Debate intensifies among House Republicans regarding the potential impact of a recently passed budget bill on the health insurance coverage of millions of Americans. The main point of contention is the number of people who might lose coverage, with Democratic lawmakers estimating this figure could reach 13.7 million, predominantly affecting Medicaid beneficiaries, a claim Republicans challenge.
In response to these concerns, Rep. Ken Calvert (R-CA) stated, “The Budget Resolution passed today does not specify any cuts to federal programs. I want to make it clear that I do not support cuts to Social Security, Medicare, and the safety net programs our vulnerable Americans rely on.”
However, the nonpartisan Congressional Budget Office (CBO) offers a different perspective. They highlight that the bill introduces more stringent work requirements for Medicaid. Beneficiaries must demonstrate 80 hours of work or school attendance in the month preceding enrollment, with states having the discretion to extend this requirement up to a year.
The legislation also proposes significant reductions in discretionary spending for the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), the agencies overseeing these programs. As a result, the CBO estimates that at least 7.6 million individuals could be removed from Medicaid.
Considering changes to the Affordable Care Act (ACA) further elevates the number of uninsured. The 2022 Inflation Reduction Act, which President Joe Biden enacted, introduced tax credits to aid low- and middle-income Americans in affording ACA plans. These credits are set to expire soon, and the current Republican bill does not extend them.
The CBO predicts that the expiration of these credits will lead many ACA enrollees to forgo insurance due to increased costs. When combined with the Medicaid changes, this is believed to be the basis for the claim that 13.7 million people could become uninsured.
Rep. Alexandria Ocasio-Cortez (D-NY) voiced her concerns, stating, “Thirteen point seven million Americans are the number of people in this country whose health care are going to be stripped in this bill. Now, Republicans are going to try to tell you every distraction in the book from that essential number.”
The potential changes to Medicaid and the ACA might also impact healthcare access for those who remain insured. Over 30% of rural hospitals in the U.S. are at risk of closure due to financial difficulties, with many relying on Medicaid payments for sustainability.
Notably, Rep. Mariannette Miller-Meeks (R-IA), a proponent of the legislation, may witness four hospitals in her district facing possible closure.
The Kaiser Family Foundation, known for its public health polling, reports significant opposition to the proposed cuts, with 76% of Americans opposing major Medicaid reductions and 65% against cuts to ACA tax credits.
