WASHINGTON (news agencies) — Roughly 11.8 million adults and children will be at risk for losing health insurance if Republicans’ domestic policy package becomes a law.
The losses won’t come all at once. The GOP’s “ One Big, Beautiful Bill Act ” makes changes that will whittle away at enrollment through federal health care programs like Medicaid and Obamacare over a decade in order to wrest nearly $1 trillion from Medicaid, the Affordable Care Act, and the Children’s Health Insurance Program.
The bill is likely to reverse years of escalating health insurance rates in the U.S., gains that have also been marked by record spending on federally-funded health care coverage. Roughly 78 million adults and children are enrolled in Medicaid’s programs while 24 million people are enrolled in the ACA’s marketplaces.
Medicaid is a joint federal-state venture that is administered by the states. The program goes by different names in some states, like Medi-Cal in California, BadgerCare in Wisconsin, or MassHealth in Massachusetts.
A look at some of the ways in which people may lose health care coverage under the GOP’s plan:
Under the GOP’s plan, states will need to verify a person’s income to check Medicaid eligibility every six months.
People who are homeless or transient may miss notices from the government to fill out paperwork more frequently, said Martha Santana-Chin, the CEO of L.A. Care Health Plan, which provides Medicaid for millions of Los Angelenos. They’ll lose their coverage if they don’t respond.
“The life experience of these individuals is not necessarily one that allows them the luxury of having to work through onerous paperwork,” Santana-Chin said.
When Texas increased income eligibility checks between 2014 and 2019, for example, thousands of kids lost coverage in the state. Critics faulted the frequent checks, too, for the state having the highest rate of uninsured children in the nation at the time.
States will also be required to check enrollees’ addresses and death records more frequently.
People enrolled in the ACA’s marketplace coverage will also be subject to more scrutiny over their reported income and face penalties if they end up earning more than they expected when signing up for the coverage. They’ll have to wait for the government to verify their information, too, before getting coverage.
It will be a sharp contrast from employer-based coverage, where people are re-enrolled every year unless they opt out.
States will be allowed to delay kids from enrolling in the Children’s Health Insurance Program in some cases.
They will be allowed to temporarily block parents from enrolling their children if they are behind on paying the premiums for the coverage. Those premiums for kids’ coverage can run as much as $100 a month in some states, according to health policy research firm KFF. States will also be able to introduce a waiting period for kids who are being transitioned from private health insurance plans to Medicaid.
The Biden administration prohibited states from locking out parents from enrolling their kids in coverage over missed payments or a waiting period when transitioning from private health insurance.
