the home He passed the budget decision On Tuesday night, after the speaker, Mike Johnson, persuaded many Republican legislators, including those who have Express reservations About possible delicacies, to support the bill.
In theory, Budget,, Which begins the process of financing the tax discounts that were enacted in 2017 and up to $ 2 trillion in spending discounts aimed at partially compensated, can become a law without significant discounts in Medicaid. But it will not be easy.
This process contains some additional steps: for one, the Senate must adopt this budget decision. Then both congressional councils will also need to write and report legislation that follows its instructions.
The budget decision itself Silent about whether Congress reduces medicaid, which provides healthy coverage to 72 million poor Americans and handicapped. But he guides the Energy and Trade Committee in the House of Representatives, which has a specialty on the program, to reduce spending at $ 880 billion over the next decade. If the committee is not able to provide this amount at least, the entire voltage may be at risk due to the special process that Congress uses to avoid the severity of the Senate.
It is not simple as finding discounts elsewhere. The special process, known as reconciliation in the budget, means that Republicans must find $ 880 billion from within the committee’s judicial jurisdiction. This leaves them with less options than one may think.
Below, the list of these options. (These numbers are not accurate; they are unofficial or old estimates. Before the reconciliation bill has passed, they will all obtain an official evaluation from the Congress Budget Office, the degree guard in Congress.)
Option 1: Cutting medical care instead
If Republicans want to avoid the main discounts in Medicaid, then the largest amount of money available is in the other large government health insurance program: Medicare.
But Republicans are facing a more strict political link when it comes to medical care more than they do with Medicaid. President Trump said repeatedly He does not want to cut medical care. Most Republicans in the House of Representatives have pledged. President Joseph R. Biden Junior during the union speech last year, “Social Security and Medical Care Outside Books”. Standing applause drawing Almost every gift of the republic.
Mr. Trump said last week in an interview with Fox News that Medicaid will not be “touched” as well. But his record He appears It was more open to Medicaid discounts than medical care discounts.
Option 2: Cut everything else supervised by the committee
Even if the committee reduces everything that does not represent health care to $ 0, it will remain more than $ 600 billion.
The committee can also provide about 200 billion dollars by eliminating the children’s health insurance program, but this option was not earned by the Budget Committee or anyone in the leadership of the House of Representatives.
Option 3: Consider the options that are not reduced, even if you do not add up to $ 880 billion
There are some creative options that would allow the committee to find budget savings without having to reduce spending. A Its distribution document earlier this year The Budget Committee included some of these ideas.
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The regulations that require car makers to raise the criteria for fuel efficiency and reduce car emissions (about $ 110 billion). The cancellation of this rule would provide government money without making direct budget discounts by reducing spending on tax credits for people who buy electric cars and increase gas tax revenues.
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Auction parts of the air waves of telecom companies (about $ 70 billion). The committee periodically passes legislation to sell signal transfer rights through specific ranges of electromagnetic spectrum, but the Ministry of Defense tends to sell a lot.
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The speed of the permission to extract energy (about 7 billion dollars).
Some of these options may conflict with the rules of the special budget process. A Senate employee, known as Parliament, will have to rule over their suitability if the final legislation to vote there.
Option 4: Cut Medicaid after all
Even if all these discounts, revenues, and the abolition of the ruling from external health care can pass, the committee will remain hundreds of billions of dollars to reduce its goal. Sports, the budget committee instructions mean that the committee will need significant discounts either for medical care or medical aid or both.
Congress leadership was indicating that medicaid was the main focus.
“880 billion dollars is a lot of money, and even if it is only 600 billion dollars in health care, it should exceed the small tampering of the margins,” said Mark Goldwin, chief policy manager at the committee to obtain a responsible federal budget. A group that supports the deficit reduction.
Many experts who advise the committee say that the changes in Medicaid policy are wise. “There is more than sufficient in the inappropriate spending to obtain meaningful savings from the program,” said Brian Plus, head of the right -wing Paraguayon Institute, who was a White House economy in the Trump administration.
Some of the leading options for discounts in medical aid below. The first few may be less politically charged with vulnerable legislators, but it will save less money. Two others will provide more, but it will have a much greater effect on the program as a result.
(Because of the way the various medicaid policies intersect with each other, it is better not to add them together. Evidence will reduce spending with less than the total of each follow -up.)
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Establishing a national work condition for adults without disabilities and without young children (about $ 100 billion). Many Republicans, even those who are concerned about Medicaid discounts, are comfortable with this approach. But this change can only save about $ 100 billion.
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Reflecting the policy of Biden’s era, which limits the times that the states can verify from the eligibility of the beneficiaries (about 160 billion dollars). Change will allow countries to verify people’s income often and ask them to fill more paperwork to stay registered.
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Reducing the ability of countries to impose hospital taxes to help pay their stake from Medicaid (about $ 175 billion). This would pressure the state budgets, and it is often described as reducing the abuse of the program. Because of the formulas used to fund medicaid, these taxes lead to high state medical bills – and thus more funding from the federal government.
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Click on government spending share on adults of the working class who were part of the program’s expansion under reasonable prices (about $ 560 billion). This would provide hundreds of billions by lower payment in the 41 states that expanded MEDICAID under Obamacare, but it will do so by suddenly reducing federal financing for the program. Some states may immediately eliminate Medicaid expansions, which leads to significant increases in the number of adults of the working class who lack health insurance. Other countries will have to find funding by other means – such as lowering education or raising taxes.
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Change the Medicaid structure (about $ 900 billion)One of them, in which the federal government pays a percentage of medical bills for the beneficiaries to one where the states give fixed fees to each person every year.
Conclusion: Healthcare is the place of dollars
The committee does not have enough other places to find money. If the budget solution will become a general policy, this requires legislation that reduces health programs. Nearly a trillion dollars is a lot of money, even in the terms of the federal budget, and health care is the place where the money is located.
If the committee cannot find $ 880 billion, the entire settlement process – including extension of tax cuts – will collapse.
“The instructions they have provided require huge health care discounts – full stopping,” said Bobby Kojan, the first director of the federal budget policy at the American Progress Center, and a former budget official in the Senate and the White House. “There is a sports demand.”
