{"id":8710,"date":"2025-02-25T15:49:21","date_gmt":"2025-02-25T15:49:21","guid":{"rendered":"https:\/\/site.itshrt.com\/worldnews\/as-g-o-p-eyes-medicaid-cuts-states-could-be-left-with-vast-shortfalls\/"},"modified":"2025-02-25T15:49:21","modified_gmt":"2025-02-25T15:49:21","slug":"as-g-o-p-eyes-medicaid-cuts-states-could-be-left-with-vast-shortfalls","status":"publish","type":"post","link":"https:\/\/site.itshrt.com\/worldnews\/as-g-o-p-eyes-medicaid-cuts-states-could-be-left-with-vast-shortfalls\/","title":{"rendered":"As G.O.P. Eyes Medicaid Cuts, States Could be Left With Vast Shortfalls"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-6606220950177433\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<!-- ItShrt World News -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-6606220950177433\"\r\n     data-ad-slot=\"1882483372\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\r\n<br \/>\n<\/p>\n<div data-testid=\"companionColumn-0\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">House Republicans hunting for ways to pay for President Trump\u2019s tax cuts have called for cutting the federal government\u2019s share of Medicaid spending, including a proposal that would effectively gut the Affordable Care Act\u2019s 2014 expansion of the program.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Cutting Medicaid spending, which is central to <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/interactive\/2025\/02\/21\/upshot\/house-gop-budget-blueprint.html\" title=\"\">the budget bill that House Republicans may bring to a vote on Tuesday<\/a>, could result in millions of Americans across the country losing health coverage unless states decide to play a bigger role in its funding.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Republicans are considering lowering the 90 percent share that the federal government is required to pay to states that enroll participants in the expansion. The change could generate $560 billion in savings over a decade, money that Republicans want to use toward extending Mr. Trump\u2019s 2017 tax cuts, which are set to expire at the end of 2025. Extending the tax cuts is <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2025\/01\/23\/us\/politics\/trump-tax-cuts-immigration-house-republicans.html\" title=\"\">expected to cost<\/a> $4.5 trillion, meaning Republicans will have to find savings beyond Medicaid from <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/interactive\/2025\/01\/23\/us\/politics\/republican-tax-spending-cuts-options.html\" title=\"\">a long menu of options<\/a>.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">A move to lower federal spending on the Medicaid expansion population could effectively gut the program. Around 10 states that have expanded their programs have so-called trigger laws that reverse the Medicaid expansion if the federal government decreases funding for the population.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-1\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The change could leave the 40 states that participate in the Obamacare program with a difficult set of choices. They could shoulder the extra costs to preserve Medicaid coverage for millions, make cuts to coverage or look for cuts from other large government programs to offset the reduction in federal funds.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Medicaid, which covers more than 70 million people, is the largest health insurance program in the nation, and the <a class=\"css-yywogo\" href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/medicaid-financing-the-basics\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">largest single source<\/a> of funding for states. More than 21 million adults who were not eligible for Medicaid under pre-expansion guidelines received coverage last year. The program had previously restricted enrollment primarily to those who were pregnant, disabled or elderly.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Among those who qualified for Medicaid under the expansion was Jeannie Brown, a 60 year-old part-time bus driver for the public school system in Belgrade, Mont. Ms. Brown went more than five years without health insurance beginning in 2009, avoiding medical care as her health deteriorated and she cared for her disabled granddaughter.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Ms. Brown, who makes around $25,000 each year, had been trapped in the so-called coverage gap, with a salary too high for Medicaid, and too low for a heavily subsidized Obamacare plan.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">After Montana lawmakers voted in 2015 to take up the Affordable Care Act\u2019s option to expand Medicaid to cover more adults, Ms. Brown enrolled. She began to see a primary care doctor, and Medicaid paid for hand surgeries, knee replacements, a double mastectomy and her inhaler, she said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-2\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cBeing a caregiver is extremely exhausting, especially with someone who has a lot of health needs,\u201d she said last week from a children\u2019s hospital in Colorado, where her granddaughter had been flown for emergency care. \u201cIf I didn\u2019t have the preventative care I needed, I\u2019d be in a much worse place physically. I\u2019d probably be disabled.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Conservative critics of Medicaid expansion have argued that it forces the federal government to spend exorbitantly, and <a class=\"css-yywogo\" href=\"https:\/\/paragoninstitute.org\/medicaid\/medicaid-financing-reform-stopping-discrimination-against-the-most-vulnerable-and-reducing-bias-favoring-wealthy-states\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">disproportionately<\/a>, to cover health services for a population Medicaid was not intended to serve.