House Republicans have proposed sweeping changes to healthcare policies and other federal programs, marking a significant shift in priorities under President Donald Trump.
These proposals, which include substantial cuts to Medicaid, Medicare and other public health initiatives, are paired with executive actions reversing key Biden administration policies.
Here are 10 things ASCs need to know:
1. Republican lawmakers on the House Budget Committee are seeking the elimination of dozens of federal spending programs, according to Politico. A significant target is healthcare spending, particularly Medicaid, which faces deep cuts as part of broader cost-saving measures.
2. The proposed Medicaid reforms could save $2.3 trillion over a decade, according to KFF. Key changes include implementing a per capita cap, reducing the Affordable Care Act expansion match rate, and lowering the Federal Medical Assistance Percentage floor below 50%.
3. The proposals include limiting healthcare access exclusively to U.S. citizens. According to Forbes, this would eliminate healthcare subsidies for Deferred Action for Childhood Arrivals program participants — undocumented individuals brought to the U.S. as children.
4. The Medicaid funding model would also shift to a "per capita cap" system, providing states with fixed funding per beneficiary, rather than covering a percentage of overall costs. According to the Congressional Budget Office, transitioning Medicaid to per capita caps could save $893 billion over 10 years.
5. The ACA's Medicaid expansion, which extended coverage to those earning up to 138% of the federal poverty level, is also under scrutiny. Republicans propose reducing the federal match rate from 90% to an average of 60%, aligning it with standard Medicaid funding levels.
5. Lawmakers are also targeting Medicare cuts, which include standardizing outpatient service reimbursements with site-neutral payments to save $146 billion, eliminating funding for hospital bad debts for $229 billion in savings and reducing uncompensated care funding.
6. Republican proposals also include adding work requirements for Medicaid recipients. Beneficiaries would need to demonstrate employment or participation in approved work-related activities to maintain their coverage.
7. On Jan. 20, Mr. Trump signed an executive order removing the U.S. from the World Health Organization due to "the organization's mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms and its inability to demonstrate independence from the inappropriate political influence of WHO member state," according to the order.
8. Another executive order signed by Mr. Trump rescinded several Biden administration initiatives, including:
- A 2021 order on racial equity and support for underserved communities.
- A 2021 order on equitable pandemic response and recovery.
- Biden’s initiative to lower prescription drug costs, halting plans to cap certain Medicare generic drug prices and negotiate pricing for high-cost therapies
10. President Trump announced a 25% tariff on Canadian and Mexican products effective Feb. 1, citing concerns about drug trafficking and immigration, The New York Times reported.