The “One Big Beautiful Bill” by President Donald Trump lowers the federal expenditure in the Medicaid markets and the Low Price Health Care Law (ACA) at around $ 1 billion for a decade, according to the Congress Budget Office (CBO), a non -party entity. This threatens the physical and financial health of tens of millions of Americans.
He accountApproved by the Senate on Tuesday 1 July, many of the progress in the medical coverage of the Biden and Obama administrations would reverse, whose policy facilitated access to millions of people and reduced the number of people without insurance in the country to historical minima.
According to the CBO, the Senate Plan to drastically reduce the financing of Medicaid and ACA markets cannot be safe, according to the CBO.
This, in turn, would harm the finances of hospitals, homes of older adults and health centers for the community – which should absorb much of the costs of treatment of people without coverage – and forcing them to reduce services and staff even to close facilities.
The legislation is on Trump’s desktop that is waiting for his company, although the Senate and the House of Representatives must first approve the same version. The House of Representatives approved its own version in May and is expected to consider the version of the Senate today (July 2), according to Tom Emmer, leader of the majority in the room.
Then there are five ways in which the plans of the Republican party can influence access to medical care.
Do you need medicaid? Then get a job
The deepest cuts in medical care stem from the proposal of a work requirement for Medicaid, which would reduce the coverage of millions of affiliated companies that do not meet these new standards.
In 40 States and Washington, DC, who have expanded Medicaid Bajo ACA, some beneficiaries of Medicaid should regularly present documentation that show that they work, do volunteer work or go to school at least 80 hours a month, or who are eligible for an exemption, as examples of a small child.
The requirement of the bill would not apply to people in the 10 states, mainly Republicans who have not expanded Medicaid.
Health researchers claim that policy would have little influence on employment. Según KffMost of the beneficiaries of Medicaid at work who do not receive incapacity for work, already work or search for work or cannot do it because they have a disability, go to school or take care of a family member.
State experiments with work requirements are plagued by administrative problems, such as the loss of coverage of eligible beneficiaries due to problems with paperwork and more costs.
Georgia’s work requirement, which was officially implemented in July 2023, cost more than $ 90 million, of which only 26 million have been assigned to health benefits, according to the Georgia Budget & Policy InstituteA non -party -related research organization.
“The hidden costs are astronomical,” says Chima Ndumele, professor at the Yale School of Public Health.
Less money means less attention in rural communities
Adjustment measures that would apply to states can translate into a decrease in health services, medical professionals and even hospitals, especially in rural communities.
The Plan of the Republican Party would be a practice that is known as taxes for suppliers, who have been using almost all states for decades to increase medical payments to hospitals, homes of older adults and other suppliers, as well as private companies of managed medical care.
States often use the federal money generated through taxes to pay more institutions more than Medicaid would pay differently. (Medicaid usually pays the lowest rates for medical care, compared to Medicare, the program for people older than 65 and some people with disabilities and private insurance).
The hospitals and homes of older adults claim that they use these extra medicaid funds to expand or add new services and to improve care for all patients.
National hospitals usually work with reduced profit margins and depend on medicaid tax payments to keep them. Researchers from the Cecil G. Sheps Center for Health Services Research They investigated the account of the Chamber that it would force more than 300 rural hospitals, many of them in Kentucky, Louisiana, California and Oklahoma, to reduce their services or close by.
Republican senators added a $ 50 billion fund to their version of the account to dampen the impact on rural hospitals.
More difficulty obtaining and maintaining ACA coverage
For those who have ACA coverage for health insurance, the Republican plan would make registration and retain the plans.
The insured person of the insurance market would be obliged to update their income, immigration status and other information every year, instead of being registered automatically, something that more than 10 million people have made this year.
They would also have less time to register; The bill shortens the annual open registration period in approximately one month.
People who ask for coverage outside that period – for example because they lose their work or other insurance, or have to add a newborn or spouse to an existing policy – they should wait until all their documents are processed before they receive government subsidies to pay their monthly premiums. They currently receive up to 90 days of help with premiums during the application process, which can take weeks.
Republican legislators and some conservative policy studies, including the Paragon Health InstituteThey confirm that the changes are needed to reduce fraudulent inscriptions, while opponents claim that they are the last attempt to dismantle the Obamacare.
The legislation also does not consider an extension of the improved subsidies that were implemented during the COVID-19 Pandemie. If the congress does not act, these subsidies will end at the end of the year, which will result in An average increase of 75% According to KFF on premiums next year on premiums.
Do you have medicaid? More will be paid for medical consultations
Many medicaid beneficiaries could pay more than their pocket for appointments.
The bill would require states that have expanded Medicaid to charge the beneficiaries up to $ 35 for some services if their income is between the federal poverty area (this year, $ 15,650 per person) and 138% of that amount ($ 21,597).
Medicaid beneficiaries generally do not pay anything when they are looking for medical services, because studies have shown that obtaining even small Copagos means that people with a low income lead to the necessary attention. In recent years, some states have added positions under $ 10 for some services.
This policy would not apply to people who are looking for primary care, mental health care or addiction treatment.
Legal home immigrants
The Republican plan could lead to at least hundreds of thousands of immigrants with legal residence – including asylum recipients, victims of human trafficking and refugees – losing their coverage of the insurance market by eliminating the subsidies that make premiums affordable. The restriction would not apply to holders of permanent residence card (green card or green card).
Since immigrants were to lose subsidies under this plan, usually younger than the general population, their departure would leave a population of older branches, with a greater risk of diseases and higher costs that would further increase the premiums of the market, according to directors of the health insurance markets in California, Maryland and Health Analists.
Remove access to medical care for immigrants who live in the country legally “will cause irreparable damage to people who have promised to protect unnecessary costs and impose on local systems that are already overloaded,” said John Slocum, executive director of Refugee Council USA, a defense group, in a statement.
Both the version of the House of Representatives and the Senate of the bill reflect the limiting approach to the Trump government for immigration.
However, because it was contrary to the Senate standards, the legislation will not contain a proposal that the federal payments of Medicaid would have reduced to states such as California, which use their own money to cover immigrants without papers.
The most important correspondent of KFF Health News in Washington, Julie Rovner, contributed this article.
#Americans #mega #project #Republican #legislation #entail #health #costs #KFF #Health #News