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Senate GOP Seek Tougher Medicaid Cuts 06/17 06:11
WASHINGTON (AP) -- Senate Republicans on Monday proposed deeper Medicaid
cuts, including new work requirements for parents of teens, as a way to offset
the costs of making President Donald Trump's tax breaks more permanent in draft
legislation unveiled for his "big, beautiful bill."
The proposals from Republicans keep in place the current $10,000 deduction
of state and local taxes, called SALT, drawing quick blowback from GOP
lawmakers from New York and other high-tax states, who fought for a $40,000 cap
in the House-passed bill. Senators insisted negotiations continue.
The Senate draft also enhances Trump's proposed new tax break for seniors,
with a bigger $6,000 deduction for low- to moderate-income senior households
earning no more than $75,000 a year for singles, $150,000 for couples.
All told, the text unveiled by the Senate Finance Committee Republicans
provides the most comprehensive look yet at changes the GOP senators want to
make to the 1,000-page package approved by House Republicans last month. GOP
leaders are pushing to fast-track the bill for a vote by Trump's Fourth of July
deadline.
Sen. Mike Crapo, R-Idaho, the chairman, said the proposal would prevent a
tax hike and achieve "significant savings" by slashing green energy funds "and
targeting waste, fraud and abuse."
It comes as Americans broadly support levels of funding for popular safety
net programs, according to the poll from The Associated Press-NORC Center for
Public Affairs Research. Many Americans see Medicaid and food assistance
programs as underfunded.
What's in the big bill, so far
Trump's big bill is the centerpiece of his domestic policy agenda, a
hodgepodge of GOP priorities all rolled into what he calls the "beautiful bill"
that Republicans are trying to swiftly pass over unified opposition from
Democrats -- a tall order for the slow-moving Senate.
Fundamental to the package is the extension of some $4.5 trillion in tax
breaks approved during his first term, in 2017, that are expiring this year if
Congress fails to act. There are also new ones, including no taxes on tips, as
well as more than $1 trillion in program cuts.
After the House passed its version, the nonpartisan Congressional Budget
Office estimated the bill would add $2.4 trillion to the nation's deficits over
the decade, and leave 10.9 fewer people without health insurance, due largely
to the proposed new work requirements and other changes.
The biggest tax breaks, some $12,000 a year, would go to the wealthiest
households, CBO said, while the poorest would see a tax hike of roughly $1,600.
Middle-income households would see tax breaks of $500 to $1,000 a year, CBO
said.
Both the House and Senate packages are eyeing a massive $350 billion buildup
of Homeland Security and Pentagon funds, including some $175 billion for
Trump's mass deportation efforts, such as the hiring of 10,000 more officers
for Immigration and Customs Enforcement, or ICE.
This comes as protests over deporting migrants have erupted nationwide --
including the stunning handcuffing of Sen. Alex Padilla last week in Los
Angeles -- and as deficit hawks such as Kentucky Sen. Rand Paul are questioning
the vast spending on Homeland Security.
Senate Democratic Leader Chuck Schumer warned that the Senate GOP's draft
"cuts to Medicaid are deeper and more devastating than even the Republican
House's disaster of a bill."
Tradeoffs in bill risk GOP support
As the package now moves to the Senate, the changes to Medicaid, SALT and
green energy programs are part of a series of tradeoffs GOP leaders are making
as they try to push the package to passage with their slim majorities, with
almost no votes to spare.
But criticism of the Senate's version came quickly after House Speaker Mike
Johnson warned senators off making substantial changes.
"We have been crystal clear that the SALT deal we negotiated in good faith
with the Speaker and the White House must remain in the final bill," the
co-chairs of the House SALT caucus, Reps. Young Kim, R-Calif., and Andrew
Garbarino, R-N.Y., said in a joint statement Monday.
Republican Rep. Nicole Malliotakis of New York posted on X that the $10,000
cap in the Senate bill was not only insulting, but a "slap in the face to the
Republican districts that delivered our majority and trifecta" with the White
House.
Medicaid and green energy cuts
Some of the largest cost savings in the package come from the GOP plan to
impose new work requirements on able-bodied single adults, ages 18 to 64 and
without dependents, who receive Medicaid, the health care program used by 80
million Americans.
While the House first proposed the new Medicaid work requirement, it
exempted parents with dependents. The Senate's version broadens the requirement
to include parents of children older than 14, as part of their effort to combat
waste in the program and push personal responsibility.
Already, the Republicans had proposed expanding work requirements in the
Supplemental Nutritional Assistance Program, known as SNAP, to include older
Americans up to age 64 and parents of school-age children older than 10. The
House had imposed the requirement on parents of children older than 7.
People would need to work 80 hours a month or be engaged in a community
service program to qualify.
One Republican, Missouri Sen. Josh Hawley, has joined a few others pushing
to save Medicaid from steep cuts -- including to the so-called provider tax
that almost all states levy on hospitals as a way to help fund their programs.
The Senate plan proposes phasing down that provider tax, which is now up to
6%. Starting in 2027, the Senate looks to gradually lower that threshold until
it reaches 3.5% in 2031, with exceptions for nursing homes and intermediate
care facilities.
Hawley slammed the Senate bill's changes on the provider tax. "This needs a
lot of work. It's really concerning and I'm really surprised by it," he said.
"Rural hospitals are going to be in bad shape."
The Senate also keeps in place the House's proposed new $35-per-service
co-pay imposed on some Medicaid patients who earn more than the poverty line,
which is about $32,000 a year for a family of four, with exceptions for some
primary, prenatal, pediatric and emergency room care.
And Senate Republicans are seeking a slower phase-out of some Biden-era
green energy tax breaks to allow continued develop of wind, solar and other
projects that the most conservative Republicans in Congress want to end more
quickly. Tax breaks for electric vehicles would be immediately eliminated.
Conservative Republicans say the cuts overall don't go far enough, and they
oppose the bill's provision to raise the national debt limit by $5 trillion to
allow more borrowing to pay the bills.
"We've got a ways to go on this one," said Sen. Ron Johnson, R-Wis.
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