The Secret Senate and the Threat to Medicaid


June 16, 2017

Did you think that the House-passed health care repeal bill was going nowhere in the Senate?
Think again.

Senate Majority Whip John Cornyn (R-TX) was of the opinion in late May that “80 percent of what the House did we’re likely to do.” But the Senate leadership absolutely does not want you to see any details on that.  They are trying to get a health care repeal bill to the floor before the July 4 recess, and the rumor is they will not share the bill’s contents until just before the vote.  The Senate rules require that the Congressional Budget Office estimate the cost or savings in the bill; CBO will most likely also calculate the expected impact on the number of uninsured.  (CBO’s analysis of the House-passed bill was that 23 million more would be uninsured over 10 years.)  This information will either not be available to the public until just before the vote, or maybe not until after.

So we’re left with rumors and Senator Cornyn’s guidance that we should not expect something very different from the House bill.

This secret scenario is very dangerous for Medicaid.  This source of health care for one-fifth of our nation covers the births of one-half of our babies and the long-term care services for one-half of our seniors or people with disabilities.  The House bill guts Medicaid.  It would cut over $800 billion in the first decade, deny Medicaid coverage to 11 million people by ending the Medicaid expansion in 2020, and cap Medicaid payments to states by a formula that is lower than actual health care cost growth, leaving states with the choice of increasing their own health care bills by a lot or (more likely) reducing benefits or eligibility for coverage.   There are senators who are concerned about the impact of these cuts on their states, especially those in states that have expanded their Medicaid enrollees.  But rumors are that the “fix” they are negotiating would simply phase out the expansion more slowly – say, over seven years.  But let’s face it:  that is no fix at all.  By the end of that time, the extra federal support for this group will end, and states will not cover them.  Some in the Senate are hoping that constituents will not recognize that future termination is still termination.  They are hoping that pots of money earmarked for certain problems (like opioid addiction) or states will get them to the 51 votes they need, even though the losses to those states will far outweigh the gains.

Please contact your senators and tell them to oppose the gutting of Medicaid.

Want to tweet?  Below is a link to all the senators’ twitter handles.  Pick yours and write something like

@SenCapito Don’t gut Medicaid. Don’t end/phase out the Medicaid expansion.  Vote no on Medicaid caps.  #ProtectOurCare

Twitter accounts for Senate are here.

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