BY PETER SULLIVAN - 02/10/20
04:02 PM EST 753
President Trump’s proposed
budget includes about $1 trillion in cuts to Medicaid and the Affordable Care
Act over a decade, analysts said.
The
budget released Monday includes $844 billion over 10 years in cuts from the
“President’s health reform vision,” a stand-in for the repeal and replacement
of ObamaCare. There are also more than $150 billion in additional cuts from
implementing Medicaid work requirements and other changes to the program, which
would result in some people losing coverage if they did not meet the
requirements.
The
cuts drew swift condemnation from Democrats, who pointed out that Trump himself
promised not to cut Medicaid, the health insurance program for the poor, during
his 2016 campaign.
“I’m
not going to cut Medicare or Medicaid,” Trump said in
2015, adding, “Every other Republican is going to cut it.”
“Americans’
quality, affordable health care will never be safe with President Trump,”
Speaker Nancy Pelosi (D-Calif.)
said in a statement on the budget proposal.
A senior
administration official defended the Medicaid cuts, arguing reforms will help
preserve the program for people who need it most. “The Budget protects and
preserves Medicaid by putting it on a sustainable path, so it can continue to
provide vital services to those who need it the most, including children, the
disabled, elderly and pregnant women,” the official said.
In
contrast to previous years, the budget does not spell out how Trump proposes to
repeal and replace ObamaCare. Instead, the budget gives a savings number of
$844 billion that could come from any number of possible changes to Medicaid or
the health law’s exchanges and subsidies.
One
policy that is specified is that the budget calls for ending the additional
federal funding that helped states expand Medicaid to cover more people under
the Affordable Care Act, with officials arguing states can step up their
spending if they want to expand the program.
Elsewhere
in the budget tables, the document puts total Medicaid cuts at about $920
billion over 10 years.
In
terms of practical impact, presidential budgets are often dead on arrival in
Congress, and there is no chance these health care changes will pass while
Democrats control the House.
“President
Trump's budget is not going to be passed this year,” Larry Levitt, a health
policy expert at the Kaiser Family Foundation tweeted. “But, it signals that he
would look to dramatically scale back the Affordable Care Act and Medicaid if
he's reelected and Republicans control Congress.”
The
budget also calls for about $600 billion in savings from Medicare, according to
Marc Goldwein, senior vice president at the Committee for a Responsible Federal
Budget.
Despite
Democratic attacks on Trump on Monday for cutting Medicare, most of those
savings come from cuts to Medicare payments to doctors and hospitals that would
actually lead to reduced costs for seniors, Goldwein said. Administration
officials stressed there are no cuts to Medicare benefits.
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