Texas lawmakers are at the center of the debate on health care cuts as part of President Donald Trump’s sweeping tax and spending plan. This is happening as Texas hospitals and health care experts worry the proposed reductions in Medicaid funding will mean the most vulnerable patients, including children and those with disabilities, will lose coverage.

On Capitol Hill, the fight over Medicaid was front and center Tuesday. The Republican-led House Energy and Commerce Committee, which has jurisdiction over the health care program, debated how it is finding $880 billion in savings over 10 years to help fund Trump’s planned tax cuts. Democrats, including those from Texas, highlighted patients who may lose care. 

“People like Ricky, who lives just down the road from me, in Texas City,” said U.S. Rep. Lizzie Fletcher, D-Houston, at the hearing. “Ricky is one of the 4.5 million or so Americans who rely on Medicaid to live life on his own. But the wait was year- long, and this bill will make the wait longer for people like him, if they can get that assistance at all.” 

“Carla, who is a cancer survivor,” said U.S. Rep. Marc Veasey, D-Fort Worth. “She’s someone whose life was saved by Medicaid.” 

Democrats seized on a report by the nonpartisan Congressional Budget Office that says the proposed cut could lead to 8.6 million people nationwide losing coverage. Some of them are in Texas, where 4 million people are covered through Medicaid and the Children’s Health Insurance Program. 

“We would see administrative hurdles created by the new policy that would not make children ineligible, necessarily for Medicaid or for the Children’s Health Insurance Program, but that would lead to paperwork problems and administrative issues that would lead them to get kicked off the plan,” said Lynn Cowles, health and food justice programs director for Every Texan. 

Texas hospitals fear the Republican-written proposals would also increase the financial pressure on them, as more patients would lack the means to pay for care.

“We still have great concerns about some of the limitations on how Texas uniquely finances its Medicaid program and our ability to continue to finance the program going forward, particularly knowing that the state is going to continue to grow, that we are still going to have lots of need in our Medicaid program,” John Hawkins, chief executive officer for the Texas Hospital Association, told Spectrum News.

“This limitation on federal supplemental payments going forward would put those rural hospitals under continued strain, so you would potentially see additional closures. In a more urban area, you’re going to see reduction in access points, reduction in service lines. Maybe in a suburban hospital, you might see a hospital that would, for example, decide not to provide OB services anymore, and so concern over reduction of access points, reduction of service lines, longer wait times, folks having to drive a larger distance for care,” Hawkins continued.   

The proposal also includes work requirements for Medicaid recipients. Still, some hardline Texas Republicans argue the cuts are not deep enough.

“Work requirements are important,” said U.S. Rep. Chip Roy, R-Austin. “I’ve been very clear that you shouldn’t have the able-bodied getting more than the vulnerable. You shouldn’t be having people on Medicaid getting more than Medicare. You shouldn’t be having the people who should work, can work, getting benefits without working.” 

Roy is pushing to reduce the federal match rates for states that have expanded Medicaid. Notably, Texas is one of 10 states that has not expanded eligibility. 

View this story in Spectrum News.