Mr. Trump’s proposed budget for fiscal year 2021 makes cuts to Medicare, Medicaid, Social Security and other safety nets which initially he had pledged to leave intact. His proposals must be passed by Congress and that action is doubtful but his actions speak to his lack of commitment to support any segment of the population needing aid. His proposed Medicaid cuts amount to 1 trillion dollars over ten years and jeopardize insurance eligibility to an estimated 13 million and otherwise compromising care. He would cut the subsidies to the states, initiated in the ACA, to expand Medicaid to those making somewhat more than the poverty level. Currently the federal government pays 90% of these costs. Since the federal government supports the states with the ACA, imposing a work requirement would reduce the number of people receiving Medicaid and allow the Trump administration to justify cutting the budget. Medicaid work requirements, mandates made by states, would also save the federal government an estimated 152 million though that figure has been contested by experts who say it would be nowhere that amount. Several states initiated a work requirement and others suspended them pending a court decision on their legality. Ten states initiated work requirements. On February 13th a US Court of Appeals upheld a lower court ruling against an Arkansas and Kentucky mandate requiring 80 hours of work for 30-49 year olds. Kentucky’s newly elected Democratic governor had withdrawn its work requirement pending the court ruling. Twenty states have pending or proposed work requirements. Other states, such as Indiana, have anticipated instituting work requirements and likely will not pursue them given the recent decision. Trump supports a pending Texas law which would eliminate the ACA altogether leaving many uncovered, priced out, or ineligible due to pre-existing conditions.
Trump’s proposals for the Medicare program would have hospitals receiving the same pay rate for services that doctors’ offices receive, which is a reduced price. This leads to the fear that Medicare recipients will be denied treatment. Other proposed cuts have targeted the food assistance program known as SNAP; opioid and mental health services; protection for student loan forgiveness, cuts for disabilities; and the children’s health program known as CHIPS.
Trump’s 4.8 trillion dollar proposed budget eats away at multiple programs constituting the federal safety net putting more pressure on the states to finance programs and jeopardizing the health and healthcare of multiple millions of vulnerable individuals and families. Trump’s justification for supporting work requirements depends on his belief that work contributes to a healthier life thus denying the reality that some people who cannot work will be cast off the Medicaid rolls. Low reimbursement will exacerbate an already lean set of provider choices for those who need federal aid in seeking health care. Additionally, should a state be successful in ending the ACA countless people will return to an uninsured status. Trump’s proposed cuts of 844 billion dollars in health care are “necessary’ to compensate for his cuts in taxes by the wealthy. He couches some of his cuts in healthcare as an effort “modernize,” while calling additional cuts to federal employee benefits and health care an effort to “modify” the system. His cuts to help student loan forgiveness programs and disability eligibilities he has called “reforms”. The Democratics will not pass the bill, as is, seeing it for the cruel effort it represents to save money of the backs of the neediest. The federal budget deficit has grown under Trump, as a result of this economic and tax policies, and represents the largest figure since the last year of the recession recovery year. Tax cuts have disproportionately accrued to the top 5% of households who gained 36.5% of the tax benefits.
- https://indivisible.org/ An organization listing grass roots groups across the country seeking to defeat Trump in 2020.