Missouri Senator Josh Hawley: Cutting Medicaid for Tax Breaks Is "Morally Wrong" and "Politically Suicidal"

Kansas City - The House Republicans have presented the key budget-cutting measure of President Donald Trump’s “large, impressive bill,” which includes at least $880 billion in reductions primarily from Medicaid to offset the $4.5 trillion in proposed tax cuts.

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

Even though Republicans argue they are merely identifying "inefficiency, deceit, and misuse" to create savings through updated work and qualification criteria, Democrats caution that millions of Americans could end up without insurance. An initial assessment from the unbiased Congressional Budget Office indicates that these plans would lead to approximately 8.6 million fewer individuals having healthcare coverage throughout ten years.

"These savings enable us to utilize this legislation to reinstate the Trump tax cuts and uphold the Republican commitment to America’s diligent middle-class households," stated Rep. Brett Guthrie from Kentucky, who serves as the GOP chair of the Energy and Commerce Committee, overseeing healthcare expenditures.

However, Democrats argued that the cuts are "dishonorable" and effectively constitute yet another effort to abolish the Affordable Care Act.

"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 political landscape remains unpredictable. Over a dozen Republican members of the House have informed Johnson and GOP leadership that they won’t endorse reductions to healthcare safety-net initiatives that their constituents rely on. Trump has distanced himself from repeating actions seen during his initial term, pledging there will be no cuts to Medicaid.

A single Republican, Senator Josh Hawley from Missouri, cautioned his fellow senators in an opinion piece on Monday that funding tax cuts by reducing healthcare benefits would be both "ethically indefensible and politically catastrophic."

In total, 11 House committees have been assembling parts of this legislative package as Republicans aim for at least $1.5 trillion in cuts to offset the expense of maintaining the 2017 tax reductions. These tax cuts were enacted during President Trump’s initial tenure and are set to expire by the end of the year.

However, the influential Energy and Commerce Committee has garnered significant attention. This panel was tasked with finding $880 billion in savings, achieving this mainly through healthcare reductions and by reversing some of President Biden’s green energy initiatives. According to an initial assessment by the Congressional Budget Office (CBO), the committee's suggestions would cut the deficit by approximately $912 billion over ten years—of which at least $715 billion would stem from changes in healthcare policies.

Key elements of these savings involve modifications to Medicaid, offering nearly free healthcare to over 70 million Americans, as well as expansions under the Affordable Care Act, which has grown to provide coverage for many additional people over the past 15 years since its initial approval.

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. The bill also adds a more rigorous income verification for those who enroll in the Affordable Care Act's health care coverage.

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.

Some Medicaid recipients who make more than 100% of the federal poverty level — about $32,000 a year for a family of four — would be required to pay out-of-pocket costs, too, for some services. Those fees, which would not apply to emergency room visits, prenatal care, pediatric visits or primary care check-ups, would be limited to $35 per visit.

And applicants could not qualify for Medicaid if they have a home that is valued at more than $1 million.

The suggested legislation similarly aims at immigrants residing within the nation unlawfully or without proper paperwork. It decreases the federal contribution to states like New York or California—places where these immigrants can enroll in Medicaid—by ten percent. In order to be eligible for Affordable Care Act (ACA) coverage, applicants will need to demonstrate that they are “lawfully admitted” into the country.

Other maneuvers would transfer expenses to every state.

numerous states have enlarged their Medicaid rolls due to federal inducements, however, the new legislation aims to reduce a 5% increase that was implemented during theCOVID-19 pandemic.

A freeze will be imposed on what is known as the provider tax, which certain states employ to fund significant parts of their Medicaid initiatives. This additional levy frequently results in increased contributions from the federal government; however, detractors argue this constitutes a loophole enabling states to artificially increase their expenditures.

The sections dealing with energy in the legislation cover significantly fewer pages but contain reversals of climate-change measures that President Joe Biden enacted through the Inflation Reduction Act.

The proposal suggests removing funding from various energy loan and investment initiatives but accelerates the approval process for natural gas projects and oil pipeline developments.

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Amanda Seitz, an Associated Press writer, contributed to this report.