Illustration: Allie Carl/Axios
House Budget Chair Jodey Arrington provided more clarity last week on which Medicaid health regulations Republicans could repeal to help pay for an extension of Trump tax cuts.
Why it matters: One of the targeted rules aims to make it easier for beneficiaries to enroll in the entitlement program and to renew their Medicaid and CHIP benefits.
- But the projected savings from repealing rules wouldn't cover even half of the $880 billion savings target the House Energy and Commerce Committee has to hit in reconciliation — leaving the door open to bigger changes to Medicaid that could lead to coverage losses.
What they're saying: "I think there's $400 billion, roughly, of health care–related rules that you could reverse on day one that would be part of the direct spending side of the ledger for reconciliation," Arrington told reporters.
- Energy and Commerce Chair Brett Guthrie confirmed to Axios that repealing both this rule and the Biden administration's nursing home staffing rule were "on the table."
Zoom in: The specific rule that Arrington referenced was issued by the Biden administration in March 2024 and finalized in two parts.
- It imposed standards to make it easier for people to keep their coverage, such as not requiring in-person interviews for certain groups and streamlining what paperwork needs to be submitted.
- States were also prohibited from checking more than once per year whether Medicaid beneficiaries are still eligible for coverage.
- Arrington has said that checking the rolls twice a year would result in savings. That's likely due to more people being found ineligible and falling off the program.
By the numbers: Arrington said doing away with the enrollment efficiencies and limits on eligibility checks would save $160 billion. The CBO hasn't yet released a public score.
- Republicans also want to cancel the Biden administration's nursing home staffing standards, which could save $22 billion.
- There's also been talk of repealing changes to state-directed payment requirements for managed care programs, which the Committee for a Responsible Federal Budget estimates could save $140 billion.
What we're watching: With Speaker Mike Johnson ruling out more controversial Medicaid policies like per capita caps and a new FMAP rate used to reimburse states for the federal share of most Medicaid expenditures, it's not clear how the math will all add up.
Nick Sobczyk contributed to this story.
