One of the big Republican talking points in favor of their very unpopular Trumpcare bill is that it doesn’t really cut Medicaid. How can they deny something that is made very clear in the Congressional Budget Office report on the bill? If you get into the details, they’re splitting hairs over the meaning of the word “cut,” but mostly they’re just denying reality.
Asked over the weekend about the prospect of Medicaid cuts, Kellyanne Conway, counselor to President Trump, said on ABC that Republicans were not in fact cutting funding for the government-run insurance program for the poor. “We don’t see them as cuts,” she said. Rather, Republicans want to slow the growth of Medicaid spending to preserve it.
Senator Pat Toomey, Republican of Pennsylvania, also resisted the notion that the Senate bill would cripple Medicaid. He argued on CBS that it would “codify and make permanent the Medicaid expansion” that was put in place by the Affordable Care Act.
Cuts or not cuts? The CBO says that Trumpcare would reduce Medicaid spending by $772 billion by 2026. That’s a reduction from spending levels projected under the current law, and millions fewer people covered by the program. According to Republicans, though, it would only count as a “cut” if that $772 billion was subtracted from the current spending right now. Somehow reducing the amount of funding the law provides for next year and the year after that doesn’t count, to Republicans. Or rather, they don’t want it to count in voters’ eyes. Try to apply that logic to defense spending, though, and see how fast they label it a cut.
Specifically, the Senate bill phases out Medicaid expansion and caps spending on each person in the program, which means pushing people out of the program and limiting the care available to those who remain. It does that while calculating lower payment growth rates than Medicaid has historically experienced. That sounds like a cut. It sounds like a cut to the nursing homes and hospitals that would close as a result, too.
And it’s sure going to feel like a cut to the millions of people who lose coverage. Republicans want to talk semantics, but this is about people’s lives.