Republicans are preparing to reduce the Medicaid deeper (a healthcare program, providing coverage to people with low income and limited resources), to fund President Donald Trump’s agenda, proposing more laws that could, according to more,

The measure reflects the willingness of the Republicans to cut the country’s safety network insurance plan, despite the doubts expressed by some Members in their ranks.

Last month, Republicans of the House of Representatives voted for taxation and costs projected to lead to 7.8 million less registered in Medicaid. The revisions of the Senate Finance Committee on the bill published Monday could cause even more coverage losses, abruptly limiting a Medicaid funding maneuvering that hospital groups argue to cut payments to their premises.

“The Senate has just made a bad bill worse,” said Chip Kahn, chief executive of the Federation of US Hospitals. “The rural communities will be hit the biggest blow, with hospitals forced to face difficult decisions on which services will be cut,” he added.

Would burden rural areas

Rural areas are disproportionately based on Medicaid and their hospitals are often the first support for patients without health coverage. Hospital networks have reported that they would likely reduce pediatric, maternity or behavioral health services, terminate telemedicine programs, close farm facilities or reduce layoffs if Medicaid cuts become law, according to recent research by the members of the US.

These changes will partially be the result of the ceilings on providers’ taxes, an unusual example of a tax that many hospitals pay. States charge additional taxes to medical services – mainly hospitals, nursing homes and facilities for people with mental disability – and in return give higher Medicaid payments to providers. This brings more federal funds, which are linked to state payments.

Taxes, which some conservatives have called a form of “money laundering”, have emerged in recent weeks at a top -notch confrontation between the Senate Republicans.

Senate legislation would put a huge obstacle to this practice. He argues that states should gradually reduce the taxes of providers in hospitals until they are not higher than 3.5% of the net revenue of a provider’s patients. Currently, this threshold is about 6% – and the House of Representatives’ bill is limiting it to this percentage.

At the same time, the Senate bill contradicts the plan of the House of Representatives, excluding the ceiling of the two other main providers subject to tax, nursing homes and facilities for people with disabilities.

The proposed ceiling will affect 18 states, including New York, Virginia and Arizona. Six red states (voting Republicans) with high taxes on providers would be excluded because they did not expand Medicaid to cover childless adults with low incomes: Texas, Kansas, Tennessee, Alabama, Mississippi and South Carolina. But three states with Republican senators – Missouri, Iowa and Indiana – would be influenced.

The cost of this traffic for hospitals is not immediately clear. But they will lose $ 321 billion over the next 10 years, according to the version of the House of Representatives and will face another $ 63 billion in costs from the service of a larger uninsured population, according to an analysis by the Urban Institute and Robert Wood Johnson Foundation. Hospitals received $ 262 billion from Medicaid in 2022.

The associations representing the hospitals denounced the Senate legislation and called on the senators to react to the cuts.

Ellen Kugler, executive of the Alliance of Safety-Net Hospitals, said the Senate bill would “eliminate the resources needed by the Security Network hospitals to keep the doors open and serve their communities”.

The Senate seeks to pass its bill until July 4, a deadline set by Trump. It should then be approved by both bodies before it is made by law.

They ask for changes

Senator Josh Hawley (R-Missouri) said on Tuesday that he is worried that the Senate’s proposal would hit Missouri’s poor citizens and lead to the closure of rural hospitals, and stressed that he needs many changes before he could vote.

“I don’t think they understand politically what our voters are,” Hawley told reporters, referring to the Senate Republicans who support funding cuts. “But also, leaving aside politics, it is not right to close a bunch of agricultural hospitals to pay for tax cuts,” he said.

However, other Republicans seemed positive, after a meeting third at a lunch with Mehmet Oz, commander of the Medicare and Medicaid Service Centers.

OZ has removed concerns about the changes in the bill on taxpayers after meeting with the Senators, telling reporters that he does not believe they would harm farm hospitals.

“The framework for dealing with legalized money laundering must be in this bill and I believe it will exist in the bill,” Oz said.

“If it were up to me, I would change the way states can increase their state share,” he said.

But there is little support for Republican Congress -controlled to increase Medicaid costs instead of providers taxes.

Other changes in the Senate to the proposal for Medicaid would extend the requirements for some beneficiaries to work, train for a job or provide voluntary work to include parents of older adolescents.

Senate majority leader John Thune (R-South Dakota) acknowledged that some members of his team are seeking changes to the bill.

“We continue to hear from our members specifically about data or pieces of the bill that they would like to see to be modified or changed or concerned, and we are processing it,” Thune told reporters.

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