The congress is launching with its budget for next year, but the most controversial program on the Cup – Medicaid – Rift within the Republican Party.
Earlier this year, the Congress adopted a budgetary plan which contains billions of dollars in federal expenses, which the president of the Chamber Mike Johnson (R-La.) promised that I did not touch Medicaid. But while legislators laughed at the details of the spending plan, changes in the government's health program are looming.
Republicans rush to find creative means to carry out 71 million people nationally and leads to cascade effects for hospitals and nursing homes.
Until now, the options being floated – increase the requirements of eligibility and work and limit access to immigrants – would have a drastic effect on Medicaid, even if the Republicans mark their vision as attacking “waste, fraud and abuse”, a popular line used by Trump administration officials who reductions in the federal government departments and programs.
The GOP “strengthens Medicaid for people who need it by eliminating things like fraud, waste and abuse, which is a huge problem in the program, in particular by removing Johnson on Tuesday at a press conference.
Other options that legislators have considered considerably imply the reduction in the quantity of money that the federal government gives to the states that have expanded the coverage of Medicaid under the affordable care law. If the minimum threshold was eliminated, California could lose up to $ 156.5 billion in federal funding for the program over the next 10 years, according to an analysis of The Robert Wood Johnson Foundation.
“States cannot really increase this type of income in general,” said Kathy Hempstead, head of foundation policies. “What the States will do is may increase income, but they should start cutting the services.”
Johnson said on Tuesday that he had moved away from this consideration.
However, defenders warn that other options repressing the adaptability of the millions of people who qualify for the program.
The budgeting conference adopted included an order for the house Energy and Commerce Committee, which governs spending on Medicaid, to reduce $ 880 billion over 10 years. The non -partisan congress budget office said that the level of reduction was only possible by reducing Medicaid.
In a letter On Wednesday, the CBO leaders, the CBO explained how federal changes in Medicaid would result in a narrowing of the program.
It provides that states would spend more for Medicaid, would reduce payment rates to health care providers, limit optional advantages and reduce registrations.
Last week, the Committee postponed a meeting provided for the draft law on continuous disagreements among its members. Matt Herdman, director of the State for Protect Our Care California, considered the delay as a partial victory.
“They clearly noticed that they had a huge problem in their hands. They have a ton of vulnerable members,” said Herdman. “They would not have rejected this if they thought it was an agreement concluded.”
But Johnson rejected the idea that the postponement was “a problem”, saying that after meeting President Trump over the weekend and examining the figures, they decided: “It was logical for us to take a break for a week … to do things well”. The speaker said he was still aiming to pass the budget through the Memorial Day.
In the meantime, Johnson is struggling with members of the far-right flank of the party, who support the funding and reform of Medicaid, and other Republicans, who prevent party leaders to avoid forcing them to vote for the cuts.
Twelve members who represent districts with high Medicaid populations – including representatives of California David Valadao (R -Hanford) and young Kim (R -Aaheim Hills) – sent a letter to the leaders of the Chamber last month, warning that a vote to reduce Medicaid would endanger their districts harshly won in the next elections.
“We cannot and will not support a final reconciliation bill which includes any reduction in Medicaid coverage for vulnerable populations,” said the letter, adding that legislators support the program reform. He concluded: “Communities like ours have earned us the majority, and we are responsible for keeping the promises we made.”
Valadao said Politico That he sends SMS and regularly meets his colleagues at Congress, working on alternative solutions. Valadao has a great motivation to save the program – he represents the California district with the highest percentage of MEDICAID beneficiaries, and he lost his headquarters in Congress after having voted to repeal the affordable care law in 2017.
His office refused an interview for this article.
Demonstrations To preserve Medicaid, sweep the nation for weeks. The International Union of Service Employees, which houses numerous healthcare workers in the United States, organized Several demonstrations Offices of the external republican congress in recent weeks, including Kim.
“I see an incredible energy on this subject,” said Herdman. “I don't think I have seen something so big in person from the pandemic on a legislative issue.”
Representative Debbie Dingell (D-Mich.), Which sits on the energy and trade committee, told journalists on Tuesday that she had heard voters from her district who count on Medicaid to support their health care.
“Medicaid is a life buoy. He maintains healthy children, he helps parents work and cares about the elderly in nursing homes, “said Dingell. “The American people cannot afford the Medicaid cuts, especially since the economy fell around them by President Trump.”
