Medicaid cuts: Democrats pan Republican plan to change major payer in U.S. health care

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Massive cuts to Medicaid will set up the nation for a health care disaster, said Democratic lawmakers opposing Republicans’ federal spending plans.

Rep. Frank Pallone (D-New Jersey), Rep. Diana DeGette (D-Colorado), and Rep. Lizzie Fletcher (D-Texas) met online with Leslie Dach, the leader of Protect Our Care, a health care advocacy organization that works at the federal and state levels.

The three legislators are members of the House Energy & Commerce Committee, which is scheduled to meet May 13 for a full committee markup of the budget reconciliation text.

Medicaid has been a popular program the people rely on, regardless of political affiliation, said Dach, a former adviser in the U.S. Department of Health and Human Services under the administration of President Barack Obama, and a management executive for Walmart Inc.

“This is a draconian bill, punitive bill that will hurt millions of Americans,” he said. “Republicans still have a chance to make this right. One thing they can't do — hide behind the rhetoric they're trying to use today. Seniors will, many will suffer, seniors in nursing homes, families, the disabled veterans, mothers, children, all will suffer. All will lose meaningful and deadly amounts of insurance. And make no mistake, people will get sick and people will die.”

‘Gotcha’ tactics

Ahead of that meeting, they and Dach ripped the proposal and its potential effects.

Rep. Frank Pallone (D-New Jersey)

The GOP plan is full of “gotcha” gimmicks and red-tape requirements that will deny care for millions, said Pallone, the committee ranking member. He called out his congressional colleagues and President Donald J. Trump.

“I mean, it is so sad the attitude they have, which is that we're not looking to give people health insurance, we're not making access to health insurance or health care more affordable. We want to do whatever we can to make sure you don't get it. And that's what I hear from the Republicans in this bill,” Pallone said. “First of all, you know, Trump and the congressional Republicans promised they would not cut Medicaid benefits or strip away people's health care. They lie. This does just the opposite.”

Pallone cited a Congressional Budget Office analysis that found 8.6 million people will lose their health insurance. In addition to that, there is no extension to subsidies that assist costs of insurance through the Affordable Care Act, so an estimated 5 million people will lose that health insurance. In total, an estimated 13.7 million people will lose coverage, Pallone said.

He listed some of the requirements that could go into effect:

• $35 co-pays for every doctor visit
• No minimum staffing requirements for nursing homes
• Limited enrollment periods for Affordable Care Act insurance, with limited options to enroll if people cannot get Medicaid coverage
• A provider tax prohibition that will limit states’ ability to make up for lower federal subsidies for care

A tax cut for billionaires

Rep. Diana DeGette (D-Colorado)

DeGette also mentioned tech billionaire Elon Musk, who has become leader of the Department of Government Efficiency (DOGE), compared with millions of Americans whose health care and jobs may be at risk.

“They're going to lose their Medicaid in order for Donald Trump and the Republicans to give a $5 trillion tax cut for Elon Musk and his billionaire friends,” she said. “You know, the reason why we cover all these people under Medicaid, including the working families who can't afford to pay for health insurance, is because, number one, it's the right thing to do for American families.

“And number two, it has greatly reduced our uninsurance rate in in this country, which has taken burdens off of hospitals, it’s taking burdens off of doctors, and most of all, it's taken burdens off American families who now no longer have to worry how they're going to pay for their health care bills,” DeGette said.

The Republican plan also targets Planned Parenthood, which is the largest provider of health care for women in the country, said DeGette, chair of the congressional Reproductive Freedom Caucus.

Huge impact on providers

Rep. Lizzie Fletcher (D-Texas)

Fletcher, vice chair of that caucus, called Medicaid a lifeline. Removing it will simultaneously deny health care for millions of people while driving up costs for millions of others, she said. Cutting Medicaid will not save money, but instead will shift costs to the states.

“One of the things they want to do is just shift people off of Medicaid, and that means that people will wind up not getting care when they need it, not getting preventive care, not getting some of the critical care that they need early on, and wind up in the emergency rooms later, which is more expensive, as we know, and it’s also a huge challenge for those facilities,” Fletcher said. “We know from our hearings that we've held in our committee that the impact on providers is going to be huge.”

Texas already has narrow eligibility to qualify for Medicaid, Fletcher said, although the state has expanded its postpartum care. In that state, a full 50% of births are covered by Medicaid. In a hearing, Fletcher said a witness acknowledged hospitals will close their labor and delivery units.

“So that means that everyone in the vicinity who's relying on that hospital, and in a big state like Texas that has some really rural parts, some of these hospitals are going to wind up having to close their labor and delivery units, if the hospitals can stay open at all,” Fletcher said. “And so it's really critical to understand this ecosystem, and the idea that what we're looking at is really going to be devastating to people across the board in ways that we're not hearing about at this moment. While we're hearing that these are such reasonable provisions, they're not, and they're going to impact people across the country.”