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThe higher federal match for able-bodied adults creates perverse incentives to divert funds from more vulnerable populations,\u201d said Michael Cannon, the director of health policy studies at the Cato Institute, a libertarian think tank.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Republicans have also pointed to what they say is unanticipated runaway Medicaid spending. Some states have seen unexpected surges in Medicaid costs in recent years, in part because many Americans delayed care during the coronavirus pandemic. Gov. Josh Shapiro of Pennsylvania, a Democrat, <a class=\"css-yywogo\" href=\"https:\/\/apnews.com\/article\/medicaid-expenses-covid-pennsylvania-shapiro-6ce9843f4adb102db507960d7398bb0f\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">recently proposed<\/a> a $2.5 billion increase in state spending on the program.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The move to pare back the federal government\u2019s financial commitments to Medicaid could profoundly reshape how it shares responsibility with states to offer health care to some of the poorest Americans, as well as the providers and nursing homes that care for them.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-3\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The change would amount to a \u201cmassive transfer of the financial responsibility from the federal government to states,\u201d said Daniel Tsai, who oversaw Medicaid under former President Joseph R. Biden Jr.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cYou\u2019d have states having enormous budget holes making decisions between how to do the right thing to keep people covered\u201d and how to preserve other programs, he said. \u201cStates are going to be cash strapped.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Medicaid expansion has become <a class=\"css-yywogo\" href=\"https:\/\/www.kff.org\/status-of-state-medicaid-expansion-decisions\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">a deeply bipartisan project<\/a> over the past decade, underscoring the Affordable Care Act\u2019s reach in the American health system and its appeal even to Republican governors and state lawmakers who once opposed it. Much of the additional enrollment comes from Republican-led states where voters passed <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2022\/11\/03\/us\/politics\/medicaid-expansion-south-dakota.html\" title=\"\">ballot initiatives<\/a> to enact the program.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Medicaid now funds almost half of all births in the United States, and represents <a class=\"css-yywogo\" href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/10-things-to-know-about-medicaid\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">more than half<\/a> of spending on long-term care. More than 70 percent of Americans say they want Medicaid to stay as it is, according to <a class=\"css-yywogo\" href=\"https:\/\/www.kff.org\/medicaid\/poll-finding\/public-opinion-on-the-future-of-medicaid-kff-medicaid-unwinding-kff-health-tracking-poll\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">a survey<\/a> conducted last year by KFF, a nonprofit health policy research group.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-4\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The program\u2019s influence has led to unusual political alliances. President Trump appeared to sense the political risks in cutting the program, saying last week that <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2025\/02\/19\/upshot\/trump-medicaid-tax-cuts.html\" title=\"\">he would not touch Medicaid<\/a>. He later endorsed the House budget that Speaker Mike Johnson negotiated, which called for $880 billion in cuts to programs overseen by the House Energy and Commerce Committee, such as Medicaid.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-5\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Senator Josh Hawley, a Missouri Republican, <a class=\"css-yywogo\" href=\"https:\/\/www.huffpost.com\/entry\/medicaid-cuts-josh-hawley_n_67b53047e4b04083cc99456a\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">told HuffPost<\/a> last week that he had filed an amendment to a Senate budget resolution prohibiting cuts from Medicaid. After his state expanded the program in 2021, <a class=\"css-yywogo\" href=\"https:\/\/dss.mo.gov\/mis\/clcounter\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">more than 300,000<\/a> low-income residents joined the rolls.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Representative Jim Jordan, an Ohio Republican, <a class=\"css-yywogo\" href=\"https:\/\/x.com\/FoxNewsSunday\/status\/1893690058672066916\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">said on Sunday<\/a> that lawmakers may focus on imposing a national work requirement on Medicaid, a <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2024\/09\/14\/us\/politics\/georgia-trump-medicaid.html\" title=\"\">controversial proposal<\/a> that would amount to only a fraction of the cuts congressional Republicans are seeking. Ohio <a class=\"css-yywogo\" href=\"https:\/\/www.cleveland.com\/open\/2024\/12\/ohio-again-asks-feds-this-time-under-trump-to-impose-medicaid-work-requirements.html\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">recently asked<\/a> the Trump administration for permission to test out the policy.