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House GOP Unveils Medicaid Cu 05/12 07:32

   

   WASHINGTON (AP) -- House Republicans unveiled the cost-saving centerpiece of 
President Donald Trump's "big, beautiful bill " late Sunday, at least $880 
billion in cuts largely to Medicaid to help cover the cost of $4.5 trillion in 
tax breaks.

   Tallying hundreds of pages, the legislation is touching off the biggest 
political fight over health care since Republicans tried to repeal and replace 
the Affordable Care Act, or Obamacare, during Trump's first term in 2017 -- 
which ended in failure.

   While Republicans insist they are simply rooting out "waste, fraud and 
abuse" to generate savings with new work and eligibility requirements, 
Democrats warn that millions of Americans will lose coverage. A preliminary 
estimate from the nonpartisan Congressional Budget Office said the proposals 
would reduce the number of people with health care by 8.6 million over the 
decade.

   "Savings like these allow us to use this bill to renew the Trump tax cuts 
and keep Republicans' promise to hardworking middle-class families," said Rep. 
Brett Guthrie of Kentucky, the GOP chairman of the Energy and Commerce 
Committee, which handles health care spending.

   But Democrats said the cuts are "shameful" and essentially amount to another 
attempt to repeal Obamacare.

   "In no uncertain terms, millions of Americans will lose their health care 
coverage," said Rep. Frank Pallone of New Jersey, the top Democrat on the 
panel. He said "hospitals will close, seniors will not be able to access the 
care they need, and premiums will rise for millions of people if this bill 
passes."

   As Republicans race toward House Speaker Mike Johnson's Memorial Day 
deadline to pass Trump's big bill of tax breaks and spending cuts, they are 
preparing to flood the zone with round-the-clock public hearings this week on 
various sections before they are stitched together in what will become a 
massive package.

   The politics ahead are uncertain. More than a dozen House Republicans have 
told Johnson and GOP leaders they will not support cuts to the health care 
safety net programs that residents back home depend on. Trump himself has shied 
away from a repeat of his first term, vowing there will be no cuts to Medicaid.

   All told, 11 committees in the House have been compiling their sections of 
the package as Republicans seek at least $1.5 trillion in savings to help cover 
the cost of preserving the 2017 tax breaks, which were approved during Trump's 
first term and are expiring at the end of the year.

   But the powerful Energy and Commerce Committee has been among the most 
watched. The committee was instructed to come up with $880 billion in savings 
and reached that goal, primarily with the health care cuts, but also by rolling 
back Biden-era green energy programs. The preliminary CBO analysis said the 
committee's proposals would reduce the deficit by $912 billion over the decade 
-- with at least $715 billion coming from the health provisions.

   Central to the savings are changes to Medicaid, which provides almost free 
health care to more than 70 million Americans, and the Affordable Care Act, 
which has expanded in the 15 years since it was first approved to cover 
millions more.

   To be eligible for Medicaid, there would be new "community engagement 
requirements" of at least 80 hours per month of work, education or service for 
able-bodied adults without dependents. People would also have to verify their 
eligibility to be in the program twice a year, rather than just once.

   This is likely to lead to more churn in the program and present hurdles for 
people to stay covered, especially if they have to drive far to a local 
benefits office to verify their income in person. But Republicans say it'll 
ensure that the program is administered to those who qualify for it.

   Many states have expanded their Medicaid rosters thanks to federal 
incentives, but the legislation would cut a 5% boost that was put in place 
during the COVID-19 pandemic. Federal funding to the states for immigrants who 
have not shown proof of citizenship would be prohibited.

   There would be a freeze on the so-called provider tax that some states use 
to help pay for large portions of their Medicaid programs. The extra tax often 
leads to higher payments from the federal government, which critics say is a 
loophole that creates abuse in the system.

   The energy portions of the legislation run far fewer pages, but include 
rollbacks of climate-change strategies President Joe Biden signed into law in 
the Inflation Reduction Act.

   It proposes rescinding funds for a range of energy loans and investment 
programs while providing expedited permitting for natural gas development and 
oil pipelines.

 
 
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