WASHINGTON (CN) — The House passed a resolution late Thursday condemning the Trump administration’s plans to allow states to place restrictions on Medicaid benefits and bite into Obama-era expansions of the program.
The resolution, which passed the House 223-190, comes in response to plans announced by the White House last week to expand the ability for states to cut Medicaid spending by turning part of that funding into block grants – a widely applicable type of federal funding. Cuts aimed at the Obama-era Medicaid expansion will allow states to impose conditions on the benefits, such as work or cost-sharing requirements.
Critics argue block grants, or the “Healthy Adult Opportunity” program could incentivize states into reducing coverage for low-income Americans. Congress already has balked at the idea of including these types of grants, most recently when the Trump administration floated the Health Care Act of 2017 as a replacement to Obama’s Affordable Care Act.
That bill, memorably pulled from the House floor hours before an expected vote, would clear that hurdle months later before eventually being tripped up in the Senate. Along with the entire Democratic caucus, 20 Republicans joined in voting against the bill.
In addition to cost-sharing and proof of employment requirements for Medicaid recipients, the Trump administration’s changes include cuts to payments fronted by providers and plans that opt for off-brand drugs.
The proposed cuts pitched by the Centers for Medicare and Medicaid Services—the federal agency which administers the Medicaid and Medicare programs—could reduce total spending on the Medicare program by $37 billion to $49 billion a year. Federal payments to hospitals could be slashed by nearly 17%.
Trump hinted in an interview with CNBC last week that looking at cutting entitlements would “at some point,” be a point of policy focus for the administration. The president touted American economic growth as reason to look at reducing waste in the program.
“We’re going to have tremendous growth. This next year it’ll be toward the end of the year. The growth is going to be incredible,” Trump said. “And at the right time, we will take a look at that. You know, that’s actually the easiest of all things, if you look, cause it’s such a big percentage.”
The Trump administration has not finalized any of these proposed changes, with some 4,000 public comments on the changes to review and consider. The administration has not set a deadline for making a decision.
The resolution passed Thursday lists failures of the administration’s health initiatives, noting that over the past three years of Trump’s presidency the number of uninsured children in the country has increased. More than a million children have lost coverage during the administration’s tenure, the resolution states, as have over 750,000 adults. Expansion of Medicaid has helped to save at least 19,000 lives since 2014 and is the largest payer of behavioral services in the country, according to the resolution.
While the resolution does not offer remedies for these cuts, it does call on the Trump administration to “immediately withdraw its illegal block grant guidance and cease its campaign to undermine and weekend Medicaid.” The resolution also charges the administration with upholding its “responsibility to faithfully execute the law, including the Medicaid Act, and cease any and all efforts that threaten the care of the millions of Americans who rely on Medicaid.”
In an interview, Representative Gerry Connolly, D-Va., said it remains to be seen whether the resolution will result in any concrete action against the Trump administration’s proposed cuts. But he said his experience in local government has taught him block grants have real problems.
Almost inevitably, the executive branch uses block grant funding to lower the amount of money offered for Medicaid coverage, Connolly said—a problem for local governments particularly. When those funds are sent to states, patients with express needs for the money are often excluded.
“Some state capitols, as you know, are still fighting the rural versus urban battle. Well, in urban areas that are heavily, densely populated, we have more people who qualify for these kind of things than rural areas,” Connolly said. “And so, we don’t want to see formulas out of the state discriminating against people like us. And that, I can tell you in many states, is a huge problem.”
He continued: “We get nervous about block granting. It’s easier for the feds to administer, but the benefits go down, total amount of money goes down and often the communities that are actually in the most need get discriminated against by state formula.”
Representative Al Green, D-Texas, said he wasn’t a fan of block grants and thinks it’s an unfair way to address health care issues. While the Affordable Care Act had its own issues, Green said he felt it was important to use the system within that good legislation.
The problem with Republican plans is the lack of that legislation, Green said, referring to the Republican push to remove Obamacare provisions without a replacement. The truth is, Republicans couldn’t agree on a plan, Green said.
“They have this secret plan that they’ve been talking about for years. They would convince people to eviscerate the Affordable Care Act without producing a plan that would replace it,” Green said. “Why would you eliminate something without having something to replace it? They have not given any real plan for replacement and as a result, I don’t take them seriously when they say, ‘We’re going to do something.’”