The Megaprock Republican Law will include

“A beautiful, beautiful draft law” for President Donald Trump reduces federal spending in the medical aid markets and the low -price health care law (ACA) by about one billion dollars over a decade, according to the CBO budget office (CBO), a non -Partisan entity. This threatens the physical and financial health of tens of millions of Americans.

he invoiceThe Senate approved on Tuesday, July 1, will reflect many progress in the medical coverage of the Biden and Obama administration, which facilitated the policies of obtaining medical care for millions of people and reduced the rate of people without insurance in the country to the historical minimum.

The Senate to reduce the financing of Medicaid and ACA markets significantly can make about 12 million people not safe by 2034, according to the Central Bank of Oman.

This, in turn, will harm the financial resources of hospitals, the housing of the elderly and community health centers – which will have to absorb a lot of the cost of treating people without coverage – and may force them to reduce services and employees, even to close the establishments.

The legislation is located on the surface of Trump’s office awaiting its company, although the Senate and the House of Representatives must first agree to the same version. The House of Representatives approved its own version in May, and it is expected to be considered in the Senate version today (July 2), according to Tom Emer, the majority leader in the Chamber.

After that, there are five ways in which the Republican Party’s plans can affect access to medical care.

Do you need medicaid? Then get a job

The deepest spending discounts in medical care comes from the work requirements for Medicaid, which would reduce the coverage of millions of subsidiaries that do not meet these new standards.

In 40 Washington, DC, who have sought Medicaid Bajo ACA, some of the Medicaid beneficiaries will have to provide regular documents that show that they work, volunteer or enroll in a school at least 80 hours a month, or eligible to obtain an exemption, as is the case for examples of caring for a young child.

The condition of the draft law will not apply to people in the ten states, most of them Republicans, who have not expanded Medicaid.

Health researchers claim that policy will not have a little effect on employment. Según KFFThe majority of the beneficiaries of medicaid at work age who do not receive deficit subsidies or search for work, or they cannot do so because of They have a disabilityThey enroll in school or take care of relatives.

Los State experiences With work requirements, administrative problems have been created, such as the loss of qualified beneficiaries coverage due to paperwork problems, and more expenses.

Georgia’s work requirements, which were officially implemented in July 2023, cost more than 90 million dollars, of which only 26 million were allocated to health benefits, according to what he said Budget and Policy Institute in GeorgiaNon -party research organization.

“The hidden costs are astronomical,” said Cheima Ndomelli, Professor of Public Health Faculty at Yale University.

Less money means less attention in rural societies

Adaptation measures that apply to countries can be translated into a decrease in health services, medical professionals and even hospitals, especially in rural societies.

The Republican Party plan will reduce the practice known as the name Tax taxesAlmost all states have been used for decades to increase medical payments for hospitals, older housing and other suppliers, as well as private companies that are managed.

The states often use federal funds created through taxes to pay more than Medicaid will pay differently. (Medicaid generally pays the lowest medical care rates, compared to medical care, a program for people over the age of 65 and some persons with disabilities, and special insurance).

Hospitals and housing for the elderly claim that they use this additional money to expand or add new services and improve care for all patients.

Rural hospitals usually operate with a decrease in profit margins and depends on Medicaid tax payments to keep them. Researchers from Cecil G. Sheps Center for Health Services Research They examined the Chamber’s bill that it will force more than 300 rural hospitals, and many of them in Kentucky, Louisiana, California and Aklamaoma, to Reduce your services or close.

Republican Senators added a $ 50 billion fund for their copy of the bill to rid the influence of rural hospitals.

More difficulty in obtaining and preserving ACA coverage

For those who have the coverage of the ACA health insurance market, the Republican plan will make registration and maintain plans.

The insured for the insurance market will be obligated to update their income, the state of immigration and other information every year, rather than automatically re -registering, which is made by more than 10 million people this year.

They will also have less time to register; The draft law limits the annual open registration period in approximately one month.

People who ask to cover outside that period – for example, because they lose their work or any other insurance, or need to add a newborn or husband to a current policy – they will have to wait for all their documents to be addressed before receiving government subsidies to help pay their monthly installments. Currently, they receive up to 90 days of help with insurance premiums during the application process, which may take weeks.

Republican lawmakers and some conservative policy studies centers, including Paraguce Institute for HealthThey claim that changes are necessary to reduce fraudulent inscriptions, while opponents claim that they are The last attempt to dismantle Obamacare.

The legislation also does not consider extending the improved benefits that were implemented during the Covid-19s. If Congress does not behave, the validity of these benefits will end at the end of the year, which will lead to this An average of 75 % increased On the insurance premiums next year, according to KFF.

Do you have a civilian? More will be paid for medical consultations

Many beneficiaries of Medicaid can have to push more than their pocket to appointment.

The draft law will require Medicaid states to impose fees on beneficiaries of up to 35 dollars for some services if their income is between the level of federal poverty (this year, $ 15,650 per person) and 138 % of this amount (21,597 dollars).

The beneficiaries of medicaid generally do not pay anything when they are looking for medical services, as studies have shown that acquiring even a small cobagus leads to low income to abandon the necessary attention. In recent years, some states have added locations less than $ 10 to some services.

This policy will not apply to people looking for primary care, mental care, or addiction treatment.

Paper residency immigrants

The Republican plan can cause at least hundreds of thousands of migrants who have legal residency – including applicants asylum and victims of human trafficking and refugees – lose their coverage from the insurance market by eliminating subsidies that make insurance premiums affordable. The restriction will not apply to permanent residence card holders (green card or green card).

Since the immigrants whose subsidies will lose under this plan tend to be smaller than the general population, their departure will leave a group of oldest subsidiaries, with an increased risk of disease and costs, which will increase the market installments, according to the directors of health insurance markets in California, Mardeland, Massachusetts and health analysts.

John behavior, CEO of the United States Refugee Council, a defense group, said in a statement that removing access to medical care for immigrants who live legally in the country “will lead to irreparable damage to people who promised to protect and impose unnecessary costs for the already loaded local systems.”

Each of the House of Representatives and the Senate in the draft law reflects the restrictions of the Trump administration to immigration.

However, since it contradicts the rules of the Senate, the legislation will not include a proposal that would reduce the federal payments of the murders to states such as California, who use their own money to cover migrants without papers.

The main correspondent of the KFF Health News in Washington, Jolly Rovener, contributed to this article.