GOP Considers Medicaid Overhaul in Upcoming Reconciliation Bill

GOP Considers Medicaid Overhaul in Upcoming Reconciliation Bill

November 20, 2024 Catherine Williams - Chief Editor Health

Hello, Wednesday!

We examine how a Medicaid overhaul could be a key part of next year’s reconciliation bill.

Event Alert: Join Victoria and Axios’ Maya Goldman tomorrow at 8 AM ET in D.C. for an event on supporting family caregivers. It features Rep. Kat Cammack and Maura Calsyn from the Administration for Community Living. RSVP here.

1 Big Thing: GOP Weighs Medicaid Overhaul

Congressional Republicans are discussing a Medicaid overhaul as part of a reconciliation bill.

Why It Matters: Changes could alter the safety net program that serves over 70 million people. While it may save money, it could also lead to significant coverage losses.

Driving the News: Imposing work requirements on Medicaid recipients is a likely change. This idea was discussed during last year’s debt ceiling talks.

  • House Majority Leader Steve Scalise indicated that work requirements may be included in next year’s reconciliation bill.
  • Scalise mentioned that there are ongoing discussions about what will be included in the bill.

Yes, But: The extent of health policy in the reconciliation bill is unclear. The primary focus remains on extending the 2017 Trump tax cuts.

  • Recent enthusiasm for controversial health policy changes among Republicans has waned, as their focus shifts to taxes, energy, and immigration.
  • However, Medicaid could help generate savings for tax cuts, given its significant budget of over $800 billion annually.
  • Previous estimates suggest work requirements could save over $100 billion over ten years, but this may also result in 600,000 people losing insurance.

What They’re Saying: Rep. Brett Guthrie proposes reviving a Medicaid per capita cap idea from the 2017 Affordable Care Act repeal bill.

  • He stated that such reforms should be included in next year’s discussions.

Between the Lines: Another potential change is reducing the federal share of spending for the Medicaid expansion population to match the lower rate for the traditional Medicaid population.

  • Critics argue that it is unfair for the federal policy to favor able-bodied enrollees over disabled individuals, children, and pregnant women.
  • This move could cause cash-strapped states to drop Medicaid expansion, impacting 40 states.

The Big Picture: The Trump administration approved Medicaid waivers for work requirements, but many were struck down in court.

  • Republicans may hesitate due to potential political backlash from changing the entitlement program.

Rep. Morgan Griffith noted that discussions around work requirements often cause concern, but exemptions for disadvantaged groups are possible.

  • He added that there have been informal talks about Medicaid changes.

The Bottom Line: Adjusting federal spending without impacting people who rely on Medicaid is challenging.