Republicans Mulling Over Scaling Back Medicaid Expansion Under ACA
Republicans ponder dismantling a crucial aspect of Obamacare within Trump's legislative plan
WASHINGTON - Top Republicans are pondering the rollback of a significant aspect of the Affordable Care Act (ACA) in their whopping bill for President Donald Trump's agenda. They're exploring savings by scaling back how much financial assistance the federal government offers for the ACA's expansion of Medicaid.
Congressman Brett Guthrie, R-Ky., the chair of the House Energy and Commerce Committee, espoused the argument for it on Monday, as Congress returned from a two-week break. Highlighting the burgeoning Medicaid expenses, he stated, "We have an expansion population that receives 90% federal money, and you have traditional Medicaid, so a disabled child in Kentucky gets 72 cents when they visit the doctor. And we know that's just unsustainable."
Guthrie's committee is tasked with discovering $880 billion in savings, a target that can't be reached without reducing Medicaid or Medicare according to Congress' nonpartisan budget scorekeeper.
The feasible solutions include alterations to Medicaid's Federal Medical Assistance Percentage (or FMAP) and a new per capita cap on the populace covered under the expansion. While Guthrie didn't confirm what will make it into the package, he expressed his desire to finalize it and vote it out of committee by next week.
The 90% federal match was a linchpin of the Medicaid expansion under the ACA, extending coverage to around 20 million people across more than 40 states. Larry Levitt, executive vice president for health policy at KFF, a research group, pointed out that reducing the federal match to the traditional rate the feds pay on Medicaid "would be a massive cost shift to states, and many would have trouble coming up with the extra money."
Under the ACA, the government took a three-pronged approach to increasing access to health coverage—Medicaid expansion, tax credits to make premiums more affordable for those lacking employer-provided insurance, and pre-existing condition protections. The Medicaid expansion has been instrumental in reducing the uninsured rate to the lowest levels in history, according to Levitt.
Some lawmakers have expressed reservations about significant Medicaid cuts, and their votes could make or break the bill's prospects. Even Trump has promised that reductions in Medicaid funding wouldn't impact benefits.
If states were to lower the Medicaid expansion match rate, as proposed, the potential impacts could be substantial:
- Coverage Losses: Approximately 22 million people could lose their coverage in expansion states, with total U.S. enrollees accounting for almost one-third of the current Medicaid population potentially impacted[5].
- Financial Burden: Reduced federal funding could lead states to experience cuts in Medicaid funding, while states pursuing coverage maintenance would be required to boost their non-federal Medicaid spending[5].
- Implications: Budgetary pressures, decreased healthcare access, and potentially diminished health care improvements achieved through Medicaid expansion could ensue.
Plenty of Republicans have raised concerns about substantial Medicaid cuts, and their support could determine the bill's success. Healthcare is currently under attack by political extremists, who aim to strip coverage from American citizens, according to House Minority Leader Hakeem Jeffries, D-N.Y. These individuals are reportedly planning to deteriorate Medicaid, hurt children, families, seniors, people with disabilities, close hospitals, and shut down nursing homes. People may even lose their lives as a result, Jeffries stated.
Sources
- The Commonwealth Fund (2021). Medicaid Expansion and the Uninsured
- Center on Budget and Policy Priorities (2017). The States Adopting the ACA Medicaid Expansion: Critical Choices Ahead
- Health Affairs (2017). Cost Divide Between Medicaid Expansion and Nonexpansion States Will Widen as Enrollment Includes Older and More Complex Populations
- KFF (2021). Interactive Map: The ACA Medicaid Expansion – Status of States
- Center on Budget and Policy Priorities (2021). Federal Policies at Risk in a Budget Reconciliation Bill
- The Republicans are contemplating a rollback of the federal government's funding for the Affordable Care Act's expansion of Medicaid, a move aimed at reducing expenses.
- The House Energy and Commerce Committee, chaired by Congressman Brett Guthrie, is tasked with finding $880 billion in savings, which can only be achieved by either reducing Medicaid or Medicare.
- Guthrie, while not confirming specific changes, expressed a desire to finalize the package and vote it out of committee soon.
- Reducing the federal match for Medicaid expansion, as proposed, could lead to substantial impacts such as coverage losses for approximately 22 million people in expansion states, increased non-federal Medicaid spending for states, and potential Budgetary pressures, decreased healthcare access, and diminished healthcare improvements.
- Some Republicans have expressed reservations about significant Medicaid cuts, and their support could determine the success or failure of the bill.
- The potential consequences of lowering the Medicaid expansion match rate include increased financial burden on states, coverage losses, and possible deterioration in health and wellness for millions of Americans, particularly the vulnerable like children, families, seniors, and individuals with medical-conditions.
- The debate over Medicaid cuts is currently a hot topic in Washington politics, with critics arguing that it could deprive millions of Americans of essential healthcare coverage.
- According to House Minority Leader Hakeem Jeffries, the aim of some political extremists is to strip coverage from American citizens, potentially leading to health issues and even loss of life.
