The Republican-run House Energy and Commerce Committee last night released their proposal on what we’ve known was coming for months, their $880 billion in cuts to Medicaid. If these survive a full House vote, it will mean kicking millions out of the program, include work requirements, and set new requirements for adults with income above 100% of the federal poverty level. For a single individual, that’s $15,650 annually. That’s $7.67 an hour. That compares with Elon Musk’s $1.6 million per hour.
Bobby Kogan, senior director of federal budget policy at the Center for American Progress, wrote in an analysis of the proposed changes: ”If you make $20,000, a state might slap $1,000 of fees onto your Medicaid. True sicko shit." He also noted that states that “have implemented work requirements have led to disaster with huge numbers of people who are working still being kicked off their Medicaid. This would be a federal mandate.”
Wrote Larry Levitt, executive vice president for health policy at KFF: "Many of the Medicaid proposals from House Republicans are technical and wonky, and will be difficult for the public to absorb. What won't be difficult to absorb: CBO's estimate that the changes will increase the number of people without health insurance by at least 8.6 million."
In a statement Sunday night, Rep. Frank Pallone Jr. of New Jersey, the top ranking Democrat on the committee, said:
“Republicans finally released the bill they’ve been drafting behind closed doors for months to make catastrophic cuts to Americans’ health care all so they can give tax breaks to billionaires and corporate interests. This bill confirms what we’ve been saying all along, Trump and Republicans have been lying when they claim they aren’t going to cut Medicaid and take away people’s health care. Let’s be clear, Republican leadership released this bill under cover of night because they don’t want people to know their true intentions.
“This is not trimming fat from around the edges, it’s cutting to the bone. The overwhelming majority of the savings in this bill will come from taking health care away from millions of Americans. No where in the bill are they cutting ‘waste, fraud, and abuse’—they’re cutting people’s health care and using that money to give tax breaks to billionaires. [...]
“Taking health care away from children and moms, seniors in nursing homes, and people with disabilities to give tax breaks to people who don’t need them is shameful. Democrats have defeated Republican efforts to cut health care before and we can do it again.”
Pallone and fellow Democrats Rep. Richard Neal of Massachusetts and Sen. Ron Wyden of Oregon sent a letter to the Congressional Budget Committee seeking answers to several questions. The answers:
We estimate that the expiration of the expanded premium tax credits will increase the number of people without health insurance by 4.2 million in 2034 relative to an estimate of a permanent extension of those credits. That amount is reflected in CBO’s baseline projections because the expanded tax credits expire after this year under current law.
We estimate that finalizing the 2025 Marketplace Integrity and Affordability Rule as proposed will increase the number of people without health insurance by 1.8 million in 2034. Half of that increase is included in CBO’s baseline because the rule is currently proposed. The other half is included in our estimate of codifying the rule in Part 2 of Subtitle D of the Committee on Energy and Commerce’s reconciliation recommendations.
Based on our analysis completed so far, CBO estimates that E&C’s reconciliation recommendations related to Medicaid as well as the marketplace provisions that extend beyond codifying the proposed rule would increase the number of people without health insurance by at least 7.7 million in 2034. (That number reflects our estimate for the legislation less 0.9 million, which is included in the estimate above). CBO continues to analyze several Medicaid provisions that could affect health insurance and we have not yet estimated the interaction between the Medicaid provisions and the marketplace provisions of E&C’s reconciliation recommendations. We anticipate that doing so will somewhat further increase the estimated number of people without health insurance.
In total, CBO estimates that these three actions would increase the number of people without health insurance by at least 13.7 million in 2034. Of that total effect, 5 million—stemming from the expiration of the expanded premium tax credits and half the estimated effect of the proposed marketplace rule—is already reflected in CBO’s baseline projections.
As if this move wasn’t bad enough, Republicans are also eager to pass a proposal cutting SNAP (Food Stamps) by $230 billion over the next decade, and include work requirements for those who continue to receive SNAP benefits. As Katie Bergh at the Center for Budget and Policy Priorities wrote in February, “The average SNAP benefit in fiscal year 2026 is projected to be only $6.40 per person per day. Under this proposal, each SNAP participant would lose an average of $1.40 per day initially, cutting the daily average benefit to only $5.00 per person.”
But, hey, there’s gotta be some pain along the way to get $880 billion from Medicaid and $230 billion from SNAP into the hands of people whose wealth has made their tax burden just too much to bear.
