Madison Czopek, PolitiFact and Amy Sherman, PolitiFact
The prospect of deep Medicaid cuts has develop into a flashpoint in Congress, with leaders of each events accusing their counterparts of mendacity.
House Democratic chief Hakeem Jeffries mentioned Feb. 27 {that a} Republican finances measure would “set in motion the largest cut to Medicaid in American history,” and that Republicans are hiding the implications.
“The Republicans are lying to the American people about Medicaid,” Jeffries said. “I can’t say it any other way. Republicans are lying. Prove me wrong.”
Republicans mentioned Democrats had been distorting the Republican finances. Rep. Steve Scalise (R-La.) said, “The word ‘Medicaid’ is not even in this bill.” House Speaker Mike Johnson said on CNN that Republicans don’t wish to reduce Medicaid, “and the Democrats have been lying about it.”
Republicans are on the lookout for huge finances financial savings to satisfy their purpose of absolutely extending President Donald Trump’s 2017 tax cuts. This is a separate course of from Congress’ have to go a unbroken decision to maintain the federal government working by March 14 or face a federal authorities shutdown.
Here’s what we all know to this point about potential Medicaid cuts.
The House GOP Budget Plan Seeks $880 Billion in Cuts
Medicaid serves about 1 in 5 Americans. The well being care program for low-income folks is paid for by the federal authorities and partly by states. Louisiana, house to Johnson and Scalise, has one of many highest state proportions of Medicaid enrollees.
The House Republican budget plan adopted Feb. 25 opens the door to slashing Medicaid, regardless that it doesn’t identify this system. The plan directs the House Energy and Commerce Committee to seek out methods to chop the deficit by a minimum of $880 billion over the subsequent decade.
The committee has jurisdiction over Medicaid, Medicare, and the Children’s Health Insurance Program, along with a lot smaller applications. CHIP offers low-cost health coverage to kids in households that earn an excessive amount of cash to qualify for Medicaid.
Republicans dominated out cuts to Medicare, the medical health insurance program for seniors that leaders reduce at their political peril. Medicare is about 15% of the federal budget, and Medicaid is about 8.6%.
When Medicare is put aside, Medicaid accounts for 93% of the funding beneath the committee’s jurisdiction, the nonpartisan Congressional Budget Office present in a March 5 analysis. That means it’s not possible for the committee to seek out sufficient cuts that don’t have an effect on Medicaid.
“It’s a fantasy to imply that federal Medicaid assistance won’t be cut very deeply,” mentioned Allison Orris, an skilled on Medicaid coverage on the Center on Budget and Policy Priorities, a left-leaning assume tank.
After Medicaid, the next-largest program beneath the committee’s jurisdiction is CHIP. Lawmakers don’t seem like planning to wipe out CHIP, however even when they did, they’d be solely a “fraction of the way there,” mentioned Joan Alker, an skilled on Medicaid and CHIP at Georgetown University.
If Medicare cuts are off the desk, the one method to obtain $880 billion in financial savings is thru massive Medicaid cuts, mentioned Larry Levitt, government vice chairman for well being coverage at KFF, the well being coverage analysis, polling, and information group that features KFF Health News.
Andy Schneider, a professor at Georgetown University who served within the Obama administration as a senior adviser on the Centers for Medicare & Medicaid Services, mentioned even when the committee eradicated all these “other” applications fully it might obtain solely $381 billion in financial savings — about 43% of the goal.
“In short, if they don’t want to cut Medicaid [or CHIP], and they don’t want to cut Medicare, the goal of cutting $880 billion is impossible,” Schneider mentioned.
The $880 billion reduce just isn’t a executed deal. House Republicans had been in a position to go their finances package deal, however Senate Republicans are taking a distinct method, without proposing such significant cuts.
Any finalized finances blueprint would want Senate Republicans’ buy-in. Sen. Josh Hawley (R-Mo.) is amongst Republicans who’ve spoken against potential cuts; he told HuffPost, “I would not do severe cuts to Medicaid.”
The numbers are beginning factors which will result in negotiation amongst a minimum of Republicans, mentioned Joseph Antos, a well being care skilled on the conservative American Enterprise Institute. “We are a long way from final legislation, so it’s not possible to predict how much any program will be cut,” he mentioned.
“If the bill also includes extending the [Trump 2017] tax cuts, we are probably months away from seeing real language,” Antos mentioned.
Once the House and Senate have reached an settlement on language and the decision passes each chambers, the committees will work on detailed cuts. To enact such cuts, each chambers would want to approve a separate invoice and obtain Trump’s signature.
Why Eliminating Fraud Doesn’t Solve the Problem
Republican leaders have deflected considerations about Medicaid cuts by speaking a couple of completely different goal: Medicaid fraud.
“I’m not going to touch Social Security, Medicare, Medicaid. Now, we’re going to get fraud out of there,” Trump informed Fox News’ Maria Bartiromo on March 9, in line with his marketing campaign rhetoric that he would defend these applications.
At the identical time, Trump on his Truth Social platform praised the House resolution that would make cuts highly likely: “The House Resolution implements my FULL America First Agenda, EVERYTHING, not just parts of it!”
Would eliminating fraud clear up the Medicaid drawback? No.
On CNN, Johnson said reducing fraud, waste, and abuse would end in “part of the savings to accomplish this mission.” He mentioned the federal government loses $50 billion a yr in Medicaid funds “just in fraud alone.”
Johnson conflated “fraud” with “improper payments.” The Government Accountability Office, the nonpartisan investigative arm that examines the usage of public funds, found about $50 billion in improper funds in Medicaid and the identical quantity in Medicare in fiscal 2023.
Those improper funds had been made in an incorrect quantity (overpayment or underpayment), shouldn’t have been made in any respect, or had lacking or inadequate documentation. But that doesn’t imply that there was $50 billion in Medicaid fraud, which might contain acquiring one thing by way of willful misrepresentation.
The system used to determine improper funds just isn’t designed to measure fraud, so we don’t know what proportion of improper funds had been losses as a result of fraud, mentioned Schneider, the previous Obama administration well being adviser.
Plus, it’s a drop within the total bucket of the potential $880 billion in cuts.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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