Republicans consider adding a small curite to the giant cut of Medicaid

Washington – The legislation of tax cuts and “beautiful” expenses of President Donald Trump could strangle rural hospitals, which provide critical attention to Americans in many red states. So now the Republicans are struggling to write a solution before a self -imposed deadline on July 4.

The bill would reduce hundreds of billions of dollars for Medicaid, even limiting the use of the so -called provider taxes, which help state governments to cover the cost of medical care along with federal assistance. A group of Senate Republicans has complained that the provider’s tax change would unjustly load rural hospitals in their states.

To win their votes, the leaders of the Senate Republican Party have proposed to include a $ 15 billion fund for rural hospitals. Some Republican senators want a much greater sum: up to $ 100 billion. That group includes senators for re -election next year as Susan Collins de Maine and Thom Tillis of North Carolina, who already face democratic attack announcements about the reduction of medical care for the poor. Senator Josh Hawley (R-MO.) Complained about Medicaid’s cuts would betray Trump’s voters and also wants more support for rural hospitals, but refused to name a specific number.

Hawley said Wednesday that his support for the invoice would be reduced to the amount of money in the hospital.

“I wouldn’t do any of this … it doesn’t make much sense,” he told News themezone. “What they propose is not to go to work. So we can get a rural hospital fund now, maybe, but sooner or later … we will have to solve it.”

Republican leaders will need to elaborate a commitment on this subject, as well as other outstanding ones, which satisfies at least 50 Republican senators before the bill can proceed under a special fast -track process known as budget reconciliation.

Experts in medical care, however, sounded skeptical that a stabilization fund would really solve the problem. The National Rural Health Association warned this week that the bill would cause rural hospitals to close their doors.

“Reductions in federal health spending in total more than $ 1 billion for a decade. A stabilization fund of $ 15 billion for rural hospitals will not occupy a large part of that hole,” Larry Levitt wrote, executive vice president of health policy in the non -profit organization Kaiser Health Foundation.

“If we are going to continue providing access to medical care services in Rural America, a very reflective approach to the reform must occur. It cannot happen as a mosaic, because it will really not solve the problem,” said Craig Thompson, CEO of Golden Valley Memorial Healthcare, a rural hospital in Clinton, Missouri, during a call with journalists on Tuesday.

Tom Williams through Getty Images

A fundamental problem with the idea of ​​the hospital fund is that if the Republicans make sure that rural hospitals were impossible to be harmless to the so -called Big Beaf Bill’s medical care changes, then there would be significantly less savings of the legislation. And every dollar of savings that Republicans subtract make it more difficult to gain votes of fiscal hawks such as Senator Ron Johnson (Wis Republican.), Who said he would vote against the bill in its current form, not to mention the hard funds of the House of Representatives that are already angry at other changes sought by their senated colleagues.

The greatest largest medicaid cut in the bill is actually the least controversial among Republicans: the new “work requirements” that make the non -disabled medicaid affiliate document be 20 hours of work or other qualified activities to maintain their medical care coverage. Several million people would end up covered by Medicaid as a result of changes, which may require significant paperwork. And many of those who end without insurance live in rural areas.

“Rural areas tend to have a population that is more transient, perhaps seasonal workers, perhaps part-time workers, and the way we have seen that these policies are historically implemented has definitely, I believe, at a disadvantage many rural populations,” said Carrie Cochran-McClain, policy director of the National Association of Rural Health, told News themezone in an interview.

Meanwhile, the Democrats made fun of the Republicans for hurrying to solve a problem that would be debatable if they had simply left Medicaid.

“The idea of ​​a ‘hospital stabilization background’ to counteract Medicaid’s cuts is madness,” Senator Chris Murphy (D-Conn (D-Conn.) In a publication on social networks.

“It’s like paying someone to set fire to their home and then ask someone to turn off the fire after half already destroyed half [your] stuff. Why not pay someone to start the fire?