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Senators warn reconciliation changes could cut Medicaid rolls and strain rural health systems
Summary
Several senators warned that reconciliation provisions under consideration could reduce Medicaid enrollment by millions, potentially harming rural hospitals, community health centers and access to care.
Senators including Patty Murray, Tammy Baldwin and Jeff Merkley raised concerns that reconciliation language moving through the House could lead to large reductions in Medicaid enrollment and weaken health-care access, particularly in rural areas.
Senator Patty Murray cited the Congressional Budget Office estimate that more than 10 million people could lose Medicaid coverage under the House proposal and said the cuts could force community health centers and nursing homes to close. Senator Merkley and others said the administration characterizes some provisions as reducing growth rather than cutting benefits, but committee members warned that changes that reduce eligibility or increase administrative burdens could have the same practical effect.
Secretary Kennedy replied that some proposals focus on reducing waste, fraud and abuse and on tightening enrollment, and he said the department identified cases of duplicate enrollment and other irregularities. He described remaining populations affected as "able-bodied" adults who do not meet proposed work or training requirements.
Lawmakers emphasized that rural hospitals and clinics operate on thin margins and that coverage losses would likely increase emergency-room use, undermine provider finances, and accelerate closures of critical local facilities. Senators asked HHS to model the proposals' effects on state health systems and on rural hospital finances and to provide data on populations likely to be disenrolled under contemplated changes.
