Fight over Medicaid cuts heats up as House Republicans release bill

WASHINGTON — House Republicans released legislative text Sunday evening of a key portion of their party-line agenda bill that includes cuts and other changes to Medicaid, one of the most contentious issues they face in trying to advance President Donald Trump’s agenda in one sweeping package.

The legislation released by the Energy and Commerce Committee heads to a markup Tuesday afternoon, and includes a 160-page section covering health care and Medicaid.

The bill would make a slew of Medicaid spending reductions through policies such as stricter eligibility verification, citizenship checks, tougher screenings on providers who get reimbursements and federal Medicaid funding cuts to states that offer coverage to residents living in the U.S. illegally.

The bill also seeks to impose work requirements to receive Medicaid for able-bodied adults aged 19 to 64 without dependents, demanding they work at least 80 hours — or perform 80 hours of community service or other programs — per month. It includes exceptions for pregnant women and short-term hardship waivers in limited cases.

It does not include some of the most aggressive provisions that had caused intraparty tension, such as per capita limits on Medicaid spending and increasing the state burden for covering the Medicaid expansion population under the Affordable Care Act.

“When so many Americans who are truly in need rely on Medicaid for life-saving services, Washington can’t afford to undermine the program further by subsidizing capable adults who choose not to work. That’s why our bill would implement sensible work requirements,” Rep. Brett Guthrie, R-Ky., the committee chairman, wrote in a Wall Street Journal op-ed making his case for the bill.

Guthrie said he expects “fear-mongering” attacks on the legislation, but maintained that it “preserves and strengthens Medicaid for children, mothers, people with disabilities and the elderly, for whom the program was designed.”

Democrats circulated a letter from the nonpartisan Congressional Budget Office with a preliminary analysis finding that the health care portion of the bill would cut spending by $715 billion and would “reduce the number of people with health insurance by at least 8.6 million in 2034.”

“Trump and Republicans have been lying when they claim they aren’t going to cut Medicaid and take away people’s health care,” Rep. Frank Pallone, of New Jersey, the top Democrat on the committee, said in a statement. “Let’s be clear, Republican leadership released this bill under cover of night because they don’t want people to know their true intentions.”

“This is not trimming fat from around the edges, it’s cutting to the bone. The overwhelming majority of the savings in this bill will come from taking health care away from millions of Americans,” he added. “No where in the bill are they cutting ‘waste, fraud, and abuse’ — they’re cutting people’s health care and using that money to give tax breaks to billionaires.”

The legislation could be amended in committee, and it needs to win over nearly every Republican on the floor of the narrowly divided House in order to become law. Then it would go to the Senate.

The Medicaid question has caused an intraparty rift as some Republicans warn their colleagues against messing with the program. That includes Sen. Josh Hawley, R-Mo., who published an op-ed in The New York Times on Monday saying: “If Congress cuts funding for Medicaid benefits, Missouri workers and their children will lose their health care. And hospitals will close. It’s that simple. And that pattern will replicate in states across the country.”