Senate, we’re going down swinging
The Senate Finance Committee has released its reconciliation legislation, which raises Medicaid and Marketplace cuts to $900 billion and reduces health care for 10.9 million people.
Even more catastrophic cuts could be coming to Medicaid and Marketplace under the Senate’s proposed reconciliation legislation, which dropped on June 16. The Senate’s proposal goes shockingly further than the House’s One Big Beautiful Bill Act, yielding savings through unraveling a grandfathered protection on provider taxes for 41 states (including Washington, D.C.) and limiting immigrant eligibility for premium tax credits, among other provisions. As a next step, the Senate will continue discussions and aim to bring the bill to the floor by Tuesday, June 24. To go deeper, subscribe to Manatt’s Health Highlights for actionable analyses.
Medicaid Cuts Will Worsen the Overdose Epidemic
Approximately one in five Medicaid enrollees have substance use disorder (SUD), a condition often marked by co-morbidities with other chronic mental and physical health issues, making their care more complex and resource intensive.
Medicaid expansion has significantly improved access to comprehensive SUD treatment, including medication-assisted treatment (MAT), inpatient, outpatient, and residential care, telehealth services, and peer support, especially in states heavily impacted by the overdose epidemic.
Proposed changes to Medicaid eligibility under the One Big Beautiful Bill Act threaten significant coverage losses across the entire expansion population and are poised to reverse recent progress on overdose prevention and SUD care. The CDC reported 27% fewer overdose deaths in 2024 compared to the previous year, an indicator that coverage and access to SUD care save lives.
At the very least, members of Congress should amend the bill to give states flexibility to exempt people with SUD (not just those in SUD treatment) entirely from work requirements and from the six-month coverage redetermination requirement. Indeed, states need flexibility to exempt any high-need populations who are most vulnerable to losing coverage and care because of the bill’s new constraints on eligibility.
Keep reading at The 80 Million.
ICYMI: Reenrollment Rollback Risks Significant Coverage Loss
The House-passed “One Big Beautiful Bill Act” (“House bill”) erects barriers to coverage by increasing verification requirements for financial assistance and ending automatic reenrollment in the Affordable Care Act’s (ACA) health insurance Marketplaces — a coverage pathway chosen by 10.8 million people for 2025 coverage, or 45% of all Marketplace enrollments.
The House-passed bill’s changes to verification processes would eradicate recent years’ coverage gains by ratcheting up “hassle factors” at the time of reenrollment. The result would be lower enrollment and higher premiums, as younger and healthier people opt out of Marketplace coverage and trigger higher premiums for others in the market.
CBO estimates that only 700,000 people would lose coverage under the onerous new requirements. This estimate greatly understates the likely impact. Overall, CBO’s estimate that the Marketplace provisions will increase the number of uninsured people by only 4 million people underestimates the House bill’s real-world impact on low- and moderate-income families who rely on financial help to afford private insurance coverage.
Keep reading at The 80 Million.
California’s health care services department is accepting applications from Medi-Cal members and stakeholders to provide direct, informed and meaningful feedback about the Medi-Cal program to DHCS leadership.
Iowa’s health and human services department submitted a request to amend its Iowa Health and Wellness Plan (IHAWP) 1115 waiver to incorporate work requirements as a condition of maintaining eligibility for IHAWP enrollees ages 19 to 64 who are not otherwise exempt.
Maryland’s health department received CMS approval to expand access to behavioral health and home and community-based services for children and youth.
Montana Gov. Greg Gianforte announced the launch of a new Medicaid-funded effort to help eligible Montanans with behavioral needs secure and maintain stable housing as part of the state’s Healing and Ending Addiction through Recovery and Treatment program.
Oregon will expand access to lower-cost cell and gene therapies for Medicaid enrollment beginning Jan. 1, 2026.
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How the Senate’s proposed Medicaid cuts could deepen the rural hospital crisis – NBC News
How Medicaid improves health and lowers costs among members experiencing homelessness – California Health Care Foundation
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