May 28, 2025

The federal budget bill passed by the House last week threatens to gut New York’s health care system, leaving 1.5 million New Yorkers without coverage and slashing $13.5 billion in funding from our state. If the Senate does not make critical changes, the fallout will be catastrophic.  The Medicaid provisions in the House bill alone (totaling somewhere around $700B over 10 years) could result in 7.6 million people becoming uninsured by 2034, according to a preliminary analysis by the Congressional Budget Office. 

Earlier this week Politico ran a story indicating that New York legislative leaders are prepared to come back to Albany to try and address the fallout should the House Budget Reso plan move through the Senate without wholesale changes to address this emergency.  But the message is clear — there is no way New York State can backfill the vast holes in our healthcare system that will result from passage of the House bill ‘as is’ in the Senate.  Major changes are needed.

We must push the Senate to reject the House Budget Reconciliation provisions it moved forward last week, and to rewrite the bill. 

Although the House and the Senate are out this week, many members of the Senate are speaking with the media, posturing and projecting what changes they want to see in order to pass this legislation in their chamber. The Senate is typically more measured and moderate than the House, but the same kinds of factions exist, and it will take some work to get a consensus that appeases enough Senators (they need at least 50) to pass the bill.  Both Speaker Mike Johnson and Senate Majority Leader John Thune say they want the reconciliation bill on President Donald Trump’s desk by July 4.  We should take this threat seriously, especially considering that the leaders have been on target and within the deadlines they have set for themselves to this point.

ACTION/ADVOCACY

Here are links to various “rapid response” events that are happening across the state in strategic congressional districts re: last week’s budget reconciliation vote in the House – show up and bring friends and family to them!  

• Wed. May 28, 7 p.m. in NY-11 (Malliotakis) – Debate & Community Town Hall hosted by NYC Comptroller (and mayoral candidate) Brad Lander about health care cuts in the House budget reconciliation bill; at Good Shepherd Lutheran Church in Bay Ridge, Brooklyn (7420 4^th Ave. – take R train to Bay Ridge Ave. stop)
• Thurs. May 29, 12 noon in NY-1 (LaLota) – “Big Bad Reconciliation Bill Rally and Press Conference” outside the local district office of Rep. Nick LaLota in Hauppauge (515 Hauppauge Rd.); hosted by Long Island Progressive Coalition and allies
• Thurs. May 29, 12 noon in NY-11 (Malliotakis) – Community Press Conference and Speak-Out on Malliotakis’ Big Ugly Budget Vote; outside her local district office in Bay Ridge, Brooklyn (7716 3^rd Ave. – take R train to 77^th St., or S); hosted by NY-11 for Health Care
• Sat. May 31, 11:30 a.m. in NY-17 (Lawler) – “NY-17 Hands-Off and Stop the Cuts!” rally; in Louis Engel Waterfront Park in Ossining; hosted by various partners in NY17 Community Coalition
• Sun. June 1, 1 p.m. in NY-11 (Malliotakis) – “Rally to Save Medicaid” hosted by Rep. Dan Goldman; outside her local district office on Staten Island (1698 Victory Blvd. – take 61 or 62 bus from St. George ferry terminal to Beechwood Pl.)
• Tues. June 10, 7 pm online (statewide) – “New York Stands Up! A Mass Mobilization Briefing”; hosted by Citizen Action of NY

 If you don’t see something in your own district or region, please empower yourself to organize one!  Events are needed in NY-2 (southern Suffolk County), NY-21 (North Country), NY-23 (Southern Tier and Buffalo suburbs), and NY-24 (rural Central and Western NY.)

NEWS CLIPS

The Hill: Trump’s ‘big, beautiful bill’ pits Senate GOP moderates against conservatives

Centrist GOP Sens. Susan Collins (Maine), Lisa Murkowski (Alaska) and Thom Tillis (N.C.) are facing off against conservatives such as Sens. Ron Johnson (R-Wis.), Rick Scott (R-Fla.) and Mike Lee (R-Utah) over potential cuts to Medicaid benefits, the phase-out of renewable energy incentives, and other deficit-reduction measures that conservatives say don’t go far enough.  The Medicaid cuts also divide conservatives, with Senator Josh Hawley (R-Mo.) warning they could be bad policy and politically suicidal.

