Head Smacker: ‘These are not cuts to Medicaid, George.’ Yes they are, Kellyanne.
I’ve had the very meaningful experience of joining people of faith in a vigil overnight outside the Capitol with the goal of saving Medicaid. The speakers are truth-tellers; sadly, that is not the case for some proponents of the Senate health care repeal bill.
“These are not cuts to Medicaid, George,” Kellyanne Conway told ABC’s George Stephanopoulos. Other Trump apologists make similar claims: Senator Pat Toomey (R-PA), for example, said that Medicaid would “never” be cut in the Senate health care repeal bill. There is a technical term for these assertions.
The Senate bill will massively cut the funding available to states for Medicaid as compared to current law (by $772 billion over the next decade, according to the Congressional Budget Office, or 26 percent less than projected spending on Medicaid under current law). That same CBO analysis of the Senate bill estimates that Medicaid will serve 15 million fewer people in 2026 than it would have under current law. That’s a cut. (A new Urban Institute analysis finds that even fewer will receive Medicaid – 15.9 million fewer as early as 2022, with the number growing as the Senate Medicaid cuts worsen in 2025.)
The Senate bill, ironically titled the Better Care Reconciliation Act, was pulled from the floor this week because, so far, it does not have enough votes. The very real cuts to Medicaid are an important reason why. The Urban Institute report shows that the federal government will spend $102 billion less on Medicaid and the Children’s Health Insurance Program (CHIP) in 2022 under the Senate bill than under current law. That’s a cut of nearly half in West Virginia (47.4 percent); a 41 percent in Alaska; and a 43 percent reduction in Nevada. And Senator Toomey? It would be nearly a 32 percent cut in Pennsylvania.
Further, it is the poorest people being served by Medicaid who would see the biggest cuts (Medicaid mostly serves poor and near poor people). Among those with incomes under 138 percent of the poverty line, 54.8 million people would be served by Medicaid and CHIP through the existing Affordable Care Act in 2022 (if it’s still around). If the Senate bill were to become law, only 40.3 million people at that low income level would be covered by Medicaid and CHIP, a decrease of almost 15 percent. Also important to note: the Urban Institute report throws cold water on the assertion that people losing Medicaid will move to employer-based insurance. While 14.5 million fewer low-income people will get Medicaid or CHIP under the Senate bill in 2022, only about 2.8 million will gain employer-based insurance. That leaves 11.7 million people with no health insurance.
In a head-smacking contrast, the CBO and Joint Committee on Taxation estimate that the tax cuts included in the legislation, which overwhelmingly help the wealthiest individuals as well as health insurance and medical industry companies, cost more than $700 billion over the next decade. So in a very real sense, depriving 15 million people of Medicaid coverage goes a long way towards paying for tax cuts for the rich. Millionaires will get $50,000 each in tax breaks, on average. People at or near poverty get…sick.
This should make it head-smackingly obvious that the Senate bill does too much damage to be fixed. But the misinformation about Medicaid alone in the bill means that we all still need to tell our Senators about the harm the bill really does, to our people and our states. It isn’t over yet.