Congressional lawmakers are dealing with 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 yr. Trump has vowed to not contact the most costly authorities applications, 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 least $880 billion from, very possible, Medicaid — the federal-state medical health insurance program for Individuals with low incomes or disabilities.
As my colleague Phil Galewitz reviews, modifications to develop Medicaid have develop into entrenched in most states — and their budgets — over the previous decade. Hospitals, which not solely deal with but additionally make use of a whole lot of Individuals, are reaching out to Congress with issues.
Medicaid can also be in style. 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 health insurance program for these 65 and older.
Greater than 79 million folks obtain companies from Medicaid or its intently associated Kids’s Well being Insurance coverage Program. That’s about 20% of the nation’s inhabitants.
About 40% of all kids 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 house residents.
State and federal spending on this system reached $880 billion final yr.
Again in Washington, Phil writes that the GOP is contemplating just a few 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 how you can plug funds holes.
One concept Republicans are overtly speaking about is imposing work necessities. Most adults enrolled in Medicaid are already working or in all probability could 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 internet be? Who deserves authorities help?
And, maybe most urgently, the place will those that might lose Medicaid go for protection?
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