Congressional Republicans’ Budget Plans Are Likely to Cut Health Coverage
End Notes
[1] Peggy Bailey et al., “Health Proposals in the President’s Budget Would Reduce Health Insurance Coverage and Access to Care,” CBPP, February 16, 2018, https://www.cbpp.org/research/health/health-proposals-in-presidents-budget-would-reduce-health-insurance-coverage-and.
[2] Republican Study Committee, “Blueprint to Save America: Fiscal Year 2023 Budget,” https://banks.house.gov/uploadedfiles/rsc_2023_budget_final_version.pdf.
[3] Center for Renewing America, “A Commitment to End Woke and Weaponized Government: 2023 Budget Proposals,” December 7, 2022, https://americarenewing.com/wp-content/uploads/2021/04/Budget-Center-for-Renewing-America-FY23.pdf.
[4] Mike Lillis, “Democrats vow fierce fight if GOP cuts Medicaid,” The Hill, March 5, 2023, https://thehill.com/homenews/house/3882349-democrats-vow-fierce-fight-if-gop-cuts-medicaid/.
[5] Centers for Medicare & Medicaid Services (CMS), “November 2022 Medicaid & CHIP Enrollment Data Highlights,” https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/downloads/november-2022-medicaid-chip-enrollment-trend-snapshot.pdf.
[6] Edwin Park, “Center for Renewing America Budget Plan Would Cut Federal Medicaid Spending By One-Third, Repeal Affordable Care Act’s Coverage Expansions,” Georgetown Center for Children and Families (CCF), February, 27, 2023, https://ccf.georgetown.edu/2023/02/27/center-for-renewing-america-budget-plan-would-cut-federal-medicaid-spending-by-one-third-repeal-affordable-care-acts-coverage-expansions/; Edwin Park, “House Republican Study Committee Budget Plan Includes Draconian Medicaid Cuts,” CCF, January 31, 2023, https://ccf.georgetown.edu/2023/01/31/house-republican-study-committee-budget-plan-includes-draconian-medicaid-cuts/.
[7] Center for Renewing America, op. cit.
[8] Lillis, op. cit.
[9] Inna Rubin, Jesse Cross-Call, and Gideon Lukens, “Medicaid Expansion: Frequently Asked Questions,” CBPP, June 16, 2021, https://www.cbpp.org/research/health/medicaid-expansion-frequently-asked-questions.
[10] CMS, Quarterly Medicaid Enrollment Data – New Adult Group, January – March 2022 Medicaid MBES Enrollment, https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-enrollment-data-collected-through-mbes/index.html.
[11] MaryBeth Musumeci and Kendal Orgera, “People with Disabilities Are at Risk of Losing Medicaid Coverage Without the ACA Expansion,” KFF, November 2, 2020, https://www.kff.org/medicaid/issue-brief/people-with-disabilities-are-at-risk-of-losing-medicaid-coverage-without-the-aca-expansion/.
[12] Madeline Guth, Rachel Garfield, and Robin Rudowitz, “The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020,” KFF, March 17, 2020, https://www.kff.org/medicaid/report/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review/; Madeline Guth and Meghana Ammula, “Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021,” KFF, May 6, 2021, https://www.kff.org/medicaid/report/building-on-the-evidence-base-studies-on-the-effects-of-medicaid-expansion-february-2020-to-march-2021/.
[13] Meghana Ammula and Madeline Guth, “What Does the Recent Literature Say about Medicaid Expansion? : Economic Impacts on Providers,” KFF, January 18, 2023, https://www.kff.org/medicaid/issue-brief/what-does-the-recent-literature-say-about-medicaid-expansion-economic-impacts-on-providers/.
[14] These matching rates do not reflect higher matching rates made available through the Families First Coronavirus Response Act, as amended by the Consolidated Appropriations Act, 2023.
[15] CBO, “Reduce Federal Medicaid Matching Rates,” Options for Reducing the Deficit, 2023-2032 – Volume I: Larger Reductions, December 7, 2022, https://www.cbo.gov/budget-options/58624.
[16] Julie L. Judson and Asako S. Moriya, “Medicaid Expansion for Adults Had Measurable ‘Welcome Mat’ Effects on their Children,” Health Affairs 36, No. 9 (2017), 1643-1651, https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2017.0347.
[17] Lindsey McPherson, “Freedom Caucus lays out debt limit, spending demands,” CQ News, March 10, 2023, https://plus.cq.com/doc/news-7684210?0&utm_medium=newsletter&utm_source=hbmorning; Emily Brooks, “Freedom Caucus lays out spending cut demands for debt limit,” The Hill, March 10, 2023, https://thehill.com/business/budget/3893956-freedom-caucus-lays-out-spending-cut-demands-for-debt-limit/.
[18] Memo from the Republican Study Committee (RSC) Policy Team to RSC Member Offices Re: Debt Limit Policy Memo, March 7, 2023, https://hern.house.gov/uploadedfiles/hern_rsc_debt_limit_memo_03082023.pdf.
[19] Lillis, op. cit.; Joseph Zeballos-Roig, “Matt Gaetz has a big demand for the debt ceiling fight,” Semafor, February 3, 2023, https://www.semafor.com/article/02/03/2023/matt-gaetz-debt-ceiling-fight. See also Arkansas Department of Human Services, “Governor Sarah Huckabee Sanders Directs DHS to Add Work Requirement to Medicaid Program,” February 15, 2023, https://humanservices.arkansas.gov/news/governor-sarah-huckabee-sanders-directs-dhs-to-add-work-requirement-to-medicaid-program/.
