{"id":42257,"date":"2025-05-14T03:12:17","date_gmt":"2025-05-14T08:12:17","guid":{"rendered":"https:\/\/ustower.net\/?p=42257"},"modified":"2025-05-14T03:16:34","modified_gmt":"2025-05-14T08:16:34","slug":"thicket-of-red-tape-for-medicaid-in-gop-bill-sparks-fears-of-coverage-losses","status":"publish","type":"post","link":"https:\/\/ustower.net\/?p=42257","title":{"rendered":"‘Thicket of red tape’ for Medicaid in GOP bill sparks fears of coverage losses"},"content":{"rendered":"\n

Melannie Bachman, 39, of Charleston, South Carolina, is among the patients closely watching the sweeping Republican bill to overhaul Medicaid that\u2019s been brought to the House. She was diagnosed with triple-negative breast cancer<\/a> \u2014 an aggressive and difficult-to-treat form of the disease \u2014 in 2021. She said she had to apply for Medicaid multiple times and wasn\u2019t approved until four months later, which meant she had to pay for multiple screenings while waiting.<\/p>\n\n\n\n

Bachman no longer qualifies for Medicaid because she’s cancer-free. But she worries that the proposed revisions could make it harder for her or others in similar situations to get covered again, or even cause them to give up on the process altogether. <\/p>\n\n\n\n

Bachman is still within five years of her diagnosis, and her doctors tell her that it\u2019s essential for her to continue being monitored in case the cancer returns.<\/p>\n\n\n\n

\u201cIt\u2019s one of the hardest parts of this journey, besides fighting for your life,\u201d Bachman said of applying for Medicaid. \u201cThe application process, the figuring how and when to find coverage, being someone who had no coverage at all.\u201d <\/p>\n\n\n\n

As House Republicans on Tuesday haggled over parts of a bill that proposes deep cuts and new restrictions on Medicaid<\/a>, patients and doctors who rely on the program said they\u2019re bracing for the worst, including overwhelming red tape and administrative hurdles that could prevent many people from getting the care they need.<\/p>\n\n\n\n

The legislation, introduced Sunday by the Energy and Commerce Committee, proposes a slew of changes to the health program, such as work requirements, patient co-pays for doctor visits, tougher eligibility checks and citizenship verification. The panel began marking it up Tuesday and hopes to send it to the full House this week, with the goal of passing the entire bill by Memorial Day.<\/p>\n\n\n\n

The legislation could lead to 8.6 million people losing Medicaid coverage<\/a>, according to a preliminary estimate from the Congressional Budget Office. More than 70 million people currently get health coverage through the program.<\/p>\n\n\n\n

The changes would make some people ineligible for coverage due to work requirements. Certain groups, such as the disabled, pregnant women and people who are in prison or rehabilitation centers, would be exempt.<\/p>\n\n\n\n

Others \u2014 particularly those covered under the Affordable Care Act\u2019s Medicaid expansion \u2014 could be forced to drop out as they face higher fees and additional paperwork to maintain their coverage.<\/p>\n\n\n\n

Republicans say they\u2019re fine with the new rules \u2014 including Sen. Josh Hawley, R-Mo., who has publicly and repeatedly warned his party not to slash Medicaid benefits<\/a>.<\/p>\n\n\n\n

\u201cBased on the work requirement, anti-fraud provisions \u2014 there\u2019s going to be coverage losses associated with that, which I\u2019m OK with,\u201d Hawley told NBC News. Republicans are proposing cutting spending to states that allow immigrants without proof of citizenship to be on Medicaid.<\/p>\n\n\n\n

\u201cBut for people who are otherwise qualified, who are able bodied and are working and need Medicaid because they cannot otherwise afford health insurance, I just am opposed to cutting these people\u2019s benefits,\u201d he said.<\/p>\n\n\n\n

Asked if he worries the red tape could end up removing rightful Medicaid recipients from coverage, Hawley downplayed the prospect saying his priority is \u201cjust no benefit cuts.\u201d<\/p>\n\n\n\n

The Medicaid provisions are expected to save the government over $715 billion over 10 years, which Republicans intend to use to pay for an extension of President Donald Trump\u2019s 2017 tax cuts<\/a> before they expire at the end of this year.<\/p>\n\n\n\n

Democrats argue the added bureaucracy is a feature \u2014 not a bug \u2014 of the GOP plan.<\/p>\n\n\n\n

Sen. Ron Wyden, D-Ore., the ranking member of the Finance Committee that oversees Medicaid, said Republicans want to throw people off the program by putting recipients through \u201cbureaucratic water torture\u201d that many won\u2019t be able to navigate.<\/p>\n\n\n\n

