May 15, 2025

Advocacy Resource for NYS Council members and especially those in Rep. Lawler’s Congressional District (Take Action Advocacy opportunity in the last item on this page)
Steve Inskeep interviewed Rep. Lawler on today’s Morning Edition on NPR: https://www.npr.org/2025/05/15/nx-s1-5398036/republican-congressman-mike-lawler-discusses-house-budget-negotiations

And remember, Medicaid Matters has Fact Sheets here:  https://medicaidmattersny.org/federal-issues/  that tell the story of the importance of the Medicaid Program to New Yorkers in 26 districts across the state.  Importantly, Medicaid makes up 43% of New York’s state budget!

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Modern Healthcare Coverage (5/14) of the Tuesday into Wednesday Energy & Commerce bill markup (article below). 

NYS Council Notes:  

The total target for E&C is $880B but apparently the Committee advanced a plan that reduces total Medicaid reductions from $880B over 10 years to $625 over 10 years.  It’s unclear where they find the remainder of the savings to hit their target.  

Generally, the proposed Medicaid cuts would (this is not an exhaustive list):

• Impose work requirements on childless adults aged 19 to 64 (with some exceptions)
• Restrict states from using provider taxes to fund Medicaid;  (think New York’s MCO Tax)
• Penalize states for covering unauthorized immigrants;
• Shorten the ACA’s open enrollment period; and 
• Prevent Medicaid and CHIP funds from covering gender transition procedures for minors.

Importantly, the bill also allows Medicaid recipients to be charged a $35 copay (PDF) starting in October 2028.

According to a partial analysis by the Congressional Budget Office, the proposed changes would strip 10.3 million people of Medicaid coverage by 2034 and leave 7.6 million people going uninsured.

The legislation now faces a challenging path through the House Budget Committee and a tight timeline for a floor vote before the Memorial Day deadline set by Speaker Mike Johnson, according to The Hill.

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(Modern Healthcare, 5/14 ppm)

The GOP-led House committee in charge of cutting healthcare spending to finance a sweeping tax cuts bill advanced its portion of the measure Wednesday, overcoming Democratic objections during a daylong session.

The Energy and Commerce Committee provisions, which are estimated to reduce Medicaid spending by $625 billion over 10 years, cleared on a party-line vote. They will be combined with policies working through other committees into final legislation House Republican leaders hope to pass by the end of the month.

The greatest savings come from implementing work requirements and stricter eligibility checks in Medicaid, which the Congressional Budget Office estimates would save about $350 billion. The measure saves another $167 billion by delaying a 2024 Centers for Medicare and Medicaid Services regulation that made it easier for people to enroll in Medicaid and the Children’s Health Insurance Program, according to the nonpartisan budget agency.

Another significant provision would bar new provider taxes that states increasingly use to fund their share of Medicaid spending, which CBO estimates would save $87 billion.

Healthcare industry groups such as the American Hospital Association and the American Medical Association strongly oppose the Medicaid cuts.

Republicans on the committee asserted repeatedly that the bill is meant to secure Medicaid and the people who need it most by addressing waste, fraud and abuse.

“Medicaid was created to protect healthcare for Americans who otherwise could not support themselves,” committee Chair Brett Guthrie said at the start of a marathon markup that began Tuesday afternoon and ended more than 26 hours later. Guthrie and other Republicans said they wanted to target people who were unwilling to work for their benefits, as well as undocumented immigrants.

“All of this is part of our effort to strengthen Medicaid for the people that need it most. When President Trump delivered his second inaugural address, he promised ‘a revolution of common sense’ that would launch a generation of growth, prosperity and health,” Guthrie said. “This reconciliation bill is critical to that promise.”

Democrats repeatedly hammered Republicans for pursuing the Medicaid cuts mainly to partially offset the much greater cost of extending the expiring Tax Cuts and Jobs Act of 2017, which they said lines the pockets of the rich.

