Congressional lawmakers are going through tough arithmetic as they hammer out a funds plan to finance President Donald Trump’s agenda.
Republicans must unlock roughly $4 trillion to pay for renewing Trump’s 2017 tax cuts, which expire on the finish of the 12 months. Trump has vowed to not contact the most expensive authorities packages, together with Medicare and Social Safety.
He’s been much less clear about his plan for Medicaid.
On Wednesday, he endorsed a Home GOP plan that cuts at the very least $880 billion from, very seemingly, Medicaid — the federal-state medical insurance program for Individuals with low incomes or disabilities.
As my colleague Phil Galewitz experiences, modifications to increase Medicaid have develop into entrenched in most states — and their budgets — over the previous decade. Hospitals, which not solely deal with but in addition make use of a variety of Individuals, are reaching out to Congress with issues.
Medicaid can also be widespread. A January KFF ballot discovered that about 3 in 4 Individuals view this system favorably. So Republicans must be strategic about cuts.
However first, let’s again up. What’s Medicaid? My colleague Sam Whitehead and I revealed a helpful explainer this week.
Medicaid, which turns 60 this summer season, was created as a part of President Lyndon B. Johnson’s “Nice Society” technique to assault poverty together with Medicare, the federal medical insurance program for these 65 and older.
Greater than 79 million folks obtain companies from Medicaid or its intently associated Youngsters’s Well being Insurance coverage Program. That’s about 20% of the nation’s inhabitants.
About 40% of all youngsters are coated by Medicaid or CHIP. Medicaid additionally pays for 4 in 10 births and covers prices of caring for greater than 60% of nursing dwelling residents.
State and federal spending on this system reached $880 billion final 12 months.
Again in Washington, Phil writes that the GOP is contemplating a couple of methods to shrink Medicaid.
They may cut back how a lot cash the federal authorities sends to states, leaving state leaders to resolve whether or not and tips on how to plug funds holes.
One thought Republicans are overtly speaking about is imposing work necessities. Most adults enrolled in Medicaid are already working or most likely can be exempt as a result of they’re in class, are caregivers, or are disabled.
However, as Sam and I report, state experiences with work necessities present they make it tougher for even eligible folks to get protection.
On the coronary heart of all of it are key questions in regards to the function of presidency in folks’s well being: How huge ought to the U.S. medical insurance coverage security web be? Who deserves authorities help?
And, maybe most urgently, the place will those that might lose Medicaid go for protection?
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