\u201cThis whole thicket of red tape bureaucracy is being deployed in order to keep people who are eligible from getting covered,\u201d Wyden said in an interview. \u201cIt\u2019d be one thing if they had found a pattern of fraud and abuse, and they were trying to root it out. But what they\u2019re doing is they are targeting eligible people who are eligible for Medicaid now.\u201d<\/p>\n\n\n\n

\u201cI think it\u2019s really a despicable thing,\u201d he said.<\/p>\n\n\n\n

The bill, as it stood before Tuesday\u2019s markup, did leave out some of the more controversial ideas Republican leaders had discussed \u2014 including limits on how much Medicaid can spend per person and making states pay more for expanded coverage under the Affordable Care Act\u2019s Medicaid expansion, for which the federal government currently pays 90%.<\/p>\n\n\n\n

Dr. Adam Gaffney, a critical care physician and\u202fassistant professor of medicine at Harvard Medical School, said the proposed changes to eligibility, even the possibility of additional paperwork, will cause people to fall through the cracks and lose their coverage.<\/p>\n\n\n\n

\u201cYou don\u2019t need to be a doctor to realize that this is dangerous,\u201d Gaffney said. \u201cIf you\u2019re facing multiple medical problems, the last thing you need to do is try to get through a lot of red tape and jump through hoops and bureaucracy, and that\u2019s exactly what this legislation would do.\u201d<\/p>\n\n\n\n

People who want to work may not be able to<\/a> because of health issues, lack of childcare or limited transportation options. <\/p>\n\n\n\n

When people lose coverage, they typically have no other options, Gaffney said. He noted that in the early 2000s, when Tennessee implemented reforms to rein in Medicaid costs, thousands of people lost coverage.<\/p>\n\n\n\n

\u201cMost people who lost Medicaid went uninsured,\u201d he said. \u201cThe reality is Medicaid covers some of the lowest-income folks in the nation, and when they lose coverage, they\u2019re probably not going to be able to afford it.\u201d<\/p>\n\n\n\n

Likewise, in Georgia, following the implementation of Medicaid work requirements in 2023, fewer people chose to enroll, said Robin Rudowitz, director of the program on Medicaid and the uninsured at KFF, a health policy research group.<\/p>\n\n\n\n

\u201cBasically reporting and having to document that you\u2019re working, or even if you\u2019re a group that might be exempt from the requirements, sometimes it\u2019s just hard to document that you might be in one of those groups,\u201d she said. <\/p>\n\n\n\n

Sen. Cory Booker, D-N.J., said the new rules are part of a \u201ccruel\u201d and \u201ccraven\u201d plot.<\/p>\n\n\n\n

\u201cAny added bureaucracy will take people who are justifiably using these services and make it more difficult for them to get on, which will result in loss of coverage \u2014 again, for Americans who have sicknesses and illnesses,\u201d Booker said.<\/p>\n\n\n\n

Rudowitz said the bill proposes a provision that would require patient co-pays for people with incomes up to 130% to 138% of the federal poverty level\u2014 around $35,000 a year for a family of three<\/a>. There\u2019s also a provision, she said, that would reduce the amount the federal government gives states if they provide coverage for undocumented immigrants.<\/p>\n\n\n\n

If the bill clears the House, it goes to the Senate, where some Republicans are eying changes.<\/p>\n\n\n\n

Sen. Thom Tillis, R-N.C., who sits on the Finance Committee, said Republicans must take a close look at the new Medicaid rules and coverage impacts.<\/p>\n\n\n\n

\u201cThat\u2019s what we\u2019re going through now. A lot of that has to do with the semi-annual versus annual affirmation, that sort of stuff. We got a lot of mechanics to work out,\u201d said Tillis, who faces re-election next year in a purple state.<\/p>\n\n\n\n

Tillis also said he wants to review how many North Carolinians are among the 8.6 million projected to lose coverage. \u201cIf you look at that distribution across the country, it probably means sizable numbers in North Carolina,\u201d he said. \u201cThis false narrative that we\u2019re going to pick up that bill and pass it as proposed \u2014 we got a lot of work to do.\u201d<\/p>\n\n\n\n

Nbcnews<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Melannie Bachman, 39, of Charleston, South Carolina, is among the patients closely watching the sweeping Republican bill to overhaul Medicaid that\u2019s been brought to the House. She was diagnosed with triple-negative breast cancer \u2014 an aggressive and difficult-to-treat form of the disease \u2014 in 2021. She said she had to apply for Medicaid multiple times and wasn\u2019t […]<\/p>\n","protected":false},"author":7,"featured_media":42258,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5784],"tags":[2284,32524,3017,1580],"class_list":["post-42257","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-medicaid","tag-procedures","tag-reform-bill","tag-republicans"],"_links":{"self":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/42257","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=42257"}],"version-history":[{"count":1,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/42257\/revisions"}],"predecessor-version":[{"id":42259,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/42257\/revisions\/42259"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/media\/42258"}],"wp:attachment":[{"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42257"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=42257"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=42257"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}