GOP plans deep cuts to Medicaid program

BOSTON — With her Republican colleagues eyeing potentially massive Medicaid cuts, U.S. Rep. Katherine Clark of Revere warned Wednesday that tens of thousands of Bay State residents could be at risk of losing public health insurance coverage.

The complex, lengthy budget process in Washington is just getting started, but House Republicans sparked an outcry from Massachusetts Democrats after they advanced a broad budget framework directing a committee that oversees Medicaid to find $880 billion in cuts.

In an email to constituents, Clark accused the GOP of “trying to steal $880 billion from Medicaid.”

Gov. Maura Healey said in a statement that Medicaid cuts would further strain Massachusetts hospitals, nursing homes, home and community-based care providers and community health centers. 

“U.S. House Republicans’ proposal to gut Medicaid funding would rip away health care from newborns, pregnant women, children and adults with disabilities, seniors and more. Nearly 2 million Massachusetts residents rely on MassHealth for their health care coverage — including nearly half of the children in this state,” Healey said. “Providers would be forced to shut their doors or lay off staff. U.S. House Republicans need to back away from this proposal and preserve Medicaid funding.”

U.S. Sen. Elizabeth Warren of Cambridge also joined the escalating criticism.

Warren blasted President Donald Trump for vowing on Fox News Tuesday that Medicaid “won’t be touched” as part of funding cuts, before he took to Truth Social Wednesday to endorse the House GOP budget plan. Trump wrote the “House Resolution implements my FULL America First Agenda, EVERYTHING, not just parts of it!”

Warren wrote on X, “It’s smoke and mirrors: Trump and Republicans are plotting to take away health care from millions of people to pay for tax breaks for billionaires.”

Clark claimed Republicans are “slashing health care access for Americans” in order to “give billionaires a $2 trillion tax break.” House Republicans argued in a budget blueprint they’re aiming to rein in “unsustainable” Medicaid spending and refocus services on “the most vulnerable Americans.”

Trump and Republicans want to extend expiring tax cuts from his first administration, including individual and estate tax provisions, which a new U.S. Treasury analysis found could benefit the wealthiest Americans, according to the Associated Press. 

The House is poised to vote next week on the budget resolution, The Hill reported. The plan does not provide specific details about the potential Medicaid cuts, and lawmakers will later need to hash out cost-saving tactics like imposing work requirements or reducing the Medicaid expansion federal match rate.

Medicaid spending totaled $880 billion across the country in fiscal 2023, according to KFF News.

“We don’t know exactly what the cuts will look like, but we do know who’s most helped by the program,” said Alex Sheff, senior director of policy and government relations at the Massachusetts-based Health Care for All advocacy organization. “We know it’s seniors, we know it’s kids, we know it’s people who give birth in the state. And so, that’s sort of all you need to know about where the pain would be.”

Sheff emphasized the cuts for now are “theoretical” and haven’t cleared Congress.

“We don’t want people to panic,” he said.

In Massachusetts, the MassHealth program — which combines Medicaid and the similar Children’s Health Insurance Program — counts about 2 million members.

About 34% of children under the age of 19 here were covered by Medicaid in 2023, as well as 21% of adults ages 19 to 64, according to the Commonwealth Fund, a foundation that supports health care research. Massachusetts secured $14 billion in federal support for Medicaid in 2023, which accounted for 61% of all Medicaid spending in the state.

The House Budget Committee says Medicaid has grown “so large,” with the program covering one in four Americans in 2022. Federal spending on Medicaid in 2023 was $616 billion, which the committee said is a 132% spike compared to a decade prior and before the passage of the Affordable Care Act that expanded Medicaid eligibility.

The committee said Medicaid is facing “rampant” fraud, failing to produce “quality” health results, and shifting resources “away from low-income children and at-risk Americans to healthy, work-capable adults.”

“Our budget makes health care more cost-effective by refocusing Medicaid resources on the most vulnerable Americans,” the committee’s blueprint states. “It puts the Medicaid program on a sustainable path through common sense and compassionate reforms that protect this critical safety net for those that need it the most: children, pregnant women, individuals with disabilities, and seniors.”

Health and Human Services Secretary Kate Walsh expressed skepticism in a recent Boston Globe interview that Congress would gut Medicaid, which covers a large share of long-term care expenses for older Bay Staters who can’t pay the care costs themselves.

“It’s going to be a long walk on this to basically kick people out of nursing homes,” Walsh told the Globe.

The secretary was not available for an interview Wednesday to discuss the evolving Medicaid situation.

Sheff said Medicaid cuts could “jeopardize access to life-saving care.” Bay Staters who lose coverage may also forego primary care and later end up in emergency rooms racking up higher care costs, he said.

“It would raise costs for people if they lose coverage,” he said. “In some cases, it’s going to result in medical debt or even bankruptcies.”