The Senate health care bill makes massive cuts to Medicaid. But you wouldn’t know that just from listening to Trump administration officials on the Sunday shows.
“These are not cuts to Medicaid, George,” Kellyanne Conway told ABC’s George Stephanopoulos.
“It just wouldn’t happen,” Health and Human Services Secretary Tom Price told CNN’s Dana Bash when asked about Republican concerns over Medicaid cuts.
“Nobody will fall through the cracks,” Price said on Fox News Sunday when asked about the Medicaid coverage gap. (Fox’s Brit Hume did not ask about Medicaid cuts specifically, focusing more on conservative criticism of the bill.)
While there’s no polling yet on the Senate bill, most Americans don’t know the House-passed bill would make significant cuts to Medicaid. Just 38 percent of respondents knew about the cuts.
Those cuts are even deeper in the Senate version, experts say, and media appearances like these make it less surprising that the public isn’t aware of the drastic changes the legislation would introduce.
The Senate bill’s main advocate and author, Sen. Mitch McConnell (R-KY), actually tried to argue that the bill will strengthen Medicaid when he introduced it last Thursday on the Senate floor. Sen. Pat Toomey (R-PA) argued on CBS’ Face the Nation that the bill would “make permanent” Medicaid expansion and also said “no one loses coverage.”
The bill would in fact massively cut Medicaid, threatening to completely phase out the program as we currently know it. The legislation would roll back Obamacare’s Medicaid expansion, starting in four short years. It would also make deeper cuts to Medicaid by placing “per capita caps” on the program such that states will receive only a set amount of money for each recipient, no matter how much their care actually costs.
Andy Slavitt, who ran Medicaid in the Obama administration, said on Twitter that “the main event in the Senate bill is the destruction of Medicaid,” characterizing it as “far, far worse than even the House bill.” And the House bill, as scored by the Congressional Budget Office, would leave 23 million more people without coverage.
But Trump administration officials presented alternative facts on Sunday.
“This bill has even more Medicaid cuts than the House bill,” said ABC’s George Stephanopoulos in an interview with White House counselor Kellyanne Conway. “Why is the president going back on his promise?”
“These are not cuts to Medicaid, George,” she replied. “It slows the rate for the future, and it allows governors more flexibility with Medicaid dollars, because they’re closest to the people in need. Medicaid’s imperative. Its founding was meant to help the poor, the sick, the needy, disabled, children, some elderly, women, particularly pregnant women. We are trying to get Medicaid back to its original mores.”
Stephanopoulos replied that $800 billion in “savings” seems like cuts and noted that some Republican senators have cited the impact on Medicaid as a reason for their concerns about the Senate bill. He asked if the president would put money back into Medicaid.
The president was prepared to negotiate with all senators, Conway said before falsely claiming there are 45 or more senators who are “yeses” on the bill, which Stephanopoulos disputed. According to The New York Times’s whip count, 17 senators have said they will support the legislation, while 28 are unclear, and the rest — all 48 Democrats and seven Republicans — are opposed.
Kelly eventually returned to Medicaid, “because I can’t just let it sit there unanswered, George.”
Conway: If you are currently in Medicaid, if you became a Medicaid recipient through the Obamacare expansion, you are grandfathered in. We’re talking about in the future. You know, Obamacare took Medicaid, which was designed to help the poor, the needy, the sick, disabled, also children and pregnant women, it went way above the poverty line and opened it up to many able-bodied Americans who should probably find other, should at least see if there are other options for them. If they’re able-bodied and they want to work then they’ll have employer-sponsored benefits like you and I do.
Stephanopoulos: Kellyanne, hold on a second. There’s no way you can say that a 15-year-old who’s on Medicaid will not be affected by the cuts in the future.
Conway: I didn’t say that.
Stephanopoulos: Well, you said everybody who’s on Medicaid now is grandfathered in and will not face cuts, and that simply is not factual if you have $800 billion in cuts.
Conway: Well you keep calling them cuts, but we don’t see them as cuts. It’s slowing the rate of growth in the future and getting Medicaid back to where it was. Obamacare expanded the pool of Medicaid recipients beyond its original intentions … When you get rid of these penalties, these taxes, when you stop the insurer from leaving and just hemorrhaging out of these exchanges …
Not only does this show a fundamental misunderstanding of how people get health insurance, but Conway says that the White House does not see the cuts they wish to make as cuts. It will be up to Republican senators to decide whether they think those cuts are too much to bear.
This is a decision with potentially critical consequences for the Trump White House as well. As a candidate, President Donald Trump said, “I’m not going to cut Social Security like every other Republican, and I’m not going to cut Medicare or Medicaid.”
Before his confirmation, meanwhile, Price refused to tell the Senate whether he supported Trump’s promise not to cut Medicaid.
CNN’s Dana Bash asked Price about Republican Nevada Governor Brian Sandoval’s criticism that the bill would cause poor people to lose Medicaid coverage.
“[T]his is a Republican governor who is concerned that your plan would erode the lives of the most vulnerable,” Bash said. “What’s your response?”
“It just wouldn’t happen,” Price responded.
He went on to say that the administration is trying to explain to Sandoval that there will be resources and waivers states can use to cover people. Bash returned to the concerns about Medicaid, citing CBO’s projection that the House bill will reduce Medicaid by $834 billion.
“It all depends what you’re comparing it to,” Price said. “The fact of the matter is the Medicaid proposal in the Senate bill goes up every single year that the plan is in place because it’s based on the consumer price index, initially based on the consumer price index that’s related to medical care across the country. And it goes up every single year. It’s important that the people appreciate that what our goal is, is to make it so folks on Medicaid, the most vulnerable in our society, those moms and kids and seniors and the disabled, that program works for them in a way that allows them to get the coverage they need in addition to those who are also in the vulnerable category—that they’re able to get the kind of coverage that they want and need for their families.”
Bash clarified that Price was saying Sandoval was wrong in his concerns about Medicaid.
“I know that’s what the divisionist [sic] news wants to do,” Prince responded.
“We would not pull the rug out from anybody,” he continued, “and we would not have individuals lose coverage that they want for themselves and for their family.”
Price did not face any direct questions about Medicaid cuts on Fox News, but he did have a revealing exchange about the coverage gap between Medicaid and the individual market.
He told Fox News Sunday guest host Brit Hume that the bill would ensure that “nobody will fall through the cracks” when it comes to the coverage gap between Medicaid and Obamacare. Instead, he said. tax credits will allow people to buy coverage. “The plan is to make it so that if individuals aren’t eligible for Medicaid, that again, there’s that seamless transition to the individual market,” Price said.
However, two changes in the bill that involve lower premium subsidies will likely make it much harder for people to purchase insurance on the individual market, as Kaiser Health News noted last week. That could undermine the gap fix Price touted.
Asked about conservative criticism from people like Sen. Rand Paul (R-KY) that the bill doesn’t cut enough, Price noted that the bill gives states much more “flexibility” on Medicaid.
The Medicaid program currently covers 20 percent of all Americans, 49 percent of all births, 60 percent of all kids with disabilities, and 64 percent of all nursing home residents.