As POLITICO reports:
House Energy and Commerce Republicans will meet behind closed doors Monday afternoon as they weigh how to cut $880 billion as part of the GOP megabill central to President Donald Trump’s agenda, according to three people granted anonymity to speak freely.
The meeting, to be led by Chair Brett Guthrie (R-Ky.), comes ahead of an expected markup next week of the committee’s piece of the massive tax, border and energy package. People granted anonymity to preview the panel’s plans say that markup could go into the night and early morning hours.
At the center of the panel’s debate is how to make changes to Medicaid, which is expected to make up a significant portion of the spending cuts Energy and Commerce is being tasked to make. And the size and shape of those cuts have emerged as a major flash point for Republicans on the committee and across the larger conference. Guthrie has said he expects overhauling existing health care programs could account for $500 billion to $600 billion of the committee’s deficit reduction target, with the rest coming from energy and telecom policies. [Pols emphasis]
Moderate House Republicans and those who hail from swing districts have said they don’t want major cuts to Medicaid to finance the bill, but have left the door open to reducing the federal share of payments in states that have expanded Medicaid under the 2010 health law. But that could lead states to make benefit cuts, raise taxes or slash other programs to fill budget holes.
For the last few months, we have been writing in this space the same thing that many critics have noted ever since the GOP narrowly passed its budget bill that requires $880 billion in cuts: There is absolutely, positively, NO WAY to make cuts of that size without virtually destroying Medicaid. After months of claiming that Medicaid is not going to be gutted and will only be examined to remove waste, fraud, and inefficiencies, it appears that Republicans on the House Energy and Commerce Committee — which includes freshman Rep. Gabe Evans (R-Fort Lupton) — are at last acknowledging that this is where they are headed next week.
Congressional Republicans cannot meet their budget goals and subsequent tax cuts for the rich — a key issue for President Trump — without destroying Medicaid and CHIP funding that are the health care lifeblood for 1.3 million Coloradans. They can’t run from this truth any longer.
This means that everything Evans has been saying about being able to save Medicaid — a program that serves one-third of all children in the eighth congressional district — was complete and utter nonsense. The same is true, to a lesser extent, for Rep. Jeff “Bread Sandwich” Hurd, who has been backpedalling from his initial strong opposition to making Medicaid cuts by suggesting that cutting waste and fraud might be sufficient after all (Evans and Hurd represent the two Colorado congressional districts with the largest percentage of residents who rely on Medicaid).
It’s still a bit hard to believe that Congressional Republicans would gut Medicaid and all but guarantee massive 2026 election losses, but that’s where things are headed. That journey starts today….behind closed doors.
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Dismantling what's left of the social safety net. Bill Clinton would be proud.
But hey, the mighty Galtian ubermenchen of free market capitalism may be less than enthusiastic here. Medicaid is often all that keeps the dirt poor slave labor force of those mighty Galtian ubermenchen healthy enough to keep showing up at those increasingly gawdawful jobs.
I think it is over-reach to describe "virtually destroying Medicaid." Even if ALL of the cuts came from Medicaid and it kicked in with a straightforward "we are cutting $88 billion per year to reach the goal," that would be about a 10% trim to the federal expenditures of the past couple of budgets.
It will be bloody, and there will be huge problems for individuals covered, those providing medical services, and the society as a whole. Some unpleasant options needed to have a plan to cut $880 billion over 10 years are laid out in a KFF article:
Putting $880 Billion in Potential Federal Medicaid Cuts in Context of State Budgets and Coverage
I'm cynically expecting Republicans to start with a cut of funds devoted to the ACA expansion for all those between 18 and 65 ("those folks can get their own health care coverage"), and then use smoke and mirrors by ramping up to cutting more deeply in years 6-10 of the ten year plan. Then say something like "We're not REALLY cutting people from coverage. We just think if states really think it is important to cover those getting Medicaid, they can raise their taxes to fund the program." And it leaves PLENTY of time for future Congresses to make change the balance — (hoping there will be once again an adequate majority of the House and Senate to pass a budget instead of Continuing Resolutions and Reconciliation Resolutions).