“I am a ‘HELL NO’ on this big, ugly bill.”
That was New Hampshire U.S. Rep. Chris Pappas’ message on the “One Big, Beautiful Bill” signed into law by President Donald Trump on Independence Day.
Like most of his fellow Democrats, his primary objection was to the Medicaid provisions in the bill. He claimed it would “strip 17 million Americans from their health care” in pursuit of some $1 trillion in reduced spending.
(Note: there are no “cuts.” Under the new law, “Medicaid spending will rise by about 3 percent per year for the next 10 years,” according to Hayden Dublois at the Foundation for Government Accountability.)
Pappas, who’s running to replace U.S. Sen. Jeanne Shaheen (D-N.H.) next year, used the Big, Beautiful Bill to hit his potential GOP opponent, Scott Brown.
“Scott Brown backs Donald Trump’s bill to gut Medicaid and strip more than 46,000 Granite Staters of their health care,” Pappas posted. “New Hampshire won’t forget this.”
His fellow New Hampshire Democrat, Rep. Maggie Goodlander, went even further, claiming the bill “will cost lives.”
Republicans have a different view. They believe New Hampshire voters will hold Pappas responsible for opposing two popular policy changes in the new law: Work requirements for able-bodied recipients and stopping an estimated 1.4 million ineligible non-citizens from illegally getting millions in taxpayer-funded health benefits.
Pappas would not respond to questions from NHJournal about what he means when he says the new law will “strip” people of their healthcare. Medicaid was launched as a welfare program for the neediest Americans, in particular young children and the elderly.
However, in the wake of Obamacare and again during the COVID-19 emergency, eligibility expanded, and now the costs to taxpayers have skyrocketed as people with higher incomes have become eligible for this welfare program.
That’s because New Hampshire has the fifth-highest income limit in the country for eligibility in Medicaid’s Children’s Health Insurance Program (CHIP). As a result, single parents with one child earning $52,875 a year are getting Medicaid coverage. As are some families of four earning $80,375 — all free.
New Hampshire Democrats opposed a GOP-backed proposal in the state budget that would have required upper-income Medicaid recipients in the Granite State to pay a monthly premium to help cover the costs, the same way employees with private insurance do. Democrats have tried to label this insurance premium an “income tax,” because it’s only paid by Medicaid recipients at the top end of the income eligibility.
At the federal level, Pappas and his fellow Democrats voted against work requirements for Medicaid, a policy supported by more than 70 percent of Americans.
The work requirement passed by Congress exempts the elderly, pregnant women, individuals with disabilities, and caretakers, such as parents with young children.
According to the Congressional Budget Office, nearly 5 million able-bodied Medicaid recipients will drop off the rolls rather than meet the requirement for 80 hours of work, volunteering, or class attendance each month. That will save $344 billion over the next decade, according to the CBO’s estimate.
Another policy (Republicans would say “reform”) that the CBO says will reduce the cost of Medicaid by billions is making it harder for illegal immigrants and ineligible non-citizens to access Medicaid.
“About 1.4 million would be people who do not meet citizenship and immigration status requirements for Medicaid enrollment but who would be covered under current law in programs funded by the states,” according to a CBO statement.
Polls show more than 60 percent of Americans oppose taxpayer-funded healthcare for illegal aliens, and that number is similar (58 percent) in the blue state of California.
Democrats point out that federal Medicaid rules don’t allow the program to cover illegal immigrants, despite years of Democratic efforts to do just that. But the CBO number stands, as does their projection that increasing the reevaluation of Medicaid eligibility twice a year would result in savings. More checking of eligibility — either citizenship or income level — will mean fewer people getting Medicaid who shouldn’t be, Republicans say.
And then there are another 1.6 million people who would be “stripped” of Medicaid because they have access to other subsidized health care coverage, such as the Obamacare exchanges. They would still get subsidies, but they would no longer be on the welfare rolls.
Pappas and his fellow Democrats are waging a political war, not an audit. Spending cuts are rarely popular, and if they can convince voters these reforms are — to quote Hassan — “devastating cuts,” they will win the political advantage.
But if Republicans are able to force Democrats to answer questions about their votes against popular policies like work requirements and keeping non-citizens off Medicaid, the impact on Granite State voters could be very different.