The Republican Party, my mother, as Congress, is preparing to reduce spending on their mandate

The last time, Congress and President Donald Trump Donald Trump moved to Medium Mudikid’s spending, in 2017, and a major political power on their way: Republican rulers.

Now, while Congress flows towards passing historical debt cuts around 1 trillion dollars over 10 years Through Trump’s legislation and spending, the rulers of the red state say little publicly about what he does for health care-even if they face discounts that would include holes in millions of dollars in the budgets of their states.

Medicaid, a program run by states and federal government, covers more than 70 million low -income people or disabled, including nearly half of the country’s children. Republicans say that the program worth $ 900 billion per year allows it to grow very large in the shadow of Democrats Barack Obama and Joe Biden by adding uncomfortable adults they say. Do not deserve government assistanceAnd they have long sought to expand it again.

Some of the largest health cuts are achieved in the legislation that Trump calls “a beautiful, beautiful draft law” through new policies that reduce joining the imposition of more papers requirements on registrants, including a condition that many prove that they are working. These policies will only affect the countries that have expanded Medicaid to more than those with low income under reasonable prices.

Nineteen of these countries Leaded by Republican rulers. Their silence on the measures of the health draft law is to give a political cover for the legislators from the Republican Party from their states, as they seek to reduce the coverage of medical aid to millions of people who have acquired it during the past decade.

KFF Health News called on all 19 conservatives to comment on Medicaid’s discounts. Only six responded. Most of them said they support the imposition of work requirements on adults registered.

“The implementation of work requirements for adults who enjoy physical is a good and necessary reform so that Medicaid is used for temporary assistance and not a permanent entitlement,” said Drew Gallowing, a spokesman for state governor Patrick Mori from West Virginia.

“The ruler Rodin supports the work of the workforce as a condition of the eligibility of expanding medical aid,” said Josie Harmz, a spokeswoman for the state of South Dakota Larry Roden, adding that the congressmen are receiving support from the ruler.

In a sign of how political winds changed, none of the conservatives said anything about the important discounts of legislation, to Supplier A tool that almost all its states use to help pay its stake from Medicaid and gain additional funds from the federal government. This change is expected to cost billions.

It is no longer an issue from the two parties

In contrast to the radio silence of the Republican Party governors, the Democratic Conservatives have a campaign against the huge weeks ago.

Pennsylvania Governor Josh Shapiro published On the social platform x Trump and the Republicans in Congress were misleading of Americans by saying that they only cut off waste, fraud and abuse in medical aid.

“They are rushing to kick hundreds of thousands of Pennsylvania from health care – and lying on this topic,” as published. “The damage that this will happen here in Pennsylvania and through America is amazing and will feel it for years to come.”

In New York, state governor Cathy Hochol accused on July 1 that Trump’s legislation would destroy hospitals and may lead to more than 34,000 reduction in its work.

She said, “The collective impact of the draft law on settlement of the Republican Party in Washington, DC, can force hospitals to reduce the services that are needed such as motherhood and psychotherapy, not to mention the reduction of operations, and even the closure completely.” In a statement.

In 2017, the choir was from the two parties, as Republican referee Ohioand NevadaAnd Massachusetts I spoke against medical aid. Trump’s draft law failed to cancel many of the sponsorship law at reasonable prices and its expansion in Medicaid has declined by a small difference in the Senate.

“It was surprising that the rulers of the red state, especially those in the states of Madikid, did not speak against Medicaid discounts,” said Larry Levitt, Executive Vice President of Health Policy at KFF, a non -profit organization for health information that includes KFF Health News. “Republican conservatives were a strong political power in the failed efforts of 2017 to cancel and replace ACA, including Medicaid’s expansion.”

Political experts say that what has been changed since 2017 is that there are fewer moderate Republican rulers and executives in the state of the Republican Party who have called for the expansion of medical aid for more than a decade who is no longer in office.

In addition, seven of the red countries at the time that expanded Medicaid I did this through the polling initiativeOften the opposition from their rulers.

In fact, Medicaid’s work requirements are supported by many Republican rulers, even if it means less than Medicaid Federal funds and leads to fewer people.

Several states, including Arkansas and Ouhyu, have already approved state laws to implement a demand from adults registered under Medicaid expansion in ACA, volunteers, go to school, or participate in work training. Most states have not yet brought work requirements because they are awaiting the approval of the federal government.

“Although less conservatives have publicly participated in trying to prevent medical aid discounts within the framework of the draft law, federal legislators hear from the legislators in their states, said Charles” Charles “Khan, President of the American Hospital Federation, a commercial group of hospitals owned by investors.

It is a political dilemma for Republican rulers that, unlike 2017, before Congress is not a legislation that explicitly aims to cancel Obamacare. With a broader domain of health care, it will extend many Trump tax cuts and direct billions in new spending towards border security, migration enforcement, and army, while reducing spending on health care.

“It is like playing a multi -dimensional chess instead of focusing on one case,” Kan said.

Larry JacobsThe director of the University of Minnesota Politics and Governance Center said that some Republican rulers may have expressed their concerns about the members of the Senate in their states, but they do not speak publicly for fear of Trump’s anger.

“Why are they a cage? Trump and the unwillingness to be” Liz Cheney “, referring to the former Republican legislator in Wyoming who helped Trump after worked as a deputy head of the investigation in his attempts to cancel the results of the 2020 election.

Walking

Republican political lawmakers are still in the political danger of Trump’s open challenge. On June 29, Thom Tillis (RN.C) announced that he would not be nominated for his re -election after he expressed his concerns about the draft law and threatened the president to support a basic competitor. Telis was one of the three Senate members of the Republican Party to vote against it on the first of July, although it was still a few acknowledged.

In addition to work requirements, the largest cuts in the draft law stems from its restrictions on the supplier taxes – the fees imposed by the states on hospitals, the role of the elderly and other health care institutions to help increase their federal payment. Then a lot of additional money is returned to health care providers in the form of higher payments for Medicaid patients.

The practice, which was adopted in every state but Alaska, Criticism By some Republicans, Biletawi, as wellMoney laundering– Despite the approval of taxes by legislators in the state and the federal centers of Medicare & Medicaid services and was allowed under decades federal law.

The Senate Bill would limit the money that countries can be raised – a step that means billions of dollars in financing discounts to the states and their hospitals.

The countries that have the rulers of Republicans who expanded Midikid are Alaska, Arkansas, Idahu, Eindana, Iowa, Louisiana, Missouri, Montana, Nebraska, New Hampsheer, Nevada, North Dakota, Ouhayu, Aklahoma, South Dakota, Fairstment, Virginia West Virgin.

One of the conservatives expressed their concerns about canceling the expansion of Obamacare Medicaid in 2017 was Justice of West Virginia, a democratic at that time.

in June 2017 Message To the West Virginia state, Senator Shelly Moore Capito, a Republican, wrote: “Since many of our employees depend on Medicaid, any discount to medicaid will destroy families in West Virginia.” He added that “the consequences will be beyond catastrophic.”

On July 1, justice – elected to the Senate as a Republican last year – voted for Trump, including Medicaid discounts.

“The Senator believes this draft law achieves a good balance between the most vulnerable protection and those who rely on the program while removing waste, fraud and ill -treatment to ensure the program is efficiently run for those who deserve,” said William Augredi, a spokesman for justice in an e -mail on July 2.

The KFF Health News ARILELLE Zionts contributed to this report.