Maryland’s two U.S. senators are sounding the alarm about potential Medicaid cuts currently in the Republican budget bill that may come up for a vote this week in the Senate.
The bill, which cuts $880 billion from Medicaid over a decade, shrinks the amount of people eligible for care, imposes work requirements and forces people to re-enroll for benefits more often, could come up for a vote as soon as this week.
“Those are lots of big numbers, but they boil down to one simple truth, which is that Medicaid helps families stay healthy, and it helps families stay out of poverty and the bottom line is it saves lives,” Sen. Chris Van Hollen (D-Md.) told reporters Tuesday. “It will slash health coverage for at least 16 million people nationwide.”
It could also lead to people missing regular tests, fill up ERs and cause thousands of preventable deaths, according to a new study in the Annals in Internal Medicine.
KFF, a health research organization, estimates more than 420,000 Marylanders will lose coverage if the bill is signed into law.
“If people wind up getting kicked off of Medicaid, that could mean potentially hundreds of thousands of people were unable to go to the doctor, unable to treat chronic illnesses,” said Christopher Myer is a research analyst at the Maryland Center on Economic Policy. “It'll also have a broader impact on our economy. Federal dollars that flow through the state budget then wind up going into families pockets, and then they cycle that back into the economy by spending it on local businesses. That would actually reduce sales at local businesses and have a ripple impact of actually reducing state GDP.”
Estimates show that cuts like that would put $16 billion of unexpected costs onto Maryland over the next ten years, according to KFF.
“The federal government pays 90% and the states pay 10%,” said Liz Williams is a senior policy manager at KFF, a nonprofit that focuses on health strategy. “One of the proposals on the table is to lower that enhanced federal match rate for the expansion population down to the standard match rate and that means that would shift substantial costs to states.”
State lawmakers are trying to preempt federal cuts with trigger laws built into the state budget in hopes of keeping the deficit from ballooning as federal funding becomes more ambiguous.
This year’s budget has a trigger built into it that could bring back the General Assembly for a special session if the state loses $1 billion in total federal funding.
“We want to be prepared with the Trump triggers, but we don't want to prejudge what's going to happen, because we don't know how much of it's going to be in education, how much is going to be in health care, how much is going to be in agriculture, how it's going to be in public safety,” said Maryland state Sen. Jim Rosapepe, the vice chair of the Budget and Taxation Committee. “The federal government supports states across a huge range of activities now some are bigger than others.”
Lawmakers are also looking for ways to give Marylanders who may lose Medicaid time to find new insurance if the state is unable to find a way to make up the deficit.
Meanwhile, insurers offering plans on the state ACA marketplace are already threatening to raise premium prices because of the cuts.
The companies are proposing a 17% average hike for premiums next year, stating the loss of the credits as a major factor in losing potential customers due to the loss of the federal tax credits for ACA plans.
With the loss of the credits, the Congressional Budget Office estimates that “the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026–2034 period.”
If Congress does not get rid of the credits, premium rates in Maryland will increase an average of 8%, according to the Maryland Insurance Administration. That number is more in line with years past.
About 500,000 Marylanders use ACA plans for insurance.
