On July 4, the Republican budget reconciliation bill, H.R. 1, became law. The law will take health coverage away from 17 million Americans and will make more than a trillion dollars of cuts to Medicaid, Medicare and SNAP (formerly Food Stamps) to pay for tax breaks to millionaires and billionaires.  This dangerous law passed the House and Senate by slim margins, 218 to 214 in the House and 51 to 50 in the Senate, (with Vice President Vance having to break the tie).  The votes were largely along party lines – no Democrat voted for the bill and only 4 Congressional Republicans voted against it.

How the Republican budget law will harm older Americans:

On July 4, the Republican budget reconciliation bill, H.R. 1, became law. The law will take health coverage away from 17 million Americans and will make more than a trillion dollars of cuts to Medicaid, Medicare and SNAP (formerly Food Stamps) to pay for tax breaks to millionaires and billionaires.  This dangerous law passed the House and Senate by slim margins, 218 to 214 in the House and 51 to 50 in the Senate, (with Vice President Vance having to break the tie).  The votes were largely along party lines – no Democrat voted for the bill and only 4 Congressional Republicans voted against it.

How the Republican budget law will harm older Americans:

·         Cuts Medicaid long-term care services.  Medicaid is the largest source of long-term care services – covering home care and nursing home care. The Republican budget law cuts Medicaid by nearly $1 trillion.  The non-partisan Congressional Budget Office says Medicaid cuts will strip health care from 12 million people and force states to cut Medicaid services, including home and community based services.

·         Bans safe staffing standards for nursing homes.  The House Republican budget law blocks actions to prevent dangerous understaffing that results in preventable falls, injuries and deaths.  Nursing homes wouldn’t have to meet minimum federal safety standards – including having a registered nurse available 24/7 – for another 10 years.

·         Imposes red tape burdens that will take Medicaid coverage away from older adults.

The Republican budget law imposes new work reporting requirements on adults, burying individuals in red tape to prove eligibility at least twice a year and twice a year for income eligibility.  This is particularly dangerous for those over 50 – who often have more difficulty finding work and dealing with cumbersome reporting burdens.  When Arkansas imposed similar requirements, more than 18,000 people lost coverage not because they weren’t working but because they couldn’t meet the paperwork burdens.

·         Increases costs for low-income seniors.  12 million low-income seniors and people with disabilities rely on Medicaid to help pay for their Medicare premiums and cost-sharing.  The Biden Administration issued regulations designed to streamline the enrollment process.  The Republican budget law prevents those regulations from being implemented, a move CBO says will harm more than 1 million people on Medicare — meaning they would either have to go without other necessities to pay for care or go without needed services.

·         Increases prescription drug costs. The Republican budget law includes a large loophole that will both expand the drugs exempt from Medicare price negotiation and allow them to be exempt for many years.  CBO estimates it will cost taxpayers $5 billion in added drug costs — in addition to raising individuals' out-of-pocket costs.  

·         Strips legal immigrants of earned Medicare benefits.   Lawfully present immigrants who pay into Medicare for 40 quarters are currently eligible for benefits.  The Republican budget law strips them of Medicare benefits — retroactively and going forward — meaning refugees, asylees, persons with Temporary Protective Status and others will be uninsured.

·         Cuts critical food assistance.  The Republican budget law cuts SNAP (the Supplemental Nutrition Assistance Program, formerly Food Stamps) by $230 billion, imposing new red tape reporting burdens and shifting costs to states.  Millions of Americans  – including nearly 5 million adults over age 60 – will lose access to food.  

·         Medicare faces across-the-board cuts:  Even with massive cuts to Medicaid, Medicare and SNAP, the Republican budget law will add $3.3 trillion to the deficit according to the non-partisan Congressional Budget Office.  That will force an across-the-board cut in Medicare payments to doctors and hospitals of $500 billion, threatening access to care,

·         Access to critical services threatened.  Seniors — like all Americans — are harmed by the massive cuts in the Republican budget law that threaten rural and safety net hospitals, community health centers and other providers.  The American Hospital Association has already warned of upcoming closures. The American Health Care Association has projected that 1 out of 2 nursing homes would have to lay off staff and 1 in 4 would close.