Comments by "Janis Williams" (@janiswilliams2766) on "Glorious Life On Wheels"
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What Project 2025 says about Medicaid
Medicaid is a free or low-cost national public health insurance program designed to provide coverage to eligible low-income adults, pregnant women, children, older adults and people with disabilities. As of March 2024, more than 82 million Americans were enrolled in Medicaid.
Project 2025 calls for Medicaid’s federal funding to be converted from its current model — the federal government paying a fixed percentage of states’ Medicare costs — to a model in which the federal government pays a block grant (or fixed amount) to each state, regardless of their specific costs.
Block grants have been floated several times over the years. Such proposals are typically “designed to fail to keep pace with expected enrollment and/or health care cost growth in order to deeply cut federal Medicaid spending over time, relative to current law,” according to a report on Project 2025 from Georgetown University’s McCourt School of Public Policy.
In 2017, a Medicaid block grant plan proposed by Republicans would have slashed Medicaid’s federal funding by more than 25% over 10 years and 30% over 20 years, according to a Congressional Budget Office projection.
For those receiving Medicaid benefits, Project 2025 also proposes coverage with “time limits” or “lifetime caps” to “disincentivize permanent dependence” on those benefits. And while the proposal is vague on details, it suggests that the incoming administration eliminate Medicaid protections and reform mandatory versus optional Medicaid benefits. Some of the benefits that Medicaid is currently required to cover are X-ray services, rural health clinic visits, nursing home care and early prevention and diagnostic screenings.
Project 2025 also proposes adding a work requirement, “similar to what is required in other welfare programs,” as well as raising premiums for higher-income beneficiaries. Eligibility should be redesigned, too, the plan reads, “to serve the most vulnerable and truly needy and eliminate middle-income to upper-income Medicaid recipients."
One recent attempt to impose a Medicaid work requirement led to thousands of beneficiaries losing coverage. Arkansas added a Medicaid work requirement in 2018 and removed it in 2019. During the nine-month period the requirement was active, roughly 18,000 enrollees lost coverage, according to The Commonwealth Fund, a health care policy think tank.
The Center for American Progress, a progressive think tank, said lifetime caps on Medicaid benefits could cause “devastating coverage losses.” Specifically, the approximately 18.5 million beneficiaries who qualify for Medicaid based on income alone — around 20% of those receiving Medicaid — would be particularly at risk of losing their coverage.
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