States and the nation’s well being trade had been thrown into disarray after the Trump administration ordered Monday that the federal government freeze practically all federal grants at 5 p.m. ET Tuesday, a sweeping directive that no less than initially appeared to incorporate funding for Medicaid, the state-federal medical health insurance program that covers greater than 70 million Americans.
By midmorning Tuesday, state officers across the nation reported that they had been shut out of a crucial on-line portal that enables states to entry federal Medicaid funding.
Sen. Ron Wyden of Oregon, the highest Democrat on the Senate Finance Committee, stated on the social media web site Bluesky that the portals had been down in all 50 states following the Trump administration’s order.
“This is a blatant attempt to rip away health care from millions of Americans overnight and will get people killed,” he wrote.
Around noon Tuesday, as state well being officers pressed the federal authorities for readability, the White House Office of Management and Budget — which issued the Monday memo — put out new steerage clarifying that “mandatory programs like Medicaid” weren’t included within the freeze.
Karoline Leavitt, the White House press secretary, declined to verify that Medicaid was exempt when pressed by reporters throughout an early afternoon briefing.
But she later said in a put up on the social platform X that “no payments have been affected” by what she described as a “portal outage.”
The chance that federal Medicaid funding can be shut off in a single day spooked advocates already on edge about this system’s future. President Donald Trump vowed on the marketing campaign path to not search cuts for Medicare or Social Security, the nation’s main entitlement applications serving largely retired folks. But he didn’t make the identical promise about Medicaid, which pays for well being look after primarily low-income and disabled folks — roughly 1 in 5 Americans.
Separate from the freeze, congressional Republicans are discussing reducing the practically $900 billion program, arguing prices have ballooned with enrollment, notably together with this system’s growth to cowl extra low-income adults. Lawmakers are additionally eyeing methods to save cash for Trump’s different legislative priorities — specifically, extending the tax cuts from his first time period that expire on the finish of this 12 months.
The federal authorities pays most prices for Medicaid, which is operated by states. Medicaid pays for many long-term look after Americans and for about 40% of all U.S. births, and along with the associated Children’s Health Insurance Program covers about 38 million children.
Federal funding for Medicaid doesn’t go on to particular person enrollees however to the states, which then distribute it to suppliers, well being plans, and different entities that serve Medicaid enrollees.
State officers can entry that funding by means of web portals.
Joan Alker, who’s government director of the Center for Children and Families on the Georgetown McCourt School of Public Policy, said on X Tuesday that the portal lockout is “a major crisis.”
She identified that many states entry their federal funding on the finish of the month — “i.e. this week,” she wrote.
The unique freeze order got here within the type of a vaguely worded two-page memo from the Office of Management and Budget to all federal businesses directing them to “temporarily pause all activities related to obligation or disbursement of all Federal financial assistance.”
“This temporary pause will provide the Administration time to review agency programs and determine the best uses of the funding for those programs consistent with the law and the President’s priorities,” the memo stated. The solely applications explicitly famous as exceptions had been Medicare and Social Security, which left it unclear how states would proceed to pay medical doctors, hospitals, nursing properties, and personal well being plans to handle Medicaid.
Around the nation, well being officers scrambled to make sense of the order, which was scheduled to take impact at 5 p.m. ET Tuesday. A federal decide halted the freeze shortly earlier than its implementation, blocking the change till subsequent week.
Even as OMB clarified that Medicaid was not included, the speedy impacts to different crucial well being applications had been changing into clear, particularly for group well being facilities and medical analysis facilities.
Democrats in Congress expressed outrage on the Trump administration for pausing federal funding not solely to Medicaid but additionally to quite a few different applications, together with the Supplemental Nutrition Assistance Program, also referred to as meals stamps, the WIC diet program for pregnant and postpartum girls and infants, and college meal applications for low-income college students.
“The Trump Administration’s action last night to suspend all federal grants and loans will have a devastating impact on the health and well-being of millions of children, seniors on fixed incomes, and the most vulnerable people in our country,” Sen. Bernie Sanders (I-Vt.) stated in a press release Tuesday. “It is a dangerous move towards authoritarianism and it is blatantly unconstitutional.”
The National Association of Medicaid Directors and the main nursing house associations had been amongst these looking for clarification from the White House on Tuesday concerning the order’s affect on Medicaid funding.
Numerous state officers and teams stated they had been contemplating or had already filed litigation difficult the order. One lawsuit was filed Tuesday in opposition to OMB in federal courtroom in Washington, D.C., by the National Council of Nonprofits and the American Public Health Association, looking for a brief restraining order to “maintain the status quo until the Court has an opportunity to more fully consider the illegality of OMB’s actions.”
Attorneys normal in California, New York, and 4 different states introduced Tuesday afternoon a joint lawsuit in opposition to the Trump administration over the order, which they stated had already frozen techniques for Medicaid, Head Start, and even youngster help enforcement throughout a number of states.
“There is no question this policy is reckless, dangerous, illegal, and unconstitutional,” stated New York Attorney General Letitia James. She added that she and different Democratic attorneys normal would search a brief restraining order to halt the OMB coverage from going into impact.
Leavitt defended the freeze throughout her White House briefing — the primary of the brand new administration — saying it was crucial to making sure that federal funding was getting used appropriately.
“This is a very responsible measure,” she stated.
Reporting contributed by Bram Sable-Smith, Jordan Rau, Renuka Rayasam, Brett Kelman, and Christine Mai-Duc.
Phil Galewitz:
pgalewitz@kff.org,
@philgalewitz
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