It has left observers skeptical the debate in the Senate will end in June.  “I would be shocked if it did not go past July 4,” said a Senate Republican aide. “There are going to be a lot more twists and turns on this road, but we’re going to get it done.”

The Hill: Hawley stakes ground as chief GOP defender of Medicaid

Sen. Josh Hawley (R-Mo.) is staking out his spot as a populist defender of Medicaid in opposition to the steep cuts contained in the House-passed megabill to fund President Trump’s domestic agenda. 

The senior senator from Missouri — who as the state’s attorney general once signed on to a lawsuit seeking to overturn the Affordable Care Act — has made his position clear: He will not support a bill that cuts Medicaid benefits. 

Hawley has long warned his party against Medicaid cuts; the $800 billion question is whether other senators will join him. 

He joined with Sen. Ron Wyden (D-Ore.) during a marathon series of votes on the budget resolution in April to introduce an amendment that would have stripped the House’s directive to find $880 billion in savings. The amendment was not adopted, but Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) also voted for it.  

Earlier this month, Hawley wrote in a New York Times op-ed that slashing health care for the working poor “is both morally wrong and politically suicidal.” 

“Republicans need to open their eyes: Our voters support social insurance programs,” Hawley wrote. “More than that, our voters depend on those programs.” 

Hawley is adamant that Republicans take President Trump seriously when he says they should not touch Medicaid benefits and instead focus on “waste, fraud and abuse.”  

“We ought to just do what the president says,” Hawley said late last week, after the House passed its version of the bill. 

Roll Call: Both sides launch ad campaigns over budget vote as bill moves to Senate

Last week’s House vote on a sweeping reconciliation bill encompassing much of Republicans’ legislative agenda is already becoming a focal point in the nascent campaign for control of Congress next year.

Party campaign committees and outside groups have already announced ad campaigns centered on the measure. 

The National Republican Congressional Committee announced a digital ad campaign last week targeting 25 vulnerable House Democrats in states such as California, Florida, New York, Ohio and Texas for “voting for the largest U.S. tax hike in generations.”

The targeted lawmakers include all 13 Democrats who represent districts that Donald Trump carried last year. 

On the Democratic side, House Majority Forward, the nonprofit arm of the top House Democratic super PAC, “is already planning paid campaigns to hold Republicans accountable for their votes to cut Medicaid and raise prices,” said CJ Warnke, a spokesperson for the group.

The ads are due to run in 25 districts across states such as California, Iowa, Michigan, Missouri, New York, North Carolina, Virginia and Wisconsin. 

Meanwhile, American Action Network, a nonprofit with ties to House Republican leadership, released a poll Tuesday showing support for various provisions included in the measure. 

According to the May 6-8 survey of 1,200 registered voters in 72 targeted congressional districts, 72 percent favored work requirements for able-bodied adults who receive Medicaid benefits and 68 percent favored “strengthening Medicaid eligibility integrity.”

The poll found that the measure’s tax provisions were also popular, with 63 percent saying they favored “ending the federal income tax on tips” and 61 percent in favor of extending the 2017 tax cuts.

CBS News: Elon Musk says he’s “disappointed” by Trump’s “big, beautiful bill” and what it means for DOGE

Elon Musk says he is “disappointed” by the price tag of the domestic policy bill passed by Republicans in the House last week and heavily backed by President Trump. The billionaire who recently stepped back from running the Department of Government Efficiency, or DOGE, made the remark during an exclusive broadcast interview with “CBS Sunday Morning.”  

“I was disappointed to see the massive spending bill, frankly, which increases the budget deficit, not just decreases it, and undermines the work that the DOGE team is doing,” Musk said.

Punchbowl News: The FY2026 spending bill fight kicks off

After months of DOGE-related layoffs for thousands of government employees, the elimination of USAID, an executive order calling for the end of the Education Department, a potential $1 billion cut to the D.C. budget and even a Trump administration official lamenting proposed spending cuts, the House Appropriations Committee is scheduled to begin subcommittee markups late next week on FY2026 spending bills.

The White House hasn’t delivered a full budget proposal yet, only a “skinny” budget plan that called for cutting $163 billion in non-defense spending while boosting Pentagon funding. The proposal stunned Democrats and moderate Republicans while setting up a contentious spending fight. House Appropriations Committee Chair Tom Cole (R-Okla.) said he’s going to try to stick to the Trump plan as closely as he can.