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Jon Tester, the former Democratic senator from Montana, said that Medicaid cuts could have a more sweeping effect on rural America than urban areas because of how the program sustains impoverished areas with few health providers. \u201cAnd that\u2019s an interesting conundrum because most of rural America is a much deeper red than urban America,\u201d he said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cIf you take away health care, you can\u2019t live there,\u201d Mr. Tester said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Republicans are also considering limiting how much the federal government spends on a state\u2019s Medicaid program, a practice known as block granting or per capita caps. That strategy could save as much as $900 billion over a decade.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-6\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">If states picked up the costs from the federal government and kept their expansion populations in place, they would spend more than $600 billion to do so over a decade, an increase of almost 20 percent, <a class=\"css-yywogo\" href=\"https:\/\/www.kff.org\/medicaid\/issue-brief\/eliminating-the-medicaid-expansion-federal-match-rate-state-by-state-estimates\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">according to KFF<\/a>. Many states would be short more than $10 billion over a decade, and some larger states, such as New York and California, would face a shortfall of more than $50 billion.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">With Montana\u2019s expansion program set to expire in June, a group of state lawmakers there <a class=\"css-yywogo\" href=\"https:\/\/www.ktvh.com\/news\/medicaid-expansion-renewal-passes-key-vote-in-montana-senate\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">advanced legislation<\/a> last week that would extend the program, in part to keep health providers in the heavily rural state solvent. Roughly 80,000 people in the state now have coverage through the state\u2019s expansion, drastically lowering the state\u2019s uninsured rate.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-7\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Health policy experts say that the state is effectively a test case that could motivate other Republican-led states to reverse their own programs.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">But like in other states, Montana\u2019s Medicaid expansion has been preserved in part because of strong Republican support in the state Legislature. One Republican state senator in favor of Medicaid expansion, Russ Tempel, said that it had increased behavioral health services in the state and was keeping the few hospitals in his rural district afloat.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div data-testid=\"companionColumn-8\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Matt Regier, the Republican president of the Montana Senate, said that hospitals in the state had become too reliant on Medicaid, and that its expansion was \u201cincentivizing people to not stand on their own two feet.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThat\u2019s the opposite of what a government safety net should be,\u201d he said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In Illinois, another state with a trigger law, roughly a quarter of the state\u2019s Medicaid program is part of the expansion population, and the state\u2019s uninsured rate dropped by 44 percent after the expansion took effect, said Alex Gough, a spokesman for Gov. JB Pritzker, a Democrat. The state receives more than $7 billion for that group, Mr. Gough added.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThreats to coverage would spell catastrophe,\u201d he said. He added that eliminating the Medicaid expansion \u201cwould cause major disruption to the state\u2019s health care infrastructure that relies on Medicaid funding and, ultimately, its economy.\u201d<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Democratic legislators in Virginia are trying to protect Medicaid by getting rid of the trigger provision. State officials are also girding for a new wave of enrollment from laid-off federal workers.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI\u2019m not confident Virginia would be able to provide full coverage\u201d with drastically lower federal funding, said Ghazala Hashmi, a Democratic state senator who has proposed a new committee to study the issue. \u201cThat is not a burden a state budget could bear.\u201d<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-6606220950177433\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<!-- ItShrt World News -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-6606220950177433\"\r\n     data-ad-slot=\"1882483372\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\r\n<br \/>\n<br \/><a href=\"https:\/\/www.nytimes.com\/2025\/02\/25\/us\/politics\/medicaid-cuts-republican-budget.html\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>House Republicans hunting for ways to pay for President Trump\u2019s tax cuts have called for cutting the federal government\u2019s share<\/p>\n","protected":false},"author":1,"featured_media":8711,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[36],"tags":[884,138,101,908,959,132,657,111],"class_list":["post-8710","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-2","tag-federal-budget-us","tag-health-insurance-and-managed-care","tag-law-and-legislation","tag-medicaid","tag-poverty","tag-presidential-election-of-2024","tag-state-legislatures","tag-united-states-politics-and-government"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>As G.O.P. Eyes Medicaid Cuts, States Could be Left With Vast Shortfalls - World News<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/site.itshrt.com\/worldnews\/as-g-o-p-eyes-medicaid-cuts-states-could-be-left-with-vast-shortfalls\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"As G.O.P. 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