Letters

President Donald Trump’s “One Big, Beautiful Bill” includes provisions to reduce Medicaid recipients and spending. The nonpartisan Congressional Budget Office was asked to review those provisions, and these are two key findings:

• The number of people without health insurance will increase by 7.8 million by 2034. (Note: Other analysts project many more losing health care coverage, but I’ll use the conservative estimate.)

• The total amount of Medicaid spending by 2034, compared to current Medicaid rules, would be reduced by $125.2 billion.

Yet, in Congressman Nick LaLota’s recent newsletter, he claims that it is a lie to assert that House Republicans are imposing Medicaid cuts and makes these points:

Medicaid spending will increase by 25 percent by 2034.

Sorry, it is a cut. The total projected amount of 2034 Medicaid dollars spent under Trump rules as compared to current rules will be reduced.

Congressman LaLota further asserts that only “illegal immigrants” and able-bodied adults who refuse work will be cut from the Medicaid rolls.

Undocumented immigrants were excluded from receiving Medicaid by the Clinton administration’s Personal Responsibility and Work Opportunity Act. However, a Medicaid-eligible “qualified immigrants” category was established in that same law that includes “lawful permanent residents, refugees, asylees, Cuban/Haitian entrants, certain abused immigrants, and certain survivors of trafficking.”

Medicaid also will cover emergency care services for immigrants. An undocumented immigrant otherwise qualified presenting to a hospital’s emergency room can receive temporary Medicaid. According to the Kaiser Family Foundation, spending in this category represented 0.4 percent of all Medicaid expenditures. Also, pregnant undocumented immigrant women can receive Medicaid coverage for prenatal care, the delivery and postnatal care, but no other services.

Mr. LaLota also brings up the canard of imposing coverage restraints on able-bodied persons. An able-bodied work requirement program exists in Georgia and, per ProPublica, it has failed: “A mere 6,500 participants have enrolled 18 months into the program, approximately 75 percent fewer than the state had estimated for the first year. Thousands of others never finished applying, according to the state’s data, as reports of technical glitches mounted. The state also never hired enough people to help residents sign up.”

The onerous bureaucratic experience in Georgia is one reason the Congressional Budget Office expects fewer Medicaid recipients.

Medicaid is already a means-tested program. Establishing eligibility necessitates extensive documentation. Additionally, recipients must undergo annual recertification, during which their employment status is reviewed.

Concerns have been raised about the impact on rural hospitals if this law is passed. New York City’s safety net hospitals, obligated to treat everyone seeking care, receive 55 percent of their funding from Medicaid. The worst-case scenario would be devastating to New York as well as Idaho.

Mike Anthony

Westhampton

Anthony is a former chair of the Southampton Democratic Committee, and a former hospital administrator — Ed.