WASHINGTON (AP) — If Republicans’ proposed domestic policy package becomes law, approximately 11.8 million adults and children may face the risk of losing their health insurance. The changes outlined in the GOP’s “One Big, Beautiful Bill Act” will gradually reduce enrollment in federal health care programs like Medicaid and Obamacare over a ten-year period, aiming to cut nearly $1 trillion from these programs. This legislation is expected to reverse the trend of rising health insurance rates in the U.S., which has coincided with record spending on federally-funded health care coverage. Currently, around 78 million individuals are enrolled in Medicaid programs, and 24 million are enrolled in the ACA’s marketplaces.
Medicaid, a joint federal-state program, operates under different names in various states such as Medi-Cal in California, BadgerCare in Wisconsin, and MassHealth in Massachusetts. Under the GOP plan, individuals may face challenges maintaining their health care coverage:
– Medicaid or Obamacare recipients will undergo more frequent income and eligibility checks.
– Homeless or transient individuals may struggle to respond to government notices for paperwork, potentially leading to loss of coverage.
– States will be required to verify enrollees’ income, addresses, and death records more frequently.
– ACA marketplace enrollees will face increased scrutiny over reported income and potential penalties for exceeding expected earnings.
– States may delay children from enrolling in the Children’s Health Insurance Program and introduce waiting periods or premium payments for coverage.
– The bill may make it harder for immigrants to qualify for lower-cost Obamacare coverage, affecting refugees and asylum seekers.
These proposed changes could have significant implications for millions of Americans’ access to health care coverage if implemented.
Each year, states that extend Medicaid coverage to immigrants without legal status will face reduced federal funding. While some states allow immigrants to access Medicaid using only state funds, a new bill threatens this coverage by decreasing the federal reimbursement rate for all legal residents from 90% to 80%. Consequently, some states may opt to discontinue their immigrant programs rather than lose federal support. California has already paused new enrollments in its state-funded Medi-Cal for immigrants, while Illinois has stopped its program altogether.
Under the new law, individuals aged 19 to 64 must work, volunteer, or attend school for 80 hours per month to qualify for Medicaid benefits, with exemptions for the disabled, pregnant, or parents of children under 14. Critics like Michael F. Cannon from the Cato Institute argue that this work requirement may dissuade those who do not value Medicaid coverage from enrolling, thus saving the government money. However, many Medicaid recipients are already employed, in school, have a disability, or are caregivers, meeting the exemption criteria. Still, some may lose coverage due to bureaucratic errors or challenges in verifying their work status, particularly if they lack internet access or face document submission difficulties.
For individuals enrolled in both Medicare and Medicaid, the new legislation will make it more challenging to apply for benefits. The bill rolls back Biden administration initiatives that simplified enrollment processes for those eligible for both programs, potentially leading to coverage losses for some due to increased paperwork burdens. Jennifer Tolbert from KFF warns that rescinding these rules could result in people getting caught up in administrative complexities and losing access to essential healthcare services.
