Insurers and providers are collaborating to combat cuts to Medicaid
Republicans are aiming to secure billions in savings from the insurance program designed for low-income individuals in order to finance tax cuts.
TroibNews 
Republicans have succeeded in bringing together two typically opposing health industry sectors—insurers and hospitals—by threatening to cut Medicaid.
Lobbyists from both sectors, facing the potential loss of billions of dollars in fees, are urgently attempting to persuade lawmakers that millions of low-income Americans relying on the program will be adversely affected. Proposed cuts in a House Republican budget blueprint could reach $880 billion over the next decade, equating to over 10 percent of federal Medicaid spending.
For President Donald Trump and congressional Republicans, the budget bill remains the top legislative priority, as it would prolong tax cuts implemented in 2017 that are set to expire in January. GOP leaders in both the House and Senate are currently negotiating funding sources, with some expressing concern over the political implications.
Industry groups are emphasizing the argument that it’s the voters who will react even more vehemently than their respective businesses.
“It's really the sheer scale of it all that really is quite significant and harmful to the 70 million Americans who rely on the program,” said Clare Krusing, a spokesperson for the Modern Medicaid Alliance, a coalition comprising insurer and provider groups.
The collaboration of these two industries underscores the significant threat they face. With more uninsured individuals potentially needing care, hospitals are bracing for financial repercussions, while insurers worry about decreased enrollment in their plans.
Health care providers and their representatives are actively engaging with lawmakers on Capitol Hill. In March, more than 150 hospitals sent delegates to Washington, while also launching six-figure advertising campaigns in the D.C. media market urging lawmakers to avoid cuts.
“Medicaid’s an investment we simply can’t afford to lose,” stated Bill Gassen, president and CEO of Sanford Health, a South Dakota-based health system operating numerous locations across the upper Midwest.
House Republicans have contended that their goal is to eliminate inefficiencies in Medicaid and target waste and fraud, rather than cutting benefits.
“I’m not for cuts in Medicaid,” Florida GOP Rep. Vern Buchanan, chair of a key House panel considering the issue, remarked at PMG’s Health Care Summit last week. However, Buchanan also stressed the need for Congress to find savings within the program, stating that “there are a lot of inefficiencies” and emphasizing the necessity to find a way to “do things better for less.”
Democrats argue that the scale of cuts Republicans are contemplating would inevitably affect benefits.
If advocates from both industries successfully encourage lawmakers to retract Medicaid cuts, it will largely be due to their ability to convey that voters will hold them responsible, remarked Larry Bucshon, a Republican health care lobbyist at law firm Holland & Knight, who previously held a seat in the Indiana House.
“I don’t think the biggest push will come from the insurers and others. It will come from people’s constituents and patient advocates and people who are concerned about access to care,” said Bucshon, who served on the House committee charged with identifying potential cuts.
Advocacy groups representing both insurers and providers are actively recruiting new members and encouraging state leaders to voice their concerns. Some organizations are hiring lobbyists who have experience working with Republicans, employing strategies that helped thwart GOP efforts to repeal the Affordable Care Act during Trump’s first term.
“You have to be at a high level of engagement,” said Craig Kennedy, president and CEO of the Medicaid Health Plans of America, a trade group for insurers serving Medicaid patients. “The rubber hits the road through reconciliation and the specific provisions that they are seeking to enact, and that's where we have to dial it up to an 11.”
Some GOP representatives are beginning to feel the pressure.
In February, six lawmakers from districts with significant Medicaid populations wrote to House Speaker Mike Johnson urging caution regarding substantial cuts to the program.
“For many families across the country, Medicaid is their only access to healthcare,” they wrote, including Reps. Tony Gonzales and Monica De La Cruz of Texas; David Valadao of California; Juan Ciscomani of Arizona; Rob Bresnahan of Pennsylvania; and Nicole Malliotakis of New York.
