Medicaid Cuts: What’s on the Table and What It Means for You
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What are the potential impacts of Medicaid cuts being debated?
Hi, What's News listeners. It's Sunday, March 23rd. I'm Luke Vargas for The Wall Street Journal, and this is What's News Sunday, the show where we tackle the big questions about the biggest stories in the news by reaching out to our colleagues across the newsroom to help explain what's happening in our world. The Affordable Care Act was signed into law 15 years ago today, a bill that kicked off a sweeping overhaul of U.S. health care, expanding coverage to more than 30 million Americans via its Medicaid expansion. And after surviving three legal challenges at the Supreme Court, it's become firmly entrenched in the American healthcare system. But with big Medicaid cuts being debated on Capitol Hill, could the U.S. healthcare landscape be in for a shock? Let's get right to it. The federal government spends about $600 billion annually on Medicaid.
States help fund and manage the program, which provides health insurance for roughly 72 million people, or about one in five Americans, including children and people with low incomes or disabilities. And as you might have heard, some big changes to the program have been tossed around on Capitol Hill lately. as congressional Republicans work to deliver a budget and tax cut bill in the coming months. We have got two excellent guests with us today to analyze the effects that those moves could have. But first, I want to play some comments from journal reporter Liz Esley White, who's been keeping a close eye on the range of proposals we've been hearing about in Washington. Here's Liz.
Medicaid work requirements are probably the most popular on the Republican side of the aisle. So this would say that most likely able-bodied Medicaid recipients without small children need to be working or seeking work or volunteering in order to be eligible for Medicaid. There's a number of other things they could do.
What are the proposed changes to Medicaid work requirements?
For example, cap the amount that the federal government gives per person to states. They could lower their contributions to richer states such as California and New York that already have a lot of state funding for Medicaid and theoretically could afford to get a lower federal contribution. They could get rid of a lot of the funding for Medicaid expansion. When Medicaid expanded under the Affordable Care Act, it came with it this promise that if your state signed up for expansion, the federal government was going to pay 90 percent for all those newly eligible people. One proposal is that the federal contribution for those people would drop. And if that happens, there are a number of states that just can't afford to keep going with the expansion and they'll likely get rid of it or cut it back severely.
So let's go through some of these potential changes we could see. Journal reporter Ana Wildey-Matthews covers health insurance. And also with us is Larry Levitt, the executive vice president for health policy at the nonprofit health policy research and polling organization KFF. Larry, let me start with you. You've been at KFF for 28 years, watching all of this in Capitol Hill and so much else. Starting with work requirements, a proposal that maybe seems to be on the more feasible end of the spectrum in D.C. right now. How many people could those changes affect?
Work requirements are an idea that has broad consensus, at least among Republicans, not among Democrats. It sort of gets to this fundamental disagreement over what Medicaid is. Is Medicaid a welfare program for the deserving poor and therefore people should have to work in order to qualify for health insurance? Or is it a kind of stepping stone to universal health insurance? And that's really the view of Democrats. The reality is the vast majority of Medicaid enrollees, other than those who are disabled or seniors, are already working or they're caring for small kids or they're too sick to work. But this is a very popular idea among Republicans to require work, and it could save a substantial amount of money.
Ana, do you have anything to say on work requirements?
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Chapters
5 chapters
1
What are the potential impacts of Medicaid cuts being debated?
0:01–1:50
2
What are the proposed changes to Medicaid work requirements?
1:50–4:52
3
How could changes to federal funding affect Medicaid?
4:52–7:14
4
What are the state-level implications of federal Medicaid funding cuts?
7:14–9:07
5
How might individuals be affected by changes to Medicaid?
9:07–12:35
Speakers
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