Latest news with #workrequirement
New York Times
4 days ago
- Business
- New York Times
Trump Administration Live Updates: Senate Republicans Propose Deeper Medicaid Cuts
The 549-page measure, released by the Senate Finance Committee, outlines changes to Medicaid that would be far more aggressive than the version passed in the House, making millions more Americans subject to a work requirement. Senate Republicans on Monday released legislation that would cut Medicaid far more aggressively than would the House-passed bill to deliver President Trump's domestic agenda, while also salvaging or slowing the elimination of some clean-energy tax credits, setting up a fight over their party's marquee policy package. The measure, released by the Senate Finance Committee, contains the core provisions of that chamber's version of the legislation that Republicans muscled through the House last month and are hoping to speed through the Senate and deliver to Mr. Trump's desk by July 4. But its differences with that bill are substantial and are all but certain to complicate the measure's path to enactment, casting doubt on that timetable. Most notably, the proposal would take a slower and less sweeping approach to phasing out clean-energy tax credits created during the Biden administration, and cover part of the cost of doing so by imposing deeper and more expansive cuts to Medicaid. While the House measure would add a new work requirement to Medicaid for childless adults, the Senate proposal would expand its application to the parents of older children. It also would crack down even harder than the House bill on strategies that many states have developed to tax medical providers and pay them higher prices for Medicaid services. In making the case for the bill, Republicans focused on another, far more politically popular element of the measure: its extension of tax cuts that were enacted in 2017 and are set to expire at the end of the year. Image A $7,500 tax credit for buyers of electric cars would phase out immediately within 180 days of the bill passing into law. Credit... Lauren Justice for The New York Times 'This bill prevents an over-$4 trillion tax hike and makes the successful 2017 Trump tax cuts permanent, enabling families and businesses to save and plan for the future,' Senator Mike Crapo of Idaho, the chairman of the Finance Committee, said in a statement. 'I look forward to continued coordination with our colleagues in the House and the administration to deliver President Trump's bold economic agenda for the American people as quickly as possible. But the changes in the Senate bill could make final passage in the House more difficult. After pushing the bill through the House by a single vote, Speaker Mike Johnson had implored senators repeatedly not to make major changes, reminding them that he is working with narrow margins. At least two factions of House Republicans on Monday said they were disappointed with the Senate provisions. Senators have yet to decide how to handle the limit on the state and local tax deduction, angering House lawmakers from high-tax states who are lobbying to raise the cap, and who have demanded that senators accept the higher one they negotiated. The House-passed bill would quadruple the current $10,000 limit. The cap would shrink for people making more than $500,000. The proposal also drew the ire of conservatives in the House who want to entirely phase out the clean-energy tax credits created by President Joseph R. Biden Jr.'s climate law. 'That's not close to enough,' Representative Chip Roy of Texas wrote on social media, describing the measure's attempt to balance additional Medicaid cuts against salvaging some tax credits into the next decade. The climate law 'needs to be terminated as President Trump said.' But much of the focus is likely to center on the Senate's Medicaid work requirement. The changes add to a House bill that already made around $1 trillion in cuts to spending on federal health programs, including Medicaid and marketplaces established under Obamacare, which together the Congressional Budget Office has estimated would cause around 11 million more Americans to be uninsured in 2034. 'The Republican Senate Finance draft cuts to Medicaid are deeper and more devastating than even the Republican House's disaster of a bill,' Senator Chuck Schumer, Democrat of New York and the minority leader, said in a statement. Unlike the House version, the Senate bill would require adults with children over age 14 to work or volunteer at least 80 hours a month to qualify for the health insurance program. The work requirement in the House bill was already the strictest Republicans have ever proposed — estimated to cause around 5.2 million Americans to lose Medicaid coverage by the end of the decade. Adding parents to the program would likely mean a larger number of people would lose coverage. The bill also would lower federal funding to many states that have expanded their Medicaid programs through a complicated formula adjustment. The change would limit how much states are allowed to tax certain health care providers from a cap of 6 percent to a new top rate of 3.5 percent, with the change phasing in over