The massive tax and domestic policy bill passed by Congressional Republicans and signed by President Trump this month expands tax cuts, limits Medicaid and food assistance programs, balloons immigration enforcement spending, and adds trillions to the national debt.
The WBUR newsroom took a look at how some key provisions may affect residents and programs in Massachusetts.
Here’s an initial look at some of the expected impacts:
Health care coverage
One of the biggest impacts of the new law is a $1 trillion cut in federal health care spending. It’s expected to result in nearly 12 million people losing health insurance coverage nationwide by 2034, according to the nonpartisan Congressional Budget Office.
Amy Rosenthal, executive director of the Massachusetts nonprofit Health Care for All, called the law’s effect on health care “unethical.”
“This bill makes the largest cuts to Medicaid in the program’s history and attempts a back door repeal of the Affordable Care Act,” she said in a statement.
Republicans say easier access to health insurance during the Obama and Biden administrations resulted in higher costs and more fraud.
Under the new law, many Medicaid recipients, including in Massachusetts, will have to prove they meet a new work requirement at least twice a year, likely starting before 2027. NPR’s health reporters broke down what you need to know about this and other provisions here.
Massachusetts health officials estimate that up to 300,000 residents currently insured through MassHealth, the state’s Medicaid program, or the state health insurance marketplace could lose coverage. Public health experts worry that many eligible residents will fall through the cracks because they fail to provide all the necessary paperwork.
Hospital leaders have warned that lower insured rates will have a ripple effect on the health care system, especially for small hospitals and community health centers. State estimates suggest the law will cost Massachusetts up to $3.5 billion a year in federal health care funding once fully implemented.
According to Michael Curry, CEO of the Massachusetts League of Community Health Centers, about 31% of revenue for community health centers comes from Medicaid reimbursements. While not all of that would go away, Curry said the new law will be “devastating.”
Public health experts argue the cost of health care is lower for everyone if more people get preventive care rather than waiting for a health crisis.
“If we don’t invest up front, we pay for it later — when our emergency rooms are packed, when people come in, sicker, more acute in their care, and quite frankly, [when] they can’t work and can’t serve in the jobs that we need them in,” Curry said.
Baystate Health, the largest health care system in western Massachusetts, projects a loss of $30 to $50 million a year due to federal Medicaid cuts, according a statement from the system’s chief financial officer, Laurie Martin. The system has an annual budget of $3 billion and operates five hospitals.
An additional provision of the law bans Medicaid payments to some nonprofit health care groups that offer abortions.
Medicaid dollars already cannot be used for abortions except in certain circumstances, but could be used for other types of care, such as cancer screenings and birth control.
Just days after Trump signed the bill into law, Planned Parenthood filed a lawsuit in federal court in Boston challenging the provision.
Nationwide, Planned Parenthood estimates about 1 million of its patients use Medicaid. In Massachusetts, about 40% of Planned Parenthood’s 30,000 annual patients have MassHealth, according to Dr. Luu Ireland, the local organization’s chief medical officer. The Planned Parenthood League of Massachusetts joined the federal lawsuit.
“The Trump administration’s hell-bent ambitions to close our clinics and abandon our patients won’t stop us. Let me be crystal clear: We are not intimidated. We were built for this moment,” said Dominique Lee, president and CEO of the Planned Parenthood League of Massachusetts. “We will never be bullied into turning our backs on health care or human rights.”
A federal judge temporarily blocked the government from implementing this provision of the law.
Read the full article here.