the end of the year. Trump has vowed not to touch the costliest government programs, including Medicare and Social Security.
He鈥檚 been less clear about his plan for Medicaid.
On Wednesday, he endorsed a House GOP plan that cuts at least $880 billion from, very likely, Medicaid 鈥 the federal-state health insurance program for Americans with low incomes or disabilities.
As my colleague Phil Galewitz reports, changes to expand Medicaid have become entrenched in most states 鈥 and their budgets 鈥 over the past decade. Hospitals, which not only treat but also employ a lot of Americans, are reaching out to Congress with concerns.
Medicaid is also popular. A January 麻豆女优 poll found that about 3 in 4 Americans view the program favorably. So Republicans would have to be strategic about cuts.
But first, let鈥檚 back up. What is Medicaid? My colleague Sam Whitehead and I published a useful explainer this week.
Medicaid, which turns 60 this summer, was created as part of President Lyndon B. Johnson鈥檚 鈥淕reat Society鈥 strategy to attack poverty along with Medicare, the federal health insurance program for those 65 and older.
More than 79 million people receive services from Medicaid or its closely related Children鈥檚 Health Insurance Program. That鈥檚 about 20% of the country鈥檚 population.
About 40% of all children are covered by Medicaid or CHIP. Medicaid also pays for 4 in 10 births and covers costs of caring for more than 60% of nursing home residents.
State and federal spending on the program reached $880 billion last year.
Back in Washington, Phil writes that the GOP is considering a few strategies to shrink Medicaid.
They could reduce how much money the federal government sends to states, leaving state leaders to decide whether and how to plug budget holes.
One idea Republicans are openly talking about is imposing work requirements. Most adults enrolled in Medicaid are already working or probably would be exempt because they鈥檙e in school, are caregivers, or are disabled.
But, as Sam and I report, state experiences with work requirements show they make it harder for even eligible people to get coverage.
At the heart of it all are key questions about the role of government in people鈥檚 health: How big should the U.S. medical insurance safety net be? Who deserves government assistance?
And, perhaps most urgently, where will those who could lose Medicaid go for coverage?
We鈥檇 like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what鈥檚 happening within the federal health bureaucracy. Please message 麻豆女优 Health News on Signal at (415) 519-8778 or .
Republicans Are Eyeing Cuts to Medicaid. What鈥檚 Medicaid, Again?
Republicans in Congress have suggested big cuts to Medicaid, the state-federal health insurance program for people with low incomes or disabilities. The complex, multifaceted program touches millions of Americans and has become deeply woven into state budgets and the U.S. health care system.
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