“It is not focused on cutting waste, fraud, and abuse. Instead, Republicans are intentionally taking healthcare away from millions of Americans so they can give giant tax breaks to the ultra-rich who don’t need them,” committee ranking member Frank Pallone (D-N.J.) said.

Pallone cited a preliminary CBO analysis issued last week that concluded allowing enhanced subsidies for health exchange customers to expire and implementing the Medicaid policies would cause 13.7 million people to lose health coverage, including 8.6 million from Medicaid cuts. A second CBO report on the Energy and Commerce Committee bill released Monday projects its Medicaid provisions would lead to 7.6 million people losing coverage.

Since the largest money-saver in the legislation is work requirements, Pallone and many other Democrats pointed to the experiences in Arkansas and Georgia, where attempts to institute work rules were expensive, ineffective and pushed eligible people off the rolls.

Several Democrats suggested the effort was reflective of historic Republican antipathy to social safety-net programs.

Rep. Troy Carter (D-La.) offered an amendment to ensure home and community-based services that are popular in red and blue states would be safe from cuts.

“Put your money where your mouth is. We all know that they won’t, because they’re beholden to [Elon Musk] and Mr. Trump and the tax cuts that they promised, because it’s never been about helping people or reforming Medicaid. It’s never been about curbing waste, fraud and abuse,” Carter said. “It’s always been about stripping away healthcare from the working poor to fill the pockets of high-paid, rich donors.”

Democrats several times offered bipartisan bills as amendments to make the point.

Rep. Alexandria Ocasio-Cortez (D-N.Y.) offered legislation authored by Senate Health, Education, Labor and Pensions Chair Dr. Bill Cassidy (R-La.) that would target what lawmakers see as abusive practices in Medicare Advantage, including so-called upcoding to generate higher federal payments. The No UPCODE Act of 2025 would save $124 billion over 10 years, she said.

“Those savings, instead of going to tax breaks for billionaires and corporations, will then be reinvested in Medicare,” Ocasio-Cortez said. “I hope we can all agree on that.”

Before Republicans voted it down, Rep. Buddy Carter (R-Ga.), the chair of the panel’s health subcommittee, said the reconciliation bill was not the platform to address the issue.

‘While I recognize the spirit of the amendment and agree that we need to more closely examine the Medicare Advantage program, these policy changes to the Medicare Advantage program warrant further discussion outside the scope of this markup,” Carter said.

Similarly, Rep. Debbie Dingell (D-Mich.) offered a non-binding amendment that it was the “sense of the House” to support the goal of an executive order on drug pricing Trump issued Tuesday, which would require the government to pay no more than the lowest prices charged in other countries.

Guthrie said while he agrees that the U.S. pays too much for pharmaceuticals, he and other Republicans disagree with Trump’s solution, saying it would discourage drug development.

“We still want the research, and the result of foreign price controls have led manufacturers to invest billions of dollars in the United States,” Guthrie said.

Although Energy and Commerce Committee Republicans stayed united and beat back Democratic amendments, there still is no guarantee the broader bill will make its way to Trump’s desk.

First, the Medicaid cuts exceed the $500 billion maximum several House Republicans in competitive districts said they could support. And some hard-right members of the GOP conference have complained the bill does not slash spending enough.

Then, the Senate also must pass matching legislation, and Republicans there have raised concerns about the deep cuts. Indeed, many senators also have misgivings about many aspects of the tax-and-spending-cuts bill beyond the healthcare provisions and have warned that they will craft a different bill. The two measures would then have to be reconciled.

“I’m confident the Senate will have its own ideas,” Sen. John Cornyn (R-Texas), who sits on the Finance Committee that has authority over Medicaid, told reporters Wednesday. “We will pass a bill here that may differ some from the House.”

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Below is coverage of the recent House Ways & Means Committee markup that occurred on Tuesday into Wednesday.  Important threats discussed below.  PLEASE TAKE ACTION as described in the information below: