Illustration: Maura Losch/Axios
The House budget resolution released Wednesday calls for the House Energy and Commerce Committee to find $880 billion in savings, setting up the prospect of major cuts to Medicaid.
Why it matters: Not all of those savings will be derived from the safety net program, but that is a very large savings target that will be tough to reach without fundamental changes such as per capita caps.
- The budget calls for $2 trillion less spending on mandatory programs, much of which could come from Medicaid.
- House GOP leaders have said they're not looking to cut Medicaid benefits, but it will be hard to pare hundreds of billions of dollars without significant coverage losses or reducing benefits.
Between the lines: "Any cut to federal Medicaid spending means less money available to states," KFF executive vice president for health policy Larry Levitt wrote on X.
- "States are then forced into a choice: Reduce Medicaid benefits, eligibility, or payments to health care providers. [Or] make up the difference by cutting other programs or raising taxes."
By the numbers: There are a range of Medicaid options for lawmakers that would provide different savings amounts.
- Work requirements, one of the most widely discussed policy options, would save around $100 billion over a decade.
- The CBO estimates that depending on how per capita caps were implemented, limiting program spending per enrollee could save from $588 billion to $893 billion.
- Medicaid block grants could save from $459 billion to $742 billion.
- Reducing the federal government's matching rate for the expansion population could save $561 billion.
The bottom line: Of all the House committees, Energy and Commerce has been instructed to find the biggest payfor.
- Although E&C Chair Brett Guthrie is eager to reduce spending on Medicaid, House moderates may still balk at changes that result in people losing health coverage.
