House Republicans have proposed substantial cuts, totaling at least $880 billion, primarily impacting Medicaid, which are central to President Donald Trump's "big, beautiful bill." These reductions are intended to offset the cost of significant tax breaks amounting to $4.5 trillion.

数百ページあるこの法案は、昨夜遅くに発表されました。これは、2017年に共和党がトランプ政権の初めにオバマケアをやめさせようとして失敗して以来、医療制度について最も大きな政治的な争いを引き起こしそうです。

共和党は、新しい仕事や資格のルールで「無駄や不正」をなくして費用を減らせると言っていますが、民主党はこれで何百万人ものアメリカ人が保険を失うかもしれないと心配しています。議会の予算を調べる中立の機関は、この案で次の10年間に860万人が医療保険に入れなくなる可能性があると見ています。

ケンタッキー州選出のブレット・ガスリー下院議員は、「このような節約によって、この法案でトランプ氏の減税を延長し、頑張っている中間層の家庭への共和党の約束を守ることができます」と述べました。彼はエネルギー・商務委員会の共和党の委員長で、医療費について担当しています。

However, the Democratic Party has denounced these cuts as 'shameful', accusing them of effectively constituting a renewed attempt to dismantle Obamacare.

"It is evident that millions of Americans will lose healthcare coverage," stated New Jersey Congressman Frank Pallone, the leading Democrat on the committee, who cautioned that "if this bill passes, hospitals will close, seniors will be unable to receive essential medical care, and the insurance premiums for millions of people will increase."

共和党は、マイク・ジョンソン下院議長のメモリアルデーの締め切りまでに、トランプ氏の大きな減税と支出削減の計画を通そうと急いでいます。その前に、今週は様々な分野で一日中公開の会議を開く準備をしています。これは、それぞれの提案を一つにまとめるためです。

政治的な状況ははっきりしませんが、12人以上の下院共和党議員は、ジョンソン議長と共和党のリーダーたちに、地元の人々が頼っている医療プログラムへの削減を支持しないと伝えました。トランプ大統領自身も、以前の失敗を繰り返さないと約束し、メディケイドの削減はしないと誓いました。

Senator Josh Hawley from Missouri wrote on Monday that he warned his colleagues it would be wrong morally and politically dangerous to cut healthcare to pay for tax breaks.

全体として、下院の11の委員会がそれぞれの部分をまとめています。彼らは、2017年にトランプ大統領の初期に承認され、今年末に終わる税金の優遇措置を続けるために、少なくとも1.5兆ドルの節約を目指しています。

However, the Energy and Commerce Committee is getting a lot of attention. This committee was asked to find ways to save 880 billion dollars. They mainly did this by cutting healthcare costs, but they also reduced the green energy programs started by the Biden administration. The CBO's first look at their ideas suggests they could lower the deficit by 912 billion dollars over the next ten years. At least 715 billion dollars of this is expected to come from healthcare rules.

At the heart of these cost-saving measures are alterations to Medicaid, which provides nearly free healthcare to over 70 million Americans, and Obamacare, which has extended coverage to millions more since its initial approval fifteen years ago.

To qualify for Medicaid, able-bodied adults without dependents will face new "community engagement requirements," mandating at least 80 hours per month of work, education, or volunteer activities. Additionally, the process for confirming program eligibility is set to increase from an annual to a semi-annual basis. Furthermore, this legislation includes provisions to tighten income verification for individuals enrolling in Obamacare health insurance plans.

This measure could potentially make it challenging for individuals to consistently maintain their insurance coverage, especially if they are required to travel to distant offices for income verification, due to the increased churn among participants in the program. However, Republicans assert that this policy ensures only eligible individuals can access the program.

Certain Medicaid recipients whose income exceeds 100% of the federal poverty level – specifically, earning over approximately $32,000 annually for a family of four – will be responsible for co-payments for some services. These charges are not anticipated to apply to emergency room visits, prenatal care, pediatric visits, or primary care check-ups, and are expected to be capped at $35 per instance.

Furthermore, if the assessed value of a residence exceeds one million dollars, applicants will be disqualified from Medicaid eligibility.

The proposed bill specifically addresses undocumented immigrants and those residing in the United States with irregular documentation, leading to a 10% reduction in the federal government's contribution to states like New York and California that extend Medicaid coverage to such individuals. Furthermore, enrolling in Obamacare will necessitate applicants demonstrating their legal residency status.

Furthermore, there is a discernible trend towards burdening all states with the associated costs.

Many states have expanded Medicaid eligibility using federal incentives, but this bill intends to roll back the 5% increase implemented during the COVID-19 pandemic.

Furthermore, the so-called provider tax freeze is included. This is something some states use to help pay for a large part of their Medicaid programs. Critics say this extra tax is a way for states to get more money from the federal government, which helps them increase their budgets.

The energy-related sections of the bill are considerably shorter and incorporate setbacks to climate change policies, including those enacted by President Joe Biden in the Inflation Reduction Act.

This bill suggests cutting funding for different energy loans and investment programs, while also speeding up the process for getting permits for natural gas projects and oil pipelines.