President Trump’s explain Medicaid spending in Senate health check ‘actually goes up’

“Democrats intentionally misstated Medicaid underneath new Senate check — indeed goes up.”
— President Trump, in a tweet, Jun 28, 2017

The White House is fortifying changes to Medicaid financing in a Senate health-care renovate bill by observant that a Better Care Reconciliation Act (BCRA) indeed increases Medicaid spending. In a tweet, Trump enclosed a graph that showed a spending increases from 2017 to 2026:

White House comparison confidant Kellyanne Conway recently done a identical explain on ABC’s “This Week”: “These are not cuts to Medicaid. … This slows a rate for a destiny and it allows governors some-more coherence with Medicaid dollars since they’re closest to a people in need.”

Does Medicaid spending indeed go up, not down, in a Senate bill?

The Facts

The Senate check would proviso out a Medicaid expansions underneath Obamacare by shortening a sovereign compare for newly authorised adults, place a top on a sovereign reimbursements to states, and lead to fewer people being enrolled than underneath stream law.

So far, 31 states and a District of Columbia have stretched Medicaid eligibility. The inactive Congressional Budget Office estimates that underneath a Senate bill, states will start rolling behind their expansions, and people who newly became authorised underneath Obamacare no longer would qualify.

The top on sovereign reimbursements would start in mercantile 2020. If a states confirm to revoke coverage as a result, some Medicaid enrollees might finish adult losing coverage. With Medicaid payment rates already being revoke than Medicare or private insurance, fewer providers might see Medicaid patients if states revoke rates. States run their possess Medicaid programs and can confirm not to make any changes to their turn of coverage. But they would need to lift revenues some other way. (For more, read this analysis by a inactive Kaiser Family Foundation on challenges states would face in responding to sovereign Medicaid caps.)

In 2017, a sovereign supervision spent $393 billion on Medicaid. If no change is done to a stream law, that spending is approaching to be $624 billion by 2026. The CBO calculates this by holding several factors into account, such as projected enrollment growth, health-care costs, inflation, race enlargement and policies that states might enact. The CBO estimates that if stream law stays in place, some-more states would enhance Medicaid, yet it doesn’t mention how many. Four states were deliberation expansion in 2017.

But things would change underneath a Senate bill. Instead of Medicaid spending flourishing to $624 billion by 2026, it would be $464 billion — a disproportion of $160 billion in 2026. This means a rebate of $772 billion over 10 years, from 2017 to 2026. Spending still increases, yet during a most slower rate than underneath stream law. Based on the approach a CBO analyzes legislation, this would be deliberate a cut in sovereign spending relations to stream projections. (An updated CBO estimate expelled Thursday showed Medicaid spending would be reduced 35 percent by 2036, compared to stream law.)

Trump says Medicaid spending “actually goes up” since he is referring usually to a tender dollar boost between $393 billion in 2017 and $464 billion in 2026.

But that omits a other partial of a full picture: The Senate check significantly reduces how most a sovereign supervision would spend on Medicaid in destiny years compared to projections though a change in a stream law. It would lead to 15 million fewer Medicaid enrollees by 2026 than there would be if stream law stayed in place. For context, Medicaid enlargement underneath Obamacare supposing word to as many as 14 million some-more people.

Here’s what this looks like, in context. Trump’s chatter usually shows a revoke line, not a one above or a opening in between.

(Congressional Budget Office)
(Julio Negron/The Washington Post)

During a campaign, Trump betrothed not to cut Medicaid. So now, a tongue he and his aides use is that Medicaid spending “actually goes up” or that a check “slows down a rate of spending.”

One health-care process researcher explained it this way: Say your employer told we that your income will go adult each year by 2.5 percent to comment for inflation. But instead, we get a 0.5 percent increase, even yet a cost of your vital losses increases 2.5 percent with inflation. You can call that a “reduction,” a “cut,” or a “slow rate of growth,” yet ultimately, we have reduction income than we would otherwise.

A White House orator said: “The existence is Medicaid spending is approaching to boost by $71 billion. Only in Washington is a $71 billion boost deliberate a cut.”

The Pinocchio Test

In fortifying a changes due in a Senate legislation to Medicaid financing, Trump says Medicaid spending “actually goes up” by a bill, and showed a graph indicating such an increase.

But that’s utterly misleading. It’s only one partial of a design that omits a fact that if a Senate check as created by a date of his chatter becomes law, sovereign spending would be reduced by $772 billion over 10 years, according to a inactive Congressional Budget Office. Moreover, 15 million fewer people would be enrolled in a module over 10 years than would be underneath stream law. We endowment Three Pinocchios.

Three Pinocchios


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