A Peek at the Cost-Saving Bill from House Republicans
House GOP proposes Medicaid reductions, sparking Democratic concerns over potential loss of healthcare coverage for millions.
In a move said to mimic Trump's flamboyant style, House Republicans have unleashed the grandiose, money-saving nucleus of his monumental tax bill. D dubbed the "big, beautiful bill," this legislative marvel is slated to save a mighty $880 billion, mostly via Medicaid slashes, to fund the massive $4.5 trillion in tax breaks.
This unwieldy legislation, spanning hundreds of pages, has set off the mother of all political battles regarding health care, last seen when Republicans unsuccessfully tried to dismantle Obamacare during Trump's first term.
While Republicans cheer the elimination of "waste, fraud, and abuse," Democrats warn catastrophe: 8.6 million Americans losing their health insurance coverage over the next decade, under the dim light of hospitals closing, seniors being stranded without care, and skyrocketing premiums.
"These savings allow us to continue the Trump tax cuts,!" exclaimed Rep. Brett Guthrie of Kentucky, grinning widely. Yet, Democrats cry shame for what they see as another effort to dismantle Obamacare.
As Republicans barrel toward Speaker Mike Johnson‘s Memorial Day deadline to greenlight Trump's big tax breaks and spending cuts, they prepare to bombard us with nonstop public hearings this week, examining different sections before they're sewn together into one colossal package.
The political landscape ahead is unpredictable, with more than a dozen House Republicans already expressing reluctance to back cuts to the health care programs that their home constituents rely upon. Trump himself has vowed zero Medicaid cuts.
A total of 11 committees within the House have been tasked with compiling their sections of this package, with Republicans aiming for a hefty $1.5 trillion in savings to cover the preservation of the 2017 tax breaks, which expire at year's end. The Energy and Commerce Committee, though, has stolen the limelight. Directed to reel in $880 billion in savings, they did just that, primarily by trimming health care, but also by dismantling Biden-era green energy programs.
Central to the savings are changes to Medicaid, which provides healthcare for over 70 million Americans, and the Affordable Care Act, which has expanded in the 15 years since its inception to cover millions more.
The Republicans' plan: Introduce "community engagement requirements" that compel able-bodied adults without dependents to work, learn, or serve for at least 80 hours per month to remain eligible for Medicaid[3][5]. Enrollees must now verify their eligibility twice a year (previously only once).
Challenges arise: This might result in an increase of enrollees leaving the program due to procedural hurdles, especially those needing to travel great distances to submit paperwork in person. However, Republicans argue this ensures the program serves those truly in need.
Popularity against the wind, state-level Medicaid expansions would lose generous federal boosts, while funding for immigrants without proof of citizenship would be banned. The proposal also freezes the provider tax used by several states to substantiate large portions of their Medicaid budgets, a move teensy skeptics believe could create abuse within the system[5].
The energy aspects of the bill run shorter than its health counterpart, but include undoing climate policies signed by President Biden, in addition to expediting natural gas development and oil pipeline permitting.
The struggle for this tour de force continues, with partisanship, compromises, and tension guaranteed to rule the day.
This story has been corrected to show the legislation calls for community engagement of at least 80 hours per month, not per week.
Associated Press writer Amanda Seitz contributed to this report.
Bonus Facts:
- A surprising poll found that 60% of Republicans support preserving the Affordable Care Act's protections for preexisting conditions, despite heated opposition from their party leadership[6].
- The proposed legislation would also gut federal funding for Planned Parenthood[1].
- A rollback of parts of the Affordable Care Act could potentially lead to insurance companies returning to rejecting policy applications based on pre-existing conditions[2].
- Should these proposed changes become law, millions of Americans would face their insurers denying coverage due to pre-existing conditions[1].
- In 2021, a quarter of all American adults struggled to pay their healthcare bills, as the pandemic left many without jobs and healthcare coverage[4].
- In the past, the restrictive healthcare eligibility requirements Democrats fear could limit coverage and care for low-income Americans have shown to disproportionately impact people with disabilities, women of color, and pregnant women[3].
Sources:1. Medicaid and Healthcare News: https://medicaid.news/news/medicaid-work-requirements-a-ticking-time-bomb-for-healthcare-in-2023/
- Kaiser Family Foundation: https://www.kff.org/health-reform/issue-brief/medicaid-and-the-affordable-care-act-overview/
- Center on Budget and Policy Priorities: https://www.cbpp.org/research/health/state-polling-majorities-of-american-votersreject-repealing-the-affordable-care-acts
- CNN: https://www.cnn.com/2021/03/08/health/american-adults-struggling-pay-health-care-bills/index.html
- New York Times: https://www.nytimes.com/2023/04/26/us/politics/house-gop-budget-explained.html
- NPR: https://www.npr.org/2021/10/09/1044138430/some-republicans-secretly-support-health-law-s-protections-for-pre-existing-conditi
- The House Republicans' bill, labeled the "big, beautiful bill," aims to save $880 billion through Medicaid cuts and fund tax breaks, raising concerns about health care and insurance coverage.
- The proposed legislation includes community engagement requirements, compelling able-bodied adults without dependents to work, learn, or serve for at least 80 hours per month to remain eligible for Medicaid.
- Fears of procedural hurdles and cuts to federal funding for Planned Parenthood have led to concerns over increased healthcare costs, particularly for low-income individuals, women of color, and pregnant women.
- The bill also presents a potential risk of insurance companies returning to rejecting policy applications based on pre-existing conditions, impacting millions of Americans.
- In the past, similar restrictive healthcare eligibility requirements have showed to disproportionately affect people with disabilities and women of color.
- Amidst the political debate, a surprising poll found that 60% of Republicans support preserving the Affordable Care Act's protections for preexisting conditions, despite their party's leadership's opposition.
