President Donald Trump’s assertion that the House Republican bill would not change Medicaid, only targeting “waste, fraud, and abuse,” was a misleading promise. The truth is more complex and far-reaching than his repeated claim.
On May 20th, President Trump visited Capitol Hill as House Republicans drafted a bill containing many of his priorities, including significant changes to Medicaid, the federal-state health insurance program for lower-income Americans. Despite this, Trump insisted that the legislation would not alter Medicaid, Medicare, or Social Security, only cutting “waste, fraud and abuse.”
However, the Congressional Budget Office projected that at least 8.6 million people will lose coverage due to the changes in the bill. Experts from organizations like George Washington University’s Center for Health Policy Research and KFF (Kaiser Family Foundation) agree that the majority of the bill’s provisions go beyond addressing fraud, waste, or abuse.
The Centers for Medicare & Medicaid Services define these terms as follows:
- Fraud: Knowingly deceiving to obtain money or property from a healthcare benefit program.
- Waste: Overusing services or practices resulting in unnecessary costs to any health care benefit program.
- Abuse: Actions that directly or indirectly result in unnecessary costs, such as overbilling or misusing billing codes.
Some provisions in the bill can be described as targeting waste, fraud, and abuse, like verifying enrollees’ addresses and eligibility. However, many other provisions are driven by ideology, including:
- Limiting Medicaid coverage for immigrants in the U.S. illegally, which could lead to a cut in federal reimbursement rates for states that currently cover these individuals.
- Requiring individuals ages 19-64 receiving Medicaid under the Affordable Care Act expansion to work or participate in qualifying activities for at least 80 hours per month.
- Banning Medicaid funds spent on nonprofit organizations primarily engaged in family planning or reproductive services, affecting Planned Parenthood and other organizations that provide abortions.
Other provisions aim to cut expenses by imposing copays and reducing retroactive coverage, but these do not specifically target waste, fraud, or abuse.
In conclusion, Trump’s statement was an ambitious lie. The House bill includes provisions that can improve the detection of ineligible beneficiaries, but it also contains significant changes to Medicaid that align with Republican priorities and ideology, rather than solely targeting “waste, fraud, and abuse.”
Sourced from https://www.politifact.com/
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