several years. The taxes, which are used in every state but Alaska, have allowed states to increase federal funding for their programs. They have been decried by critics as a form of 'money laundering,' but the reduction would mean significant holes in state Medicaid budgets, and could result in lower payments to hospitals or other cuts to state budgets. Like the House measure, the Senate bill would quickly end many federal tax credits for clean energy, but it phases out a few others more slowly. Some Republican senators, including Lisa Murkowski of Alaska, Thom Tillis of North Carolina, and John Curtis of Utah, had expressed concerns that the House bill would withdraw support from energy companies too abruptly. A lucrative tax credit for businesses that build wind and solar farms would begin rapidly winding down. Companies could qualify for the full tax break if they begin construction this year, 60 percent of the tax break if they begin in 2026 and 20 percent of the tax credit if they begin in 2027. After that, the credit would disappear. That's a slightly longer runway for renewable energy than allowed by the House bill, which would have ended these tax breaks almost immediately. But it is a much quicker phaseout than many clean-energy proponents had pushed for. In another notable change, the Senate bill would preserve existing tax credits for companies that build nuclear reactors, geothermal plants, hydropower dams or battery storage through 2033. Energy Secretary Chris Wright and some companies had urged Congress to keep credits for so-called base load electricity sources that can operate at all hours, unlike wind and solar power. Other tax breaks would end almost immediately: A $7,500 tax credit for buyers of electric cars would phase out within 180 days of the bill's enactment. Tax credits for homeowners who install solar panels on their rooftops or install heat pumps would also end within that time frame. A subsidy for making hydrogen fuels would expire this year. The Senate measure, like the House version, also adds new restrictions on tax breaks for both power plants and factories that build solar panels, batteries or other low-carbon technologies by disqualifying companies that use certain components from China. Many companies had complained that the House language on 'foreign entities of concern' was far too restrictive, since China dominates global supply chains. While the Senate version makes numerous adjustments, industry groups said they were still reviewing the new language. The measure looks to deliver on the president's promises to eliminate taxes on tips and overtime pay, but would make some key tweaks. The amount that individuals could claim is capped under each, and the benefits are phased out starting at new income levels. The House version of the legislation sought to make good on Mr. Trump's campaign promise to eliminate taxes on Social Security benefits by instead creating a bonus $4,000 deduction available to Americans 65 and older, with the benefit shrinking at higher income levels. The Senate bill would grant them a $6,000 tax deduction. The child tax credit is also handled differently. Senate Republicans proposed to permanently increase the credit to $2,200 per child beginning in the 2025 tax year. House Republicans had proposed to bump up the credit to $2,500, but only through 2028. It also would grant some of businesses's most sought-after tax deductions, including for research and development, on a permanent basis, unlike the House bill. The provisions proposed by the Senate would increase the debt limit by $5 trillion; the House-passed bill called for lifting it by $4 trillion, a move that was expected to allow the nation to continue borrowing money through the 2026 midterm elections.
CBS News
6 days ago
- Health
- CBS News
Medicaid enrollees fear losing health coverage if Congress enacts work requirements
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition. Strickland, who's unable to work due to her condition, chafed when she learned that the U.S. House had passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people. "What sense does that make?" she asked. "What about the people who can't work but can't afford a doctor?" The measure is part of the version of President Donald Trump's "Big Beautiful" bill that cleared the House last month and is now up for consideration in the Senate. Trump is seeking to have it passed by July 4. The bill, as it stands, would cut taxes and government spending — and also upend portions of the nation's social safety net. For proponents, the ideas behind the work requirement are simple: Crack down on fraud and stand on the principle that taxpayer-provided health coverage isn't for those who can work but aren't. The measure includes exceptions for those who are under 19 or over 64, those with disabilities, pregnant women, main caregivers for young children, people recently released from prisons or jails, or during certain emergencies. It would apply only to adults who receive Medicaid through expansions that 40 states chose to undertake as part of the 2010 health insurance overhaul. Many details of how the changes would work would be developed later, leaving several