WASHINGTON—Democrats challenged Health and Human Services Secretary Alex Azar to explain the Trump administration’s attempt to cut Medicaid funding in the proposed fiscal 2021 budget, which they said would further undermine health care coverage, at a Senate Finance Committee hearing Thursday.
President Trump’s proposed budget released Monday calls for cuts in Medicaid and Affordable Care Act spending by $1 trillion over the next decade. In the proposal, the administration said the “allowance for the President’s health reform vision” would protect those with pre-existing conditions, prioritize federal resources for the most vulnerable and provide assistance for low-income people, while saving $844 billion over 10 years.
The budget would eliminate the ACA’s enhanced federal matching funding for the expansion of Medicaid coverage to low-income adults, which could lead states to drop Medicaid expansion and put 17 million Americans at risk of losing coverage, Sen. Maggie Hassan, D-N.H., said.
“How does an almost one trillion dollar cut square with our understanding that Medicaid saves dollars and saves lives?” Hassan said. “Your budget doesn’t slow the Medicaid growth rate by addressing the rising cost of health care, it does so by cutting funding and eliminating access to coverage.”
Azar said the budget proposal allows for the administration to work with Congress to address how to fix “perverse incentives” in the Medicaid expansion program, including ones that prioritize able-bodied adults over children and pregnant women.
“Part of the budget is to restore the focus and make sure Medicaid is there for them,” Azar said.
According to the Center for Budget and Policy Priorities, the proposal would make access to Medicaid more difficult through allowing states to require more paperwork from children and adults seeking coverage.
The administration has backed a lawsuit brought by 18 states seeking to strike down the ACA. But Democrats said the budget proposal does not include specific provisions for people who were protected under the act, especially those with pre-existing conditions. Sen. Bob Menendez, D-N.J., questioned Azar on the administration’s plan if the act is struck down, as millions would lose health care coverage and protections.
“I have yet to see one plan that the administration has put forward over the health care of millions of Americans,” Menendez said. “Why would you wait with the health care of millions of Americans and their fate to see what the court decides? Why would you wait until there’s a disaster to then deal with the millions of Americans who don’t have health care insurance?”
Azar said the administration will not comment on possible plans until the lawsuits are decided, saying “these are hypotheticals at this point.”
“These are hypotheticals we don’t play with,” Menendez said. “This is not some abstract consequence if it happens.”