Republicans in the House of Representatives who are looking for ways to pay the price of tax discounts of President Trump have called for reducing the federal government’s share of the relevant spending, including the proposal that would actually extend to the expansion of the sponsorship law at reasonable prices for 2014.
Cutting spending medical aid, which is essential The budget bill that Republicans may bring in the House of Representatives to vote on TuesdayIt can lead to the loss of millions of Americans across the country, unless countries decide to play a greater role in their financing.
Republicans are considering reducing the 90 percent stake that the federal government is required to pay for the states that record the participants in the expansion. Change can generate $ 560 billion of savings over a decade, which is the money that Republicans want to use to expand the tax discounts of Mr. Trump for the year 2017, which is scheduled to end at the end of 2025. Extension of tax cuts is It is expected to cost 4.5 trillion dollars, which means that Republicans will have to find savings that go beyond Medicaid from Long list of options.
The transition to a decrease in federal spending on Medicaid expansion can destroy the program effectively. About 10 states and its programs have expanded the so -called trigger laws that reflect the expansion of medical aid if the federal government reduces the financing of the population.
Change may leave the forty cases that participate in the Obacare program with a difficult set of options. They can bear the additional costs to keep Medicaid coverage of millions, or discounts for coverage or search for discounts from other large government programs to compensate for a decrease in federal funds.
Medicaid, which covers more than 70 million people, is the largest health insurance program in the country, The largest source From financing countries. More than 21 million adults who were not eligible to obtain medicaid under pre -expanding guidelines were received last year. The program has already restricted the registration in the first place on those who were pregnant, disrupted or the elderly.
Among those who qualified for Medicaid under expansion, Jenny Brown, a 60 -year -old bus driver for the public school system in Belgrade, Mont. Mrs. Brown went for more than five years without health insurance, starting in 2009, avoiding medical care with the deterioration of her health and cared for her granddaughter.
Mrs. Brown, who reaps about $ 25,000 every year, was besieged in the alleged coverage gap, with a very high salary for the picker, and very low for the highly backed Obamacare plan.
After the lawmakers in Montana voted in 2015 to take over the option of the law of sponsorship at reasonable prices to expand medical aid to cover more adults, Mrs. Brown registered. She started seeing an initial care doctor, and she paid medicaid for manual surgeries, knee replacement, and dual breast removal, and her inhalation.
“Being a care provider is very stressful, especially with someone with a lot of health needs,” she said last week from a children’s hospital in Colorado, where her granddaughter for emergency care was transferred. “If I do not have the preventive care I need, I will be in a worse place. I may be handicapped.”
Conservative critics have argued in the expansion of medical aid by forcing the federal government to heavy spending, InconsistentTo cover the health services of the Medicaid residents, it was not intended from the service.
“The Federal Supreme Federal match for adults with the body is able to create harmful incentives to transfer money from the most vulnerable population,” said Michael Canon, director of health policy studies at the Cato Institute, a Libertari research tank.
The Republicans have also referred to what they say are unexpected to spend. Some states have witnessed an unexpected increase in medical aid costs in recent years, in part due to the delay in many Americans from care during the Coronverus Virus. State Governor Josh Shapiro from Pennsylvania, Democrat, I suggested recently An increase of $ 2.5 billion in government spending on the program.
The transition to the decline in the financial obligations of the federal government towards Medicaid can deeply reshape how it shares responsibility with the states to provide health care to some of the poorest Americans, as well as service providers and the role of the elderly care they care about.
Daniel Tsai, who supervised Midikid during the era of former President Joseph R. said. Biden Junior, the change will be a “tremendous transfer of financial responsibility from the federal government to the states.”
He said: “You will have countries that have huge budget holes that make decisions between how to make the right thing to keep people cover” and how to maintain other programs. “The countries will be tied to criticism.”
The expansion of medical aid has become A deep -party project Over the past decade, it has affirmed reasonable prices in the American health system and its attractiveness even for Republican rulers and the legitimates of the states who have once known. A lot of additional enrollment comes from countries led by the Republic, where the voters passed Police initiatives For the program.
Medicaid now funds nearly half of all birth in the United States, and represents More than half From spending on long -term care. More than 70 percent of Americans say they want to stay mediaid as it is, according to to survey It was conducted by KFF last year, a non -profit health policy research group.
The impact of the program has led to unusual political alliances. President Trump seemed to feel the political dangers in cutting the program, saying last week that He will not touch medical aid. He later supported the budget of the House of Representatives negotiated by Parliament Speaker Mike Johnson, which called for $ 880 billion discounts for programs supervised by the Energy and Trade Committee in the House of Representatives, such as Medicaid.
Senator Josh Holie, Missouri Republic, HuffPost said Last week, he made an amendment to the Senate Budget Resolution prohibiting discounts from Medicaid. After expanding his mandate the program in 2021, More than 300000 Low income population joined the menus.
Actor Jim Jordan, Republican in Ohio, He said on Sunday Legionships may focus on imposing a national action condition on medicaid, a A controversial suggestion This would reach a small part of the discounts that Republicans are looking for in Congress. Ohio Request recently Trump administration to obtain permission to test policy.
John Ter, a former democratic Senator of Montana, said that Midikid may have a more sweeping impact on rural America than urban areas because of how the program maintained poor areas with a few health service providers. “This is an interesting mystery because most of the rural America is much deeper red than urban America,” he said.
Mr. Tester said: “If you take health care, you cannot live there.”
Republicans are also considering reducing the amount of the federal government on the state’s Medicaid program, a practice known as grants or individual covers from the individual. This strategy can provide up to $ 900 billion over a decade.
If the states choose the costs of the federal government and keep the residents of expansion in place, it will spend more than 600 billion dollars to do this over a decade, an increase of 20 percent, According to KFF. Many states will be more than $ 10 billion over a decade, and some large states, such as New York and California, will face a shortage of more than $ 50 billion.
With the expansion of the Montana expansion program in June Advanced legislation Last week, it would expand the program in part to preserve health service providers in the severe rural state solvent. Nearly 80,000 people in the state now have coverage by the state’s expansion, which greatly reduces the average un.
Health policy experts say that the state is actually a test issue that can motivate other Republican countries, unlike its own programs.
But as in other states, Montana’s expansion of medical aid has been maintained in part due to the strong Republican support in the state legislature. Ross Temple, a member of the Republican Senate in favor of Medicid’s expansion, said he had increased behavioral health services in the state and kept the few hospitals in his rural area.
Matt Regeir, Republican President of the Senate in Montana, said that the state’s hospitals have become dependent on a maid, and that their expansion was “motivating people not to stand on their feet.”
“This is the opposite of what a government safety net should be,” he said.
In the state of Illinois, another state with an operating law, nearly a quarter of the state’s Medicaid Program is part of the expansion population, and the uninterrupted state rate decreased by 44 percent after the expansion entered. Pritzker, democratic. Mr. Gowh added that the state is receiving more than 7 billion dollars for that group.
“The coverage threats will spell the disaster,” he said. He added that eliminating the expansion of medical aid “will lead to a significant disruption of the health care infrastructure in the state that depends on financing medical aid, and ultimately, its economy.”
Democratic lawmakers in Virginia are trying to protect Medicaid by getting rid of the trigger rule. State officials are also for a new wave of enrollment of exhausted federal workers.
“I am not sure that Virginia will be able to provide full coverage” with significant federal funding. “This is not a burden that the state budget can bear.”
