Senate amendment leaves $880 billion in cuts that would likely target Medicaid

Photo: Michael Duva/Getty Images

Congress is plowing ahead toward a budget reconciliation process ahead of its two-week recess starting on April 10.

Troubling for hospitals is a Senate amendment to a House budget resolution introduced by Senate Budget Committee Chairman Sen. Lindsey Graham, R-S.C., on Wednesday. 

"Of note," the American Hospital Association said on Wednesday, "the Senate amendment leaves unchanged the instruction for the House Energy and Commerce Committee to cut a minimum of $880 billion in spending."

The cuts would be expected to target Medicaid, as the Energy and Commerce Committee has primary jurisdiction over that program. The Congressional Budget Office has indicated that the $880 billion target could not be reached without slashing Medicaid.

The House and Senate must pass a common budget resolution to move forward with the reconciliation process. 

Graham's compromise resolution blends separate versions passed by the House and Senate earlier this year. If his amended budget resolution for fiscal year 2025 is approved by both the House and Senate, it would allow for a reconciliation process that bypasses the Senate's 60-vote filibuster rule with a simple majority.

WHY THIS MATTERS

Cuts in Medicaid would likely mean that many beneficiaries would lose coverage, leading to more uncompensated care for hospitals.

State treasurers from four states recently warned that most people who lost Medicaid coverage would not get other health insurance due to the cost, such as through plans available on the Affordable Care Act marketplace.

Without Medicaid, most would have no insurance at all, said Oregon State Treasurer Elizabeth Steiner. 

THE LARGER TREND

The Senate budget resolution also would increase the debt limit by $5 trillion, which is $1 trillion more than what was in the House budget resolution.

The Senate has already approved one version of the budget resolution -- which involved a grinding, all-night series of amendments known as vote-a-rama -- and the chamber is preparing to do it a second time as soon as this week, according to Politico.

The AHA has faced the proposed $880 billion in cuts since the last round of deliberations for a continuing resolution that passed in March to avoid a government shutdown.

AHA President and CEO Rick Pollack said by statement in February: "As the Senate and House Budget Committees begin deliberations on their Fiscal Year 2025 budget resolutions, the American Hospital Association urges Congress to take seriously the impact of reductions in healthcare programs, particularly Medicaid. While some have suggested dramatic reductions in the Medicaid program as part of a reconciliation vehicle, we would urge Congress to reject that approach. Medicaid provides health care to many of our most vulnerable populations, including pregnant women, children, the elderly, disabled and many of our working class." 

Email the writer: SMorse@himss.org