[20] LaDonna Pavetti et al., “Expanding Work Requirements Would Make it Harder for People to Meet Basic Needs: Would Do Little to Improve Long-Term Work Opportunities and Outcomes,” CBPP, March 15, 2023, https://www.cbpp.org/research/poverty-and-inequality/expanding-work-requirements-would-make-it-harder-for-people-to-meet.
[21] Rachel Garfield et al., “Work Requirements Among Medicaid Adults: Implications of Economic Downturn and Work Requirements,” Kaiser Family Foundation (KFF), February 11, 2021, https://www.kff.org/report-section/work-among-medicaid-adults-implications-of-economic-downturn-and-work-requirements-issue-brief/; Kristin F. Butcher and Diane Whitmore Schanzenbach, “Most Workers in Low-Wage Labor Market Work Substantial Hours, in Volatile Jobs,” CBPP, July 24, 2018, https://www.cbpp.org/research/poverty-and-inequality/most-workers-in-low-wage-labor-market-work-substantial-hours-in.
[22] Jennifer Wagner and Jessica Schubel, “States’ Experiences Confirm Harmful Effects of Medicaid Requirements,” CBPP, updated November 18, 2020, https://www.cbpp.org/research/health/states-experiences-confirm-harmful-effects-of-medicaid-work-requirements.
[23] Benjamin Sommers et al., “Medicaid Work Requirements – Results from the First Year in Arkansas,” New England Journal of Medicine, September 2019, Vol. 318, No. 11, https://www.nejm.org/doi/full/10.1056/NEJMsr1901772.
[24] Jennifer Wagner, Farah Erzouki, and Jennifer Sullivan, “States Can Reduce Medicaid’s Administrative Burdens to Advance Health and Racial Equity,” CBPP, July 19, 2022, https://www.cbpp.org/research/health/states-can-reduce-medicaids-administrative-burdens-to-advance-health-and-racial.
[25] Republican Study Committee, op. cit.
[26] Peter Sullivan, “Debt ceiling fight looms over Medicare, Medicaid,” Axios, January 13, 2023, https://www.axios.com/2023/01/13/debt-ceiling-fight-medicare-medicaid.
[27] In addition to capped funding proposals, both the Republican Study Committee and the Center for Renewing America budget also propose harmful reductions to the FMAP that also undermine the federal government’s support for Medicaid. The Republican Study Committee plan would cut the matching rate to 50 percent for all states; the Center for Renewing America budget would significantly reduce the federal Medicaid matching rate for a segment of states by eliminating the so-called “FMAP floor,” which ensures that no state’s FMAP drops below 50 percent.
[28] CBPP, “Medicaid Per Capita Cap Would Shift Costs to States,” updated February 7, 2023, https://www.cbpp.org/research/health/medicaid-per-capita-cap-would-shift-costs-to-states.
[29] Edwin Park, “Medicaid Per Capita Cap Would Shift Costs and Risks to States and Harm Millions of Beneficiaries,” CBPP, revised February 27, 2017, https://www.cbpp.org/research/health/medicaid-per-capita-cap-would-shift-costs-and-risks-to-states-and-harm-millions-of.
[30] Edwin Park, “Medicaid Block Grant Would Slash Federal Funding, Shift Costs to States, and Leave Millions More Uninsured,” CBPP, November 30, 2016, https://www.cbpp.org/research/health/medicaid-block-grant-would-slash-federal-funding-shift-costs-to-states-and-leave.
[31] KFF, “Medicaid Enrollees by Enrollment Group: 2019,” https://www.kff.org/medicaid/state-indicator/distribution-of-medicaid-enrollees-by-enrollment-group/?dataView=1¤tTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
[32] KFF, “Medicaid Spending by Enrollment Group: 2019,” https://www.kff.org/medicaid/state-indicator/medicaid-spending-by-enrollment-group/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
[33] Edwin Park, “Limiting State Provider Taxes Would Shift Costs to States and Weaken Medicaid,” CBPP, updated March 16, 2016, https://www.cbpp.org/research/health/limiting-state-provider-taxes-would-shift-costs-to-states-and-weaken-medicaid.
[34] Republican Study Committee, op. cit.
[35] Center for Renewing America, op. cit.
[36] CMS, “Health Care-Related Taxes and Hold Harmless Arrangements Involving the Redistribution of Medicaid Payments,” February 17, 2023, https://www.medicaid.gov/federal-policy-guidance/downloads/cib021723.pdf.
[37] Medicaid and CHIP Payment and Access Commission, “Health Care-Related Taxes in Medicaid,” May 2021, https://www.macpac.gov/wp-content/uploads/2020/01/Health-Care-Related-Taxes-in-Medicaid.pdf; KFF, “States With At Least One Provider Tax in Place: SFY 2004 - SFY 2022,” https://www.kff.org/medicaid/state-indicator/states-with-at-least-one-provider-tax-in-place/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
[38] Center for Renewing America, op. cit.
[39] House Budget Committee Republicans, “The Debt Limit and Fiscal Restraint” [Press release], February 8, 2023, https://mailchi.mp/budgetgop.housecommunications.gov/chairman-arrington-announces-budget-committee-roster-461535?e=62a56cb896.
[40] KFF, “Health Insurance Marketplace Calculator,” https://www.kff.org/interactive/subsidy-calculator/#state=&zip=&income-type=dollars&income=120000&people=4&alternate-plan-family=&adult-count=2&adults%5B0%5D%5Bage%5D=40&adults%5B0%5D%5Btobacco%5D=0&adults%5B1%5D%5Bage%5D=40&adults%5B1%5D%5Btobacco%5D=0&child-count=2&children%5B0%5D%5Bage%5D=10&children%5B0%5D%5Btobacco%5D=0&children%5B1%5D%5Bage%5D=5&children%5B1%5D%5Btobacco%5D=0.