unknowns and causing anxiety among recipients who worry that their illnesses might not be enough to exempt them. Advocates and sick and disabled enrollees worry, based largely on their experience, that even those who might be exempted from work requirements under the law could still lose benefits because of increased or hard-to-meet paperwork mandates. Strickland, a 44-year-old former server, cook, and construction worker who lives in Fairmont, North Carolina, said she could not afford to go to a doctor for years because she wasn't able to work. She finally received a letter this month saying she would receive Medicaid coverage, she said. "It's already kind of tough to get on Medicaid," said Strickland, who has lived in a tent and times and subsisted on nonperishable food thrown out by stores. "If they make it harder to get on, they're not going to be helping." Steve Furman is concerned that his 43-year-old son, who has autism, could lose coverage. The bill the House adopted would require Medicaid enrollees to show that they work, volunteer or go to school at least 80 hours a month to continue to qualify. A disability exception would likely apply to Furman's son, who previously worked in an eyeglasses plant in Illinois for 15 years despite behavioral issues that may have gotten him fired elsewhere. Furman said government bureaucracies are already impossible for his son to navigate, even with help. It took him a year to help get his son onto Arizona's Medicaid system when they moved to Scottsdale in 2022, and it took time to set up food benefits. But he and his wife, who are retired, say they don't have the means to support his son fully. "Should I expect the government to take care of him?" he asked. "I don't know, but I do expect them to have humanity." About 71 million adults are enrolled in Medicaid now. And most of them — around 92% — are working, caregiving, attending school or disabled. Earlier estimates of the budget bill from the Congressional Budget Office found that about 5 million people stand to lose coverage. A KFF tracking poll conducted in May found that the enrollees come from across the political spectrum. About one-fourth are Republicans; roughly one-third are Democrats. The poll found that about 7 in 10 adults are worried that federal spending reductions on Medicaid will lead to more uninsured people and would strain health care providers in their area. About half said they were worried reductions would hurt their ability or their family to get and pay for health care. Amaya Diana, an analyst at KFF, points to work requirements launched in Arkansas and Georgia as keeping people off Medicaid without increasing employment. Amber Bellazaire, a policy analyst at the Michigan League for Public Policy, said the process to verify that Medicaid enrollees meet the work requirements could be a key reason people would be denied or lose eligibility. "Massive coverage losses just due to an administrative burden rather than ineligibility is a significant concern," she said. One KFF poll respondent, Virginia Bell, a retiree in Starkville, Mississippi, said she's seen sick family members struggle to get onto Medicaid, including one who died recently without coverage. She said she doesn't mind a work requirement for those who are able, but worries about how that would be sorted out. "It's kind of hard to determine who needs it and who doesn't need it," she said. Lexy Mealing, 54 of Westbury, New York, who was first diagnosed with breast cancer in 2021 and underwent a double mastectomy and reconstruction surgeries, said she fears she may lose the medical benefits she has come to rely on, though people with "serious or complex" medical conditions could be granted exceptions. She now works about 15 hours a week in "gig" jobs but isn't sure she can work more as she deals with the physical and mental toll of the cancer. Mealing, who used to work as a medical receptionist in a pediatric neurosurgeon's office before her diagnosis and now volunteers for the American Cancer Society, went on Medicaid after going on short-term disability. "I can't even imagine going through treatments right now and surgeries and the uncertainty of just not being able to work and not having health insurance," she said. Felix White, who has Type I diabetes, first qualified for Medicaid after losing his job as a computer programmer several years ago. The Oreland, Pennsylvania, man has been looking for a job, but finds that at 61, it's hard to land one. Medicaid, meanwhile, pays for a continuous glucose monitor and insulin and funded foot surgeries last year, including one that kept him in the hospital for 12 days. "There's no way I could have afforded that," he said. "I would have lost my foot and probably died." ___ Associated Press writer Susan Haigh in Hartford, Connecticut, contributed to this article.
Washington Post
6 days ago
- Health
- Washington Post
Medicaid enrollees fear losing health coverage if Congress enacts work requirements
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition. Strickland, who's unable to work due to her condition, chafed when she learned that the U.S. House has passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people.
