House GOP Makes Official Its Plan For Devastating Cuts To Medicaid

In announcing their intentions to move forward with a mammoth one bill budget plan that will supposedly sweep up key elements of Donald Trump’s fiscal agenda, enact tax cuts and raise the debt ceiling, House Republicans have placed themselves on a collision course with not just members of their own conference but also Senate Republicans.

But one thing is clear now that has been clear for months: Medicaid, the program that covers health care costs for low-income Americans, is, by design, the main target of the House GOP’s federal spending cuts proposal.

Here’s a breakdown of the key elements of the budget blueprint, which the House Budget Committee released the text of Wednesday:

House Republicans want to enact $4.5 trillion worth of tax cuts over the course of the next decade, some of that will include extending Trump’s 2017 tax cuts that provided the most benefits to wealthy Americans.

They propose $2 trillion in federal spending cuts.

Those spending cuts would offset the cost of the tax cuts, but only partially, meaning the entire proposal would actually end up adding trillions to the national deficit, roughly $3 trillion over 10 years, by the New York Times’ calculation.

That coupled with plans to raise the debt limit by $4 trillion has fiscal hawks in the House howling, Politico reported. Hardliners in the House Freedom Caucus are reportedly pressing for at least another $500 billion in spending cuts to be outlined in the proposal, plus they want to see work requirements (another GOP word for spending cuts) for Medicaid, food aid benefits and at least one other social safety net program made explicit in the resolution.

It is not entirely clear where the $2 trillion in cuts will come from, rather the House Budget Committee is proposing that various committees find enough savings to hit fixed spending reduction targets.

So while it is not explicitly stated in the House Budget Committee’s document, Medicaid and Supplemental Nutrition Assistance Programs are the programs most directly in the crosshairs. Here’s why: The document charges the House Energy and Commerce Committee with finding $880 billion in ten-year savings, more than half of the total cuts outlined in the proposal. It also directs the House Committee on Agriculture to identify another $230 billion in cuts. The Energy and Commerce Committee oversees Medicaid spending and the Ag panel has jurisdiction over SNAP and other nutritional programs.

While House Speaker Mike Johnson (R-LA) has pushed work requirement rhetoric in recent days when pressed on the nature of potential impending cuts to Medicaid and other social safety net programs, the magnitude of the spending reductions being proposed means cuts to Medicaid will have to extend far beyond Republicans simply imposing work requirements. That language has become a rhetorical catchall for Republicans for months as they sidestep engaging seriously on the political ramifications of cutting programs for low-income Americans to extend tax cuts for the wealthy.

Republicans could for example try to introduce a “per capita cap” or some other mechanism that would limit federal spending on the program going forward, effectively ending the open-ended funding commitment Washington now makes to the states. Republicans could also roll back several reforms designed to make enrollment simpler, especially for children. “Cuts of the magnitude required of the Energy and Commerce Committee leave little doubt that the Budget Resolution sets the stage for deep cuts to Medicaid,” Allison Orris, a senior fellow at the left-leaning Center on Budget and Policy Priorities, told HuffPost. “This is not a budget that protects Medicaid enrollees.”

Republicans have been rhetorically creative about shielding their interest in slashing the social safety net for years. And as TPM has reported, even before the new Congress was sworn in this year, House Republicans made it clear Medicaid was on the chopping block, even as Trump vowed to protect Social Security and Medicare at all costs.

In the new budgetary blueprint, they’re barely hiding the ball.

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