Topic: Medicare/Medicaid
“HHS is home to Medicare and Medicaid, the principal drivers of our $31 trillion national debt.”
Are Medicare and Medicaid really the principal drivers of our national debt? Only when you combine them. Social Security by itself is the largest driver, followed by the interest on the national debt, followed by the military, health spending, and Medicare, who are all tied at around 13% of our total spending. (Social Security is 22%, net interest is 14%.) [Source] Veterans’ benefits and services account for 5%.
This statement is laying the groundwork for the writer to argue for cuts to these programs.
Full contextual analysis of Section 3: The General Welfare here.
“Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program and Inflation Reduction Act.”
Obviously this would result in higher prescription drug prices, loss of savings programs, inequality in health care access, and more. Severino proposes no alternatives here. “…reforms that will have meaningful impact for seniors should be pursued.”
Full contextual analysis of Section 3.5: Department of Health and Human Services here.
“Clarify that states have the ability to adopt work incentives for able-bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees.”
This one is blink-and-you’ll-miss-it. He’s arguing for tying Medicaid benefits to work requirements, especially for able-bodied people, and likens Medicaid to a “welfare program.”
The ability to apply premiums and cost-sharing to higher-income enrollees suggests that some beneficiaries might face additional financial responsibilities based on their income, which can further complicate access to care.
Implementing targeted time limits or lifetime caps on benefits aims to prevent long-term dependence on Medicaid. This could mean that beneficiaries might only be eligible for coverage for a certain period, incentivizing them to find work or transition off Medicaid.
Full contextual analysis of Section 3.5: Department of Health and Human Services here.
“CMS should add flexibility to eliminate obsolete mandatory and optional benefit requirements and, for able-bodied recipients, eliminate benefit mandates that exceed those in the private market. This should include flexibility to redesign eligibility, financing, and service delivery of long-term care to serve the most vulnerable and truly needy and eliminate middle-income to upper-income Medicaid recipients.”
This one requires some unpacking to fully explain.
To sum up, able-bodied Medicaid recipients could lose access to their benefits, leading to gaps in health care coverage and care quality. Fewer people would qualify for Medicaid in the first place, potentially leaving millions without affordable care options. Wealthier individuals may face greater financial burdens for long-term care, either needing to purchase private insurance or pay out of pocket for care that Medicaid no longer covers. By cutting benefits and tightening eligibility, this approach could disproportionately affect vulnerable populations, leading to greater healthcare disparities.
Full contextual analysis of Section 3.5: Department of Health and Human Services here.
“Separate the subsidized ACA exchange market from the non-subsidized insurance market. The Affordable Care Act has made insurance more expensive and less competitive, and the ACA subsidy scheme simply masks these impacts.”
The consequences of separating the subsidized market (Affordable Care Act) exchange market from the non-subsidized insurance market would likely result in higher premiums in the non-subsidized market for people who don’t qualify for ACA subsidies. Without the ACA’s regulatory mandates (such as protections for pre-existing conditions or essential health benefits), insurers in the non-subsidized market will almost certainly charge more, offer plans with fewer benefits, or go back to dropping people with pre-existing conditions. This is another example of good for insurance companies, bad for people.
Full contextual analysis of Section 3.5: Department of Health and Human Services here.
“Prohibit Planned Parenthood from receiving Medicaid funds.”
This isn’t going to result in fewer abortions, it’s just a way to punish the poor. The Hyde Amendment already dictates that no federal funds go towards abortions. So do you know what Planned Parenthood uses that funding for? Cancer screenings. STD and STI tests and treatment. Breast exams. Offering sex education, contraceptives, and birth control options. HIV tests. Pregnancy tests and planning. Prenatal and Postpartum services. Vaccines. Wellness and preventative care.
They provide all of these services affordably to low-income families. Abortions comprise about 3% of the services they provide to patients. [Source] This proposal would result in a cut of 40% of their funding. By contrast, about 45% of services provided in FY14-15 at Planned Parenthood clinics were for sexually transmitted infection tests, and 31% were for contraceptive services.
All this proposal would result in is more low-income people with sexually transmitted infections and unwanted pregnancies.
Full contextual analysis of Section 3.5: Department of Health and Human Services here.
“Withdraw Medicaid funds for states that require abortion insurance or that discriminate in violation of the Weldon Amendment. The Weldon Amendment declares that no HHS funding may go to a state or local government that discriminates against pro-life health entities or insurers. In blatant violation of this law, seven states require abortion coverage in private health insurance plans, and HHS continues to fund those states. HHS under President Trump disallowed $200 million in Medicaid funding from California because of the state’s flouting of the law, but the Biden Administration restored it.”
Yanking Medicaid from states that mandate abortion coverage in private insurance plans would result in that entire state’s health care coverage being severely impacted, instantly dumping everyone on Medicaid from coverage through no fault of their own. This is strong-arming and coercion, and disproportionately affects the most vulnerable among us – children, low-income families, the elderly, and the disabled. (And do recall that covering abortion with insurance – since abortion is a medical term – is really just requiring insurance to cover pregnancy-related complications resulting in abortion; meaning that women who miscarry for any reason or have ectopic pregnancies won’t be covered by insurance for those items if their states cave to the government’s mafia tactics here.)
Another consequence would be that healthcare providers in states that lose Medicaid funding may face financial difficulties. Medicaid often reimburses for services provided to low-income patients, and losing those funds would strain providers who rely on that revenue, potentially resulting in staffing cuts, reduced services, or closures of clinics and hospitals, particularly in underserved areas.
Further, do you want state sovereignty, or don’t you, Heritage Foundation? States have historically regulated their own health insurance markets, including what services insurers must cover. By withdrawing Medicaid funds, the federal government would be punishing states for exercising their rights to regulate insurance coverage within their borders. States affected by this would be California, New York, Oregon, Washington, Illinois, Maine, and Vermont. According to Medicaid enrollment by state31 numbers, this would instantly dump 26,765,270 Americans off of their health care coverage.
Full contextual analysis of Section 3.5: Department of Health and Human Services here.
“In addition, intermediate tax reform should repeal all tax increases that were passed as part of the Inflation Reduction Act, including the book minimum tax, the stock buyback excise tax, the coal excise tax, the reinstated Superfund tax, and excise taxes on drug manufacturers to compel them to comply with Medicare price controls.”
Oh good, let’s go back to uncontrolled prescription prices. /sarcasm
Full contextual analysis of Section 4.2: Department of the Treasury here.