Associated Press
6 days ago
- Health
- Associated Press
Medicaid enrollees fear losing health coverage if Congress enacts work requirements
It took Crystal Strickland years to qualify for Medicaid, which she needs for a heart condition. Strickland, who's unable to work due to her condition, chafed when she learned that the U.S. House has passed a bill that would impose a work requirement for many able-bodied people to get health insurance coverage through the low-cost, government-run plan for lower-income people. 'What sense does that make?' she asked. 'What about the people who can't work but can't afford a doctor?' The measure is part of the version of President Donald Trump's 'Big Beautiful' bill that cleared the House last month and is now up for consideration in the Senate. Trump is seeking to have it passed by July 4. The bill as it stands would cut taxes and government spending — and also upend portions of the nation's social safety net. For proponents, the ideas behind the work requirement are simple: Crack down on fraud and stand on the principle that taxpayer-provided health coverage isn't for those who can work but aren't. The measure includes exceptions for those who are under 19 or over 64, those with disabilities, pregnant women, main caregivers for young children, people recently released from prisons or jails — or during certain emergencies. It would apply only to adults who receive Medicaid through expansions that 40 states chose to undertake as part of the 2010 health insurance overhaul. Many details of how the changes would work would be developed later, leaving several unknowns and causing anxiety among recipients who worry that their illnesses might not be enough to exempt them. Advocates and sick and disabled enrollees worry — based largely on their past experience — that even those who might be exempted from work requirements under the law could still lose benefits because of increased or hard-to-meet paperwork mandates. Benefits can be difficult to navigate even without a work requirement Strickland, a 44-year-old former server, cook and construction worker who lives in Fairmont, North Carolina, said she could not afford to go to a doctor for years because she wasn't able to work. She finally received a letter this month saying she would receive Medicaid coverage, she said. 'It's already kind of tough to get on Medicaid,' said Strickland, who has lived in a tent and times and subsisted on nonperishable food thrown out by stores. 'If they make it harder to get on, they're not going to be helping.' Steve Furman is concerned that his 43-year-old son, who has autism, could lose coverage. The bill the House adopted would require Medicaid enrollees to show that they work, volunteer or go to school at least 80 hours a month to continue to qualify. A disability exception would likely apply to Furman's son, who previously worked in an eyeglasses plant in Illinois for 15 years despite behavioral issues that may have gotten him fired elsewhere. Furman said government bureaucracies are already impossible for his son to navigate, even with help. It took him a year to help get his son onto Arizona's Medicaid system when they moved to Scottsdale in 2022, and it took time to set up food benefits. But he and his wife, who are retired, say they don't have the means to support his son fully. 'Should I expect the government to take care of him?' he asked. 'I don't know, but I do expect them to have humanity.' There's broad reliance on Medicaid for health coverage About 71 million adults are enrolled in Medicaid now. And most of them — around 92% — are working, caregiving, attending school or disabled. Earlier estimates of the budget bill from the Congressional Budget Office found that about 5 million people stand to lose coverage. A KFF tracking poll conducted in May found that the enrollees come from across the political spectrum. About one-fourth are Republicans; roughly one-third are Democrats. The poll found that about 7 in 10 adults are worried that federal spending reductions on Medicaid will lead to more uninsured people and would strain health care providers in their area. About half said they were worried reductions would hurt the ability of them or their family to get and pay for health care. Amaya Diana, an analyst at KFF, points to work requirements launched in Arkansas and Georgia as keeping people off Medicaid without increasing employment. Amber Bellazaire, a policy analyst at the Michigan League for Public Policy, said the process to verify that Medicaid enrollees meet the work requirements could be a key reason people would be denied or lose eligibility. 'Massive coverage losses just due to an administrative burden rather than ineligibility is a significant concern,' she said. One KFF poll respondent, Virginia Bell, a retiree in Starkville, Mississippi, said she's seen sick family members struggle to get onto Medicaid, including one who died recently without coverage. She said she doesn't mind a work requirement for those who are able — but worries about how that would be sorted out. 'It's kind of hard to determine who needs it and who doesn't need it,' she said. Some people don't if they might lose coverage with a work requirement Lexy Mealing, 54 of Westbury, New York, who was first diagnosed with breast cancer in 2021 and underwent a double mastectomy and reconstruction surgeries, said she fears she may lose the medical benefits she has come to rely on, though people with 'serious or complex' medical conditions could be granted exceptions. She now works about 15 hours a week in 'gig' jobs but isn't sure she can work more as she deals with the physical and mental toll of the cancer. Mealing, who used to work as a medical receptionist in a pediatric neurosurgeon's office before her diagnosis and now volunteers for the American Cancer Society, went on Medicaid after going on short-term disability. 'I can't even imagine going through treatments right now and surgeries and the uncertainty of just not being able to work and not have health insurance,' she said. Felix White, who has Type I diabetes, first qualified for Medicaid after losing his job as a computer programmer several years ago. The Oreland, Pennsylvania, man has been looking for a job, but finds that at 61, it's hard to land one. Medicaid, meanwhile, pays for a continuous glucose monitor and insulin and funded foot surgeries last year, including one that kept him in the hospital for 12 days. 'There's no way I could have afforded that,' he said. 'I would have lost my foot and probably died.' ___ Associated Press writer Susan Haigh in Hartford, Connecticut contributed to this article.