While all of them eventually voted to approve the House’s budget plan, they did so only after Johnson assured them he would protect Medicaid enrollees’ benefits during discussions of where to achieve the $880 billion in savings.
Senate Republicans are similarly cautious about potential cuts, seeking to reassure constituents that savings will stem from eliminating waste, fraud, and abuse, rather than benefits.
“There are going to be some adjustments to it maybe, but I don’t think they are going to cut anything,” Sen. Tommy Tuberville remarked to PMG.
Other lawmakers have sidestepped inquiries about the specifics of Medicaid reforms. Bill Cassidy, the chair of the Senate health committee, previously mentioned to PMG that “the package cannot be judged except in its totality.”
However, Medicaid policy experts believe it’s difficult for Republicans to achieve the necessary savings without inflicting pain on enrollees or states that share Medicaid costs with the federal government. Congressional investigators have indicated that improper payments in the program would need to triple, and Republicans would need to recover all of it to reach the proposed $880 billion.
Democrats are strongly criticizing the GOP regarding potential cuts, with some viewing it as a critical legislative showdown for Trump’s second term.
“Cuts to Medicaid at the scale Republicans are directing will mean hospitals and clinics—especially in our rural areas—will close their doors,” Sen. Patty Murray recently informed reporters.
Facing off against the Democrats and the industry critics of Medicaid reductions is Republicans’ commitment to extending the 2017 tax cuts passed by a GOP Congress and signed into law by Trump.
Allowing these cuts to expire at the end of the year as currently scheduled would be seen by Republicans as an unthinkable failure.
In addition to combating waste and fraud, Republicans are weighing options such as imposing work requirements on Medicaid recipients, reducing the federal Medicaid match rate for states, capping Medicaid funding based on state populations, and decreasing the taxes states impose on providers—a policy often resulting in higher reimbursement rates for health systems.
The success of Republican efforts will hinge on their ability to control messaging, noted Bucshon.
“If programmatic changes are effectively framed politically as cuts to the program, it's more challenging,” he explained. “If it is framed as reform to the program, to actually strengthen the program, then maybe not as challenging.”
Jessica Kline for TROIB News
Lobbyists from both sectors, facing the potential loss of billions of dollars in fees, are urgently attempting to persuade lawmakers that millions of low-income Americans relying on the program will be adversely affected. Proposed cuts in a House Republican budget blueprint could reach $880 billion over the next decade, equating to over 10 percent of federal Medicaid spending.
For President Donald Trump and congressional Republicans, the budget bill remains the top legislative priority, as it would prolong tax cuts implemented in 2017 that are set to expire in January. GOP leaders in both the House and Senate are currently negotiating funding sources, with some expressing concern over the political implications.
Industry groups are emphasizing the argument that it’s the voters who will react even more vehemently than their respective businesses.
“It's really the sheer scale of it all that really is quite significant and harmful to the 70 million Americans who rely on the program,” said Clare Krusing, a spokesperson for the Modern Medicaid Alliance, a coalition comprising insurer and provider groups.
The collaboration of these two industries underscores the significant threat they face. With more uninsured individuals potentially needing care, hospitals are bracing for financial repercussions, while insurers worry about decreased enrollment in their plans.
Health care providers and their representatives are actively engaging with lawmakers on Capitol Hill. In March, more than 150 hospitals sent delegates to Washington, while also launching six-figure advertising campaigns in the D.C. media market urging lawmakers to avoid cuts.
“Medicaid’s an investment we simply can’t afford to lose,” stated Bill Gassen, president and CEO of Sanford Health, a South Dakota-based health system operating numerous locations across the upper Midwest.
House Republicans have contended that their goal is to eliminate inefficiencies in Medicaid and target waste and fraud, rather than cutting benefits.
“I’m not for cuts in Medicaid,” Florida GOP Rep. Vern Buchanan, chair of a key House panel considering the issue, remarked at PMG’s Health Care Summit last week. However, Buchanan also stressed the need for Congress to find savings within the program, stating that “there are a lot of inefficiencies” and emphasizing the necessity to find a way to “do things better for less.”
