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Kennedy testifies during a Senate Committee on Health, Education, Labor and Pensions hearing on April 22. Photo by Saul Loeb \/ AFP via Getty Images.<\/p>\n
At the hearings, however, Kennedy repeatedly<\/a> clashed<\/a> with Democrats who said that the Republican legislation that President Donald Trump signed into law<\/a> last summer made cuts to Medicaid and would reduce access to healthcare for millions of people.<\/p>\n For example, during an April 22 Senate Finance Committee hearing on the HHS budget,\u00a0Democratic Sen. Tina Smith of Minnesota, while talking about mental health services covered by Medicaid,\u00a0said<\/a> that the Trump administration and congressional Republicans had \u201cpushed through the biggest cuts to Medicaid in the history of that program.\u201d\u00a0<\/p>\n In response, Kennedy said<\/a> that wasn\u2019t the case.\u00a0\u201cFirst of all, there are no cuts in Medicaid,\u201d he said. \u201cI keep saying this. Here\u2019s what the CBO said: In fiscal year 2025, $668 billion. Fiscal year 2036, $981 billion. That\u2019s not a cut. It\u2019s a 47% increase.\u201d<\/p>\n Smith interjected, by saying: \u201cSecretary Kennedy, a trillion dollars in cuts, according to the CBO. Seven million people losing their health insurance because of the Trump administration actions. That\u2019s not debatable.\u201d<\/p>\n Smith was largely correct about what the CBO said<\/a>. It estimated a more than $900 billion reduction in Medicaid spending and an increase in the uninsured of 7.5 million people over 10 years.<\/p>\n Based on a CBO analysis, KFF, an independent health policy research organization, estimated<\/a> that the OBBBA reduces federal Medicaid spending by precisely $911 billion. Most of the federal savings, KFF said, come from the law imposing new work requirements on individuals who became eligible for Medicaid due to an expansion of the program under the Affordable Care Act, as well as \u201climiting states\u2019 ability to raise the state share of Medicaid revenues through provider taxes, restricting state-directed payments to hospitals, nursing facilities, and other providers, and increasing barriers to enrolling in and renewing Medicaid coverage.\u201d<\/p>\n KFF said that those Medicaid spending reductions in the OBBBA would offset some of the costs of another part of the bill, which extended some expiring tax cuts for individuals.<\/p>\n Those spending reductions count as \u201ccuts,\u201d experts in health policy told us.<\/p>\n \u201cBy conventional budget scoring methods, including those used by CBO, as well as [Office of Management and Budget] and others, there were very large cuts to Medicaid in OBBBA,\u201d Leighton Ku<\/a>, director of the Center for Health Policy Research at George Washington University, said in an email. \u201cCBO (and others) compare estimated federal Medicaid expenditures under OBBBA with the amount that would have been spent WITHOUT the legislation.\u201d<\/p>\n Furthermore, Ku said, \u201cA more telling sign of the impact of the cuts is that CBO estimated that the Medicaid and related CHIP cuts will cause the number of uninsured to rise by about 7.5 million people\u201d by 2034<\/a>. (CHIP is the Children\u2019s Health Insurance Program<\/a> for families that make too much money to qualify for Medicaid but can\u2019t afford private insurance.)<\/p>\n We reached out to HHS about Kennedy\u2019s claims, but haven\u2019t received a response.<\/p>\n In an April 22 hearing before the Senate Committee on Health, Education, Labor and Pensions, Kennedy said<\/a> the statement that \u201cwe\u2019ve cut Medicaid by a trillion dollars\u201d was a Democratic talking point. He claimed that the CBO \u201cdisagrees\u201d with Democrats, and referenced the agency\u2019s estimate<\/a> that federal spending on Medicaid will increase from more than $600 billion in fiscal 2025 to well over $900 billion 10 years from now.\u00a0<\/p>\n But Kennedy \u201cis using smoke and mirrors here \u2014 everything gets more expensive over time, especially in health care,\u201d Dr. Benjamin Sommers<\/a>, a Harvard University professor of health care economics and medicine, told us in an email.<\/p>\n Akeiisa Coleman<\/a>, senior program officer for Medicaid at the Commonwealth Fund, said in an emailed statement that, despite the projected spending reductions resulting from OBBBA, \u201cfederal spending on Medicaid is likely to increase over time to reflect changes in population and the cost of health care.\u201d<\/p>\n Ku called\u00a0Kennedy\u2019s claim \u201cmisleading\u201d because it \u201cignores the reality of medical care inflation, the aging of the population (which causes medical expenditures to rise even more) and other pressures.\u201d He said \u201cthe reality is that people will receive much less health care under Medicaid because of these cuts,\u201d and that \u201chealth care providers like hospitals, doctors\u2019 offices and nursing homes will hurt financially because of the loss of revenue.\u201d<\/p>\n Meanwhile, HHS has argued that some spending reductions were part of necessary changes to overhaul the Medicaid program.<\/p>\n \u201cTo be clear, HHS is taking steps to ensure Medicaid serves those it is intended to support,\u201d Andrew Nixon, an HHS spokesman, told<\/a> the Associated Press for an April 23 story about Kennedy\u2019s claims. \u201cThese actions are not cuts \u2014 they are focused on addressing waste, fraud, and abuse to better position the program for those who rely on it.\u201d<\/p>\n However, Sommers said \u201cthis is not simply cutting out waste and abuse,\u201d since the CBO estimates that millions of people will lose health insurance because of eligibility restrictions and other changes that the law made to Medicaid.<\/p>\n \u201cAny reasonable person would interpret that as a sizable cut to the program \u2013 particularly if you\u2019re one of the millions of people expected to lose their health insurance under the law,\u201d Sommers said.<\/p>\n