Associated Press
09-06-2025
- Health
- Associated Press
Georgia's experience raises red flags for Medicaid work requirement moving through Congress
ATLANTA (AP) — Georgia's experiment with a work requirement for Medicaid offers a test of a similar mandate Republicans in Congress want to implement nationally, and advocates say the results so far should serve as a warning. Just days shy of its two-year anniversary, the Georgia Medicaid program is providing health coverage to about 7,500 low-income residents, up from 4,300 in the first year, but far fewer than the estimated 240,000 people who could qualify. The state had predicted at least 25,000 enrollees in the first year and nearly 50,000 in the second year. Applicants and beneficiaries have faced technical glitches and found it nearly impossible at times to reach staff for help, despite more than $50 million in federal and state spending on computer software and administration. The program, dubbed Georgia Pathways, had a backlog of more than 16,000 applications 14 months after its July 2023 launch, according to a renewal application Georgia submitted to the Trump administration in April. 'The data on the Pathways program speaks for itself,' said Laura Colbert, executive director of Georgians for a Healthy Future, an advocacy group that has called for a broader expansion of Medicaid without work requirements. 'There are just so many hurdles at every step of the way that it's just a really difficult program for people to enroll in and then to stay enrolled in too.' Georgia's rules A tax and spending bill backed by President Donald Trump and Republican lawmakers that passed the U.S. House in May would require many able-bodied Medicaid enrollees under 65 to show that they work, volunteer or go to school. The bill is now in the Senate, where Republicans want significant changes. Pathways requires beneficiaries to perform 80 hours a month of work, volunteer activity, schooling or vocational rehabilitation. It's the only Medicaid program in the nation with a work requirement. But Georgia recently stopped checking each month whether beneficiaries were meeting the mandate. Colbert and other advocates view that as evidence that state staff was overburdened with reviewing proof-of-work documents. Fiona Roberts, a spokeswoman for the state Department of Community Health, said Gov. Brian Kemp has mandated that state agencies 'continually seek ways to make government more efficient and accessible.' Georgia's governor defends Pathways The governor's office defended the enrollment numbers. Kemp spokesman Garrison Douglas said the early projections for Pathways were made in 2019, when the state had a much larger pool of uninsured residents who could qualify for the program. In a statement, Douglas credited the Republican governor with bringing that number down significantly through 'historic job growth,' and said the decline in uninsured residents proved 'the governor's plan to address our healthcare needs is working.' For BeShea Terry, Pathways was a 'godsend.' After going without insurance for more than a year, Terry, 51, said Pathways allowed her to get a mammogram and other screening tests. Terry touts Pathways in a video on the program's website. But in a phone interview with The Associated Press, she said she also experienced problems. Numerous times, she received erroneous messages that she hadn't uploaded proof of her work hours. Then in December, her coverage was abruptly canceled — a mistake that took months of calls to a caseworker and visits to a state office to resolve, she said. 'It's a process,' she said. 'Keep continuing to call because your health is very important.' Health advocates say many low-income Americans may not have the time or resources. They are often struggling with food and housing needs. They are also more likely to have limited access to the internet and work informal jobs that don't produce pay stubs. Republican lawmakers have promoted work requirements as a way to boost employment, but most Medicaid recipients already work, and the vast majority who don't are in school, caring for someone, or sick or disabled. Kemp's administration has defended Pathways as a way to transition people to private health care. At least 1,000 people have left the program and obtained private insurance because their income increased, according to the governor's office. After a slow start, advertising and outreach efforts for Pathways have picked up over the last year. At a job fair in Atlanta on Thursday, staff handed out information about the program at a table with mints, hand sanitizer and other swag with the Pathways' logo. A wheel that people could spin for a prize sat on one end. Since Pathways imposed the work requirement only on newly eligible state residents, no one lost coverage. The Arkansas experiment That's a contrast with Arkansas, where 18,000 people were pushed off Medicaid within the first seven months of a 2018 work mandate that applied to some existing beneficiaries. A federal judge later blocked the requirement. The bill that passed the U.S. House would likely cause an estimated 5.2 million people to lose health coverage, according to an analysis from the nonpartisan Congressional Budget Office released Wednesday. Arkansas Republican Gov. Sarah Huckabee Sanders has proposed reviving the work mandate but without requiring people to regularly report employment hours. Instead, the state would rely on existing data to determine enrollees who were not meeting goals for employment and other markers and refer those people to coaches before any decision to suspend them. Arkansas is among at least 10 states pursuing work requirements for their Medicaid programs separate from the effort in Congress. Republican state Sen. Missy Irvin said Arkansas' new initiative aims to understand who the beneficiaries are and what challenges they face. 'We want you to be able to take care of yourself and your family, your loved ones and everybody else,' Irvin said. 'How can we help you? Being a successful individual is a healthy individual.' ___ Associated Press writers Jonathan Mattise in Nashville, Tennessee, Andrew DeMillo in Little Rock, Arkansas, and Geoff Mulvihill in Philadelphia contributed to this report.
