House GOP releases plan to cut Medicaid

The cost-saving centerpiece of President Trump’s “big, beautiful bill” was unveiled late Sunday, with at least $880 billion in cuts largely to Medicaid to help cover the cost of $4.5 trillion in tax breaks, reports The Associated Press.

The legislation is touching off the biggest political fight over health care since Republicans tried and failed to repeal and replace the Affordable Care Act, or Obamacare, during Trump’s first term in 2017, AP says.

Republicans say they’re just rooting out “waste, fraud and abuse” to generate savings with new work and eligibility requirements, as Democrats say millions of Americans will lose coverage. A preliminary estimate from the nonpartisan Congressional Budget Office says the proposals would reduce the number of people with health care by 8.6 million over a 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,” says Rep. Brett Guthrie of Kentucky, the GOP chairman of the House Energy and Commerce Committee, which handles health care spending.

Rep. Frank Pallone of New Jersey, the top Democrat on the committee, says, “In no uncertain terms, millions of Americans will lose their health care coverage. 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.”

The bill will face unified opposition from congressional Democrats, hospitals and other groups that depend on Medicaid funding, says The Wall Street Journal. Those groups say cuts to Medicaid would devastate state budgets, force rural hospitals to close and leave vulnerable people without coverage.

The proposal would require some able-bodied Medicaid recipients making more than 100 percent of the federal poverty level, or $15,650 for a single adult, to pay for some of their coverage, the WSJ says. The contributions would be capped at $35 a service or 5 percent of an individual’s income, and wouldn’t be required for primary, prenatal, pediatric or emergency care.

The bill includes work requirements — which is broadly popular across the GOP — though they’re not as strict as some fiscal hawks had hoped, the WSJ says. Medicaid recipients would be required to work, volunteer or attend school for 80 hours a month. The requirement would apply to most able-bodied adults through age 64 without dependents and includes exceptions for pregnant women, people with substance-use disorders and others.

And the bill aims to stop federal funds from going to facilities and organizations that provide abortion services such as Planned Parenthood, a provision some centrist Republicans have tried to block, the WSJ says.

While GOP budget hawks are trying to find at least $1.5 trillion in spending cuts over the next decade, with the goal of reaching at least $2 trillion, a bloc of Republicans has warned that deep reductions in Medicaid coverage will harm GOP voters who depend on the program and hamper their efforts to keep the House majority in 2026, the WSJ says.

States will bear the brunt of the Energy and Commerce plan, says Politico.

Medicaid covers a large share of America’s mental health patients, and spending cuts could accelerate a decades-long wave of psychiatric unit closures, says KFF.

Here is a press release from the Energy and Commerce Committee with the text of an opinion article by Chairman Guthrie that’s running in The Wall Street Journal.

The committee meets on Tuesday, May 13, at 2 p.m. to discuss and approve the details of the bill text.

As Americans concerned about Medicaid cuts contact their lawmakers, Republicans in competitive districts who serve on the Energy and Commerce Committee, such as Reps. Gabe Evans, Colo.; Mariannette Miller-Meeks, Iowa; and Thomas Kean Jr., N.J., are getting particular focus.

Eleven House committees are compiling their sections of the package as Republicans seek at least $1.5 trillion in savings to help cover the cost of preserving the tax breaks were approved during Trump’s first term and are expiring at the end of the year.