This is a fight for the health and future of our state. Let’s make sure the Senate hears us loud and clear: Fix the bill or people in New York, and around the nation, will face the consequences.

 Call 1-855-245-3682 to talk to your senators and tell them to vote NO on the reconciliation bill if there are no significant changes.

————————–

Becker’s Hospital News:  5/28/25

Proposed federal Medicaid work requirements will include some exceptions for individuals with mental health and substance use disorders. 

The House passed President Donald Trump’s One Big Beautiful Bill Act on May 22. The package includes significant cuts to Medicaid. 

The bill would implement requirements for able-bodied adults ages 19-64 to prove they work at least 80 hours a month, or participate in other qualifying activities, to receive Medicaid benefits. 

The bill also lists an inpatient psychiatric hospitalization as a “short term hardship event” that exempts individuals from work requirements during the month in which the event occurs. 

The program exempts Native Americans, full-time caregivers, disabled veterans and other disabled individuals from work requirements. Substance use disorders and disabling mental disorders are included among these exceptions. 

Additional information re:  impact on the federal Medicaid Program and its beneficiaries present and future:

Medicaid 

13. The bill introduces a two-year acceleration of Medicaid work requirements for able-bodied adults ages 18 to 64, which is slated to take effect no later than Dec. 31, 2026,instead of 2029. States have the ability to implement these requirements earlier to secure quicker savings. 
14. Beginning Oct. 21, 2027, states will be mandated to redetermine Medicaid eligibility every six months for people in the expansion population. 
15. Medicaid and CHIP federal financial participation is prohibited under the bill revisions for people who fail to verify immigration status, citizenship or nationality in the designated “reasonable opportunity” window. 
16. States will also be required to cross-check their Death Master File quarterly to confirm deceased individuals are disenrolled. Should errors occur, there will be reinstatement provisions.
17. The Social Security Act is amended tocut retroactive Medicaid coveragefrom three months to one month before the application date. 
18. Federal Medicaid and CHIP funding is prohibited for “specific gender transition procedures” provided to people under 18 years of age.
19. Eligibility for increased federal medical assistance percentage for states that are newly expanding Medicaid will be wound down. To qualify, states must start expansion by Jan. 1, 2026 to restrict late expansion states from receiving an elevated match rate.
20. New rules forwaiving the uniform tax requirement for Medicaid provider taxes will be imposed, which tightens conditions for states to use the financial tools. 

————————-

It should be noted that years ago the federal government approved how NYS has structured the Essential Plan and how NYS uses state-only dollars for Medicaid services for immigrants not entitled to federal funding. As such, and contrary to the assertions being made (below) it’s not a matter of “oversight”.  Instead, the Trump Admin issued an Executive Order in February re:  use of federal dollars for individuals who are in the country illegally.  CMS is now moving to implement the Order.

(CMS Announcement, 5/27/25)

CMS Increasing Oversight on States Illegally Using Federal Medicaid Funding for Health Care for Illegal Immigrants

The Centers for Medicare & Medicaid Services (CMS) announced today increased federal oversight to stop states from misusing federal Medicaid dollars to cover health care for individuals who are in the country illegally. Under federal law, federal Medicaid funding is generally only available for emergency medical services for noncitizens with unsatisfactory immigration status who would otherwise be Medicaid-eligible, but some states have pushed the boundaries, putting taxpayers on the hook for benefits that are not allowed.

“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” said CMS Administrator Dr. Mehmet Oz. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice—CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”

As part of the action, CMS is ramping up financial oversight across the board to identify and stop improper spending. This includes:

• Focused evaluations of select state Medicaid spending reports (CMS-64 form submissions);
• In-depth reviews of select states’ financial management systems; and
• Assessing existing eligibility rules and policies to close loopholes and strengthen enforcement.

“Medicaid funds must serve American citizens in need and those legally entitled to benefits,” said CMS Deputy Administrator and Director of the Center for Medicaid & CHIP Services Drew Snyder. “If states cannot or will not comply, CMS will step in.”

CMS is also urging all states to immediately examine and update internal controls, eligibility systems, and cost allocation policies to ensure full compliance with federal law. Any improper spending on noncitizens will be subject to recoupment of the federal share.

This effort aligns with President Trump’s broader focus to restore integrity to federal programs, secure the border, and put Americans first. CMS will continue to act decisively to ensure Medicaid dollars serve their true purpose—protecting people eligible for the program under federal law.