APA Services and scores of other national and state health care organizations are stepping up efforts to protect Medicaid, following House and Senate passage of a joint budget resolution setting high level targets for spending and tax code changes over the next 10 years. The budget resolution lays the groundwork for Congressional leaders’ attempt to make permanent the tax cuts enacted during the first Trump administration and add $1.5 trillion in new tax cuts, offset by an equal amount of deep federal spending reductions in Medicaid and other programs.
The exact size of the federal spending cuts has yet to be determined. With narrow margins for passage, the budget resolution maintained the spending reduction targets contained in the resolution initially passed by the House, without similar explicit commitments for the Senate. In