House Republicans on Wednesday highlighted changes to Medicaid in a series of bills that target eligibility, but got stiff pushback from Democrats who argue the GOP actually wants to cut federal aid to low-income Americans.
A subcommittee of the House Energy and Commerce Committee examined three draft bills that would prevent lottery winners and illegal immigrants from getting Medicaid coverage. Another bill would close a loophole that allows couples to get Medicaid although their income and assets are beyond the threshold for eligibility.
Republicans argued the bills, introduced in earlier Congresses, are needed to reform an entitlement program that has used more and more federal funding.
“We have a budgetary crisis and we need to find ways to strengthen the program and reform it and make sure we get the money to the most vulnerable,” said Rep. Joe Barton, R-Texas.
Democrats charged that the bills were really a ruse by Republicans.
“I don’t think the biggest problems facing Medicaid are lottery winners getting advantages,” said Rep. Diana Degette, D-Colo. “Let’s talk about what we are really discussing today under the guise of these three bills: the majority’s intention to gut the Medicaid expansion for a variety of reasons.”
Thirty-one states and the District of Columbia expanded Medicaid under the Affordable Care Act, which Republicans aim to repeal.
“Medicaid has always been under attack by Republicans, but the threat to this program are more present than ever before,” said Rep. Frank Pallone of New Jersey, the top Democrat on the full committee.
Republicans pushed back against claims that the bills are intended to gut Medicaid.
“I’ve only been on the committee for 30 years so maybe there are some things happening behind my back,” Barton said.
The three bills target several parts of Medicaid eligibility. The bill on lottery winners focuses on income eligibility.
Income eligibility is based monthly household income. However, irregular income such as gambling winnings, inheritance or lottery winnings received as a lump sum is counted as income only in the month it is received.
“As a result, lottery winners, including multi-million dollar winners, have been allowed to retain taxpayer-financed Medicaid coverage,” the committee said in a memo.
The committee pointed to a 2014 report from Michigan, which passed a state law that requires a state to identify lottery winners of $1,000 or more with current residents who get state assistance.
That report from Michigan’s health department found that in 2013, 18 lottery winners who hit jackpots of $100,000 or more received some type of public assistance. Seven of those cases involved food assistance benefits, but the report didn’t detail how many people were on Medicaid.
Another bill targets a grace period for applicants while their citizenship is being verified. Illegal immigrants are not able to receive Medicaid benefits, but applicants can attest to being a citizen when they sign up.
The applicant can get Medicaid while citizenship is being verified, a loophole the bill would close. The bill also would require applicants to show documentation to verify citizenship.
The last bill aims to close a loophole surrounding annuities. The bill notes that couples can use an annuity to get assets and income above the Medicaid’s limit.
None of the bills has been introduced, but the hearing is the latest to focus on overhauling Medicaid. An earlier hearing in the Energy and Commerce Committee focused on waste and fraud in the entitlement program.
The GOP has tasked four committees in the House and Senate to create legislation to repeal the Affordable Care Act using reconciliation, a budget move that lets a bill pass via a simple 51-vote majority in the Senate.
Republicans haven’t coalesced around a plan for reforming Medicaid, but several plans have pointed toward turning it into a block grant program. Under a block grant, a state would receive a fixed amount of federal funding as opposed to funding now that does not have any cap and requires states to match any payments made by the federal government.
While Republicans argue block grants can give states more flexibility to run their Medicaid program the way they want, Democrats charge they could lead to cuts in benefits to people.
