Congress and Medicaid Cuts: Where Are We and What's Next?

Admin
May 19
4 min read

Updated: May 24

Maria, a Floridian, describes the impact of Medicaid cuts for Floridians with disabilities.

Recently, the House voted to pass its version of the reconciliation bill that cuts more than $700 billion from Medicaid. This would be the largest cut in the program’s history.

In addition to the cuts laid out in the original E&C and W&M markups, the manager’s amendment put forth by House leadership last night to appease House Freedom Caucus members in their calls for deeper cuts includes provisions that:

Accelerate the start date of mandatory Medicaid work requirements and the requirement for states to redetermine people's eligibility for Medicaid every six months to December 2026;
Penalize states that have expanded Medicaid and disincentivizes states from expanding Medicaid moving forward by allowing higher payment rates in non-expansion states; and
Reduces the amount of tax credits people get to purchase health insurance on the ACA marketplaces and increasing the cost of purchasing a plan for everyone.

We expect Senate leadership to work quickly to get their version of the reconciliation bill cobbled together. Congressional leaders are hoping to move the bill through the Senate and then back to the House for a final vote before the July 4th recess.

Join us in sending a clear message to the incoming members of Congress that Medicaid is a critical program that millions of families rely on and it must be protected.

What Has Happened Since Last Week

Last week, the House Energy & Commerce (E&C) Committee voted along party lines to pass a “markup” of the reconciliation bill that emerged over the weekend. See Community Catalyst’s new blog post with the full rundown.

Though there were several amendments offered by Democratic members – including those aimed at making the enhanced premium tax credits permanent, closing the coverage gap, making room for people losing Medicaid under the other provisions to get access to more affordable coverage, and others – they all failed along party line votes.

ICYMI: Below is our quick review of what’s in the markup. See Community Catalyst's full breakdown of the proposed cuts and their likely impacts here.

Mandatory Work Requirements that require states to verify, at the time of enrollment and during eligibility determinations, that all “able-bodied” adults, 19-64 years of age, comply with 80 hours per month of employment, community service, work program, or education enrollment as part of eligibility requirements. If people aren’t able to navigate this new red tape, they’ll not only lose their Medicaid coverage, but will also be locked out of subsidized health insurance on the Marketplace.
Increased frequency for eligibility determinations to every six months for individuals enrolled in Medicaid expansion.
Prospectively ending the 5% enhanced federal match established under the American Rescue Plan Act (ARPA) for states that newly expand Medicaid.
Shifting costs to Medicaid expansion enrollees through required increased cost sharing up to 5% of an individual's income.
Restricting retroactive coverage for Medicaid and CHIP to one month prior to an individual’s application date.
Prohibiting Medicaid funding to large providers that offer family planning and abortion care services.
Delaying implementation of the final rule to Streamline Enrollment in Medicare Savings Programs by 10 years.
Delaying implementation of the final rule for Minimum Staffing Standards for Long-term Care Facilities by 10 years.

According to the CBO, these would be the largest cuts to Medicaid in the history of the program and would cause at least 13.7 million people to lose their health insurance coverage, including the number of people who will lose coverage if Congress fails to extend the enhanced premium tax credits – and House Republicans are banking on that failure.

Additionally, the Ways & Means and Agriculture Committees moved their markups forward this week, which included additional ACA cuts – mostly targeting immigrant communities – and cutting $300 billion from SNAP, which will shift an unsustainable share of costs to states, ensuring that people will lose access to vital food/nutrition supports.

Take Action: Contact Senate Members Now

Flood member offices with phone calls if you/your organization are in their district or state. We’re using SEIU’s call in number, 866-426-2631, and this template script. All members should be hearing from their constituents – let’s not leave any stone unturned. You can also send your member an email or social media post with a couple of quick clicks.
Send in Medicaid stories. Health care champions in the House are still collecting community stories from people in key House districts to read on the floor and/or use to amplify the disconnect between the needs of communities and the actions House leaders are taking. Share your story with us here.
Please sign and share this petition with your networks to tell Congress: HANDS OFF MEDICAID!