The Trump administration’s new budget proposal includes massive cuts to Medicaid that health policy experts are characterizing as “astounding.”
These cuts could result in at least 14 million low-income people losing their Medicaid benefits over the next decade, according to an estimate from the Congressional Budget Office (CBO) that examined part of the proposal.
The human impact would likely be much greater than that, however. The CBO estimate, which was released earlier this month, doesn’t take into account the full scope of the proposed hundreds of billions in budget cuts.
Trump’s budget document, called “A New Foundation for American Greatness,” assumes the Obamacare replacement bill that was narrowly passed by the House in early May will become law. That legislation proposes slashing Medicaid funding by $800 billion over the next 10 years, which is about 25 percent less funding than the CBO projects under current law.
But the draft document that was published online Monday evening suggests Trump’s budget will go even further than that — calling for an additional $610 billion in cuts to the program over the next decade.
The Health and Human Services (HHS) budget document was removed shortly after it was made public on Monday, after the administration appeared to accidentally break its embargo. But several reporters took screenshots of the document while it was still up.
If that version of the budget is accurate, its impact on Medicaid could be staggering. It would essentially result in cutting the program’s funding in half by the end of the tenth year.
The proposal would also pave the way for restructuring Medicaid in significant ways that would ultimately reduce access to care.
For example, it would transition the program to either a block grant or a per capita cap, which would make it difficult for Medicaid funding to keep pace with growing health care costs and the rate of inflation. It would also permit states to impose work requirements in exchange for Medicaid benefits, which experts say is a misunderstanding of how health insurance interacts with employment among low-income populations.
Although the budget proposal doesn’t include direct cuts to Medicare, which Trump has repeatedly promised not to touch, deep cuts to Medicaid will hurt the older Americans who rely on Medicare. The Medicaid program covers some Medicare beneficiaries — the people known as “dual-eligible beneficiaries”—along with the majority of nursing home residents.