Republicans taking away healthcare from “poor” People to fund tax breaks for the 1% which would come with billionaires (as if Musk and others are struggling). I imagine it’s time to put a few of them again within the Labor Power.
Republicans have determined which 21 million People ought to lose their healthcare,
– Charles Gaba
As common readers know, I’ve been a bit obsessed over the previous month or so with producing pie charts which escape the whole healthcare program enrollment for the whole inhabitants of all 435 U.S. Congressional Districts in addition to all 50 states +DC.
As you’ll be able to think about, this has been a monumental activity; not solely did I’ve to crunch plenty of knowledge to interrupt out the statewide numbers into Home district-level estimates, I additionally needed to convert that knowledge into practically 480 easy-to-read graphics . . . after which I doubled my workload by going one step additional and including high-res PDF variations for people to print out in giant format for city halls, rallies and #HandsOff protests nationally. (Click on on the picture to enlarge.)
Now that I’ve lastly accomplished this undertaking, it’s time to show again to the principle purpose for it within the first place: The upcoming risk to healthcare protection for actually tens of hundreds of thousands of People being posed by the funds decision just lately handed by Home Republicans, which (happily) nonetheless has a variety of factors the place it may well doubtlessly be stopped.
The funds decision requires a draconian $880 BILLION to be slashed from the Home Power & Commerce Committee’s jurisdiction over the following decade. Whereas Congressional Republicans are fast to level out that technically the phrase “Medicaid” isn’t included within the decision itself, basic math makes it clear that there’s completely no method to obtain that kind of federal spending discount with out completely gutting Medicaid a technique or one other.
The CBO letter confirms early expectations, discovering that over the following 10 years, 93% of non-Medicare spending within the E&C jurisdiction is from the federal share of Medicaid spending: $8.2 trillion out of a complete $8.9 trillion. An extra $200 billion of federal spending comes from the Kids’s Well being Insurance coverage Program (CHIP). Among the committee’s remaining spending is budget-neutral, and subsequently, received’t depend in the direction of deficit discount. Even when E&C eradicated all non-Medicaid and CHIP spending, the committee would want to chop federal spending on Medicaid and CHIP by effectively over $700 billion, practically 10% of projected spending; and most agree that E&C is unlikely to get rid of all different sources of non-mandatory spending.
OK, so they’re certainly going after Medicaid…however how a lot of it and what number of would lose protection?
Nicely, again in January, Politico acquired ahold of a “wish list” of potential methods Home Republicans have been tossing round to intestine Medicaid and kick hundreds of thousands of individuals off of their healthcare protection. I wrote up a breakout of those (whereas additionally relying closely on an explainer by Edwin Park of Georgetown College):
- “REPEAL MAJOR BIDEN HEALTH RULES” ($420B): The Biden Administration put guidelines into place to cut back paperwork and streamline the method for eligible seniors & disabled people to enroll in Medicaid/CHIP. Home Republicans are proposing to make it tougher for folks to take action.
- “Per Capita Caps” ($918B): Beneath the present federal-state monetary partnership, the federal authorities pays a set proportion of states’ Medicaid prices, no matter these prices are. [Under a per capita cap] …states would obtain solely a set quantity of federal Medicaid funding on a per-beneficiary foundation, regardless of states’ precise prices.
- “Equalize Medicaid Payments for Able Bodied Adults” – as much as $690B: For non-ACA Medicaid, the federal authorities pays between 50 – 83% of the fee relying on the state/territory (this is called the Federal Medical Help Proportion, or FMAP). For the ~21 million folks enrolled in Medicaid through the ACA, the federal gov’t picks up 90% of the fee. Home Republicans are proposing to drop that 90% to the identical 50 – 83% charges as for non-ACA Medicaid, which averages simply 57% nationally.
- Restrict Supplier Taxes – $175B: By making it tougher for states to fund their share of Medicaid, it could drive them to chop these applications completely, which in flip would imply much less federal spending on the applications. It’s like telling your child you’ll pay for half their faculty tuition however then forbidding them to get a part-time job to cowl their half.
- Decrease FMAP Flooring – $387B: Once more, proper now the federal authorities pays anyplace between 50 – 90% of Medicaid bills relying on the state and program. Home Republicans are proposing to cut back the decrease threshold from 50% to…one thing lower than 50%. This may be devastating to the ten states which at present have a 50% FMAP charge…9 of that are blue, I ought to be aware (CA, CO, CT, MD, MA, NH, NJ, NY & WA).
- Particular FMAP Remedy for DC – $8B: Beneath the usual FMAP formulation, the District of Columbia could be set at a 50% federal matching charge, down from its present 70% (I’m a bit of unclear as to why it’s 20 factors increased than it “should” be beneath the usual formulation, and Park’s clarification doesn’t lend a lot perception).
- Repeal American Rescue Plan FMAP Incentive – $18B: As I wrote about on the time, the ARPA regulation included one provision particularly supposed to encourage the holdout states into lastly increasing Medicaid by merely bribing them to take action with a beneficiant 2-year FMAP enhance for doing so. This was a essential think about North Carolina’s resolution to broaden Medicaid to over 600,000 low-income residents.
- Work (Reporting) Necessities – $120B: (Sigh) Work reporting necessities have been an obsession of Republicans for many years. I’ve written about how absurdly (and intentionally) inefficient and pointless they’re numerous instances.
There have been a number of different healthcare-related bullets as effectively which largely give attention to the ACA’s particular person market change plan subsidies. I’ll be writing about these individually quickly, however for the second I’m sticking with Medicaid.
As you’ll be able to think about, there’s been a loud and rising backlash in opposition to Congressional Republicans in response to their proposed gutting of Medicaid & different essential applications…a backlash which my very own pie chart undertaking has been part of, I’m proud to say.
/https://static.texastribune.org/media/files/b91e8e4112324f5849d3597e325926f2/0409%20Texas%20Wastewater%20ICN%20DB%2003.JPG?w=150&resize=150,150&ssl=1 "In booming Central Texas, wastewater is polluting rivers and streams")
