Brendan Boyle

U.S. Rep. Brendan Boyle appeared in Harrisburg on Tuesday to roll out a plan to reverse the Medicaid cuts set to go into effect later this year, giving a preview of Democrats’ agenda if they succeed in re-taking the House this November.

Boyle was joined by state Rep. Anthony Bellmon, D-Philadelphia, who introduced a resolution demanding the federal government provide additional details on Medicaid work requirement reporting, something Pennsylvania and other states fear will result in losses of coverage for qualified people.

An estimated 300,000 Pennsylvanians are expected lose Medicaid coverage due to changes that start as early as the end of this year, out of a total of 2.9 million recipients in the state.

The upcoming Medicaid changes were approved by Republicans as last year’s House Resolution 1, which President Donald Trump dubbed his “One, Big, Beautiful Bill.”

Boyle’s legislation to halt the cuts won’t go anywhere this year while the GOP controls both chambers of the federal legislature. But it provides a taste of how Democrats would handle the issue if they succeed in winning back the House majority in this year’s mid-term elections.

“This is important enough to me that I believe we should use every bit of leverage we have over that budget process, which if we’re in the majority will be substantial,” said Boyle, of Philadelphia, the ranking Democrat on the House Committee on the Budget.

Trump’s signature piece of budget legislation remains unpopular, as Republicans face steep declines in public opinion on fiscal issues and the economy. Democrats have made it clear they see this as key to an electoral rebound.

If Democrats regain control of the House, “there is no question that, in my mind, what our H.R. 1 should be next January is absolutely reversing every single one of the healthcare cuts that were passed by this Republican Congress and signed into law last Fourth of July by this President,” Boyle said.

Last year’s federal budget deal includes a $715 billion reduction in Medicaid spending over the next ten years, intended to partially offset continued and expanded tax cuts. The budget is expected to grow the national debt by $3.8 trillion over the next decade.

Republicans pitched the deal as a way to cut down on waste in Medicaid and other public benefits systems, but Democrats and the state agencies that run the programs say the cuts appear designed to collapse the system.

Medicaid is a joint state-federal program that provides health coverage to low-income and disabled people. Many of the changes approved in Trump’s budget deal don’t go into effect until later this year at the earliest, with some not hitting until 2028.

But the earliest and potentially most significant change is that states, starting no later than Jan. 1, 2027, must begin enforcing an 80-hour-per-month work requirement on Medicaid enrollees ages 19 to 64 who aren’t caregivers and aren’t disabled.

Federal survey data shows that only about 5% of Medicaid enrollees don’t meet this requirement. Much of the savings for the federal budget is expected to come from people who are working, but can’t navigate the red tape around reporting their hours.

“Most Medicaid recipients already work. What they’re up against is paperwork delays in a system that this already stretched too thin, and now the federal government is requiring states to implement a work requirement without giving states the clear guidance to do what is right,” Bellmon said.

His resolution will ask the federal Centers for Medicare and Medicaid Servies (CMS) to “provide immediate detailed guidance to states like Pennsylvania” as to how the work verification system will function, Bellmon said, given that the state has received virtually no information from CMS ahead of implementation deadlines later this year.

Boyle’s legislation would repeal all of the scheduled changes to Medicaid. In addition to the work requirements, Trump’s budget deal would also require states to re-verify Medicaid eligibility every six months (as opposed to annually), and begin collecting new per-service cost-sharing payments from patients making above the poverty line (about $16,000 for a single person, $33,000 for a family of four) starting in 2028.

The bill would also limit retroactive coverage for patients who are found to be eligible for Medicaid after receiving care, reducing the window to enroll from 90 to 30 days.

Despite promises from some Republicans that additional healthcare reform measures would go into place before the new rules hit, “it is very clear, now that we’re under six months away, that there is no alternative coming from those who currently run our Congress,” Boyle said.

Reductions in Medicaid coverage are also accompanied by Congress’ decision to not renew additional subsidies for insurance purchased through Affordable Care Act exchanges, commonly known as Obamacare. The drop in coverage has already been blamed for rising premium costs for those who remain insured, and accelerating hospital closures due to a greater burden of uninsured patients.

“Make no mistake about it, every one of us will be impacted by these cuts, regardless of whether we’re on Medicaid, Medicare, Affordable Care Act, a private employer plan, the VA, etc.,” Boyle said.