Democrats argue that the scale of cuts Republicans are contemplating would inevitably affect benefits.
If advocates from both industries successfully encourage lawmakers to retract Medicaid cuts, it will largely be due to their ability to convey that voters will hold them responsible, remarked Larry Bucshon, a Republican health care lobbyist at law firm Holland & Knight, who previously held a seat in the Indiana House.
“I don’t think the biggest push will come from the insurers and others. It will come from people’s constituents and patient advocates and people who are concerned about access to care,” said Bucshon, who served on the House committee charged with identifying potential cuts.
Advocacy groups representing both insurers and providers are actively recruiting new members and encouraging state leaders to voice their concerns. Some organizations are hiring lobbyists who have experience working with Republicans, employing strategies that helped thwart GOP efforts to repeal the Affordable Care Act during Trump’s first term.
“You have to be at a high level of engagement,” said Craig Kennedy, president and CEO of the Medicaid Health Plans of America, a trade group for insurers serving Medicaid patients. “The rubber hits the road through reconciliation and the specific provisions that they are seeking to enact, and that's where we have to dial it up to an 11.”
Some GOP representatives are beginning to feel the pressure.
In February, six lawmakers from districts with significant Medicaid populations wrote to House Speaker Mike Johnson urging caution regarding substantial cuts to the program.
“For many families across the country, Medicaid is their only access to healthcare,” they wrote, including Reps. Tony Gonzales and Monica De La Cruz of Texas; David Valadao of California; Juan Ciscomani of Arizona; Rob Bresnahan of Pennsylvania; and Nicole Malliotakis of New York.
While all of them eventually voted to approve the House’s budget plan, they did so only after Johnson assured them he would protect Medicaid enrollees’ benefits during discussions of where to achieve the $880 billion in savings.
Senate Republicans are similarly cautious about potential cuts, seeking to reassure constituents that savings will stem from eliminating waste, fraud, and abuse, rather than benefits.
“There are going to be some adjustments to it maybe, but I don’t think they are going to cut anything,” Sen. Tommy Tuberville remarked to PMG.
Other lawmakers have sidestepped inquiries about the specifics of Medicaid reforms. Bill Cassidy, the chair of the Senate health committee, previously mentioned to PMG that “the package cannot be judged except in its totality.”
However, Medicaid policy experts believe it’s difficult for Republicans to achieve the necessary savings without inflicting pain on enrollees or states that share Medicaid costs with the federal government. Congressional investigators have indicated that improper payments in the program would need to triple, and Republicans would need to recover all of it to reach the proposed $880 billion.
Democrats are strongly criticizing the GOP regarding potential cuts, with some viewing it as a critical legislative showdown for Trump’s second term.
“Cuts to Medicaid at the scale Republicans are directing will mean hospitals and clinics—especially in our rural areas—will close their doors,” Sen. Patty Murray recently informed reporters.
Facing off against the Democrats and the industry critics of Medicaid reductions is Republicans’ commitment to extending the 2017 tax cuts passed by a GOP Congress and signed into law by Trump.
Allowing these cuts to expire at the end of the year as currently scheduled would be seen by Republicans as an unthinkable failure.
In addition to combating waste and fraud, Republicans are weighing options such as imposing work requirements on Medicaid recipients, reducing the federal Medicaid match rate for states, capping Medicaid funding based on state populations, and decreasing the taxes states impose on providers—a policy often resulting in higher reimbursement rates for health systems.
The success of Republican efforts will hinge on their ability to control messaging, noted Bucshon.
“If programmatic changes are effectively framed politically as cuts to the program, it's more challenging,” he explained. “If it is framed as reform to the program, to actually strengthen the program, then maybe not as challenging.”
Jessica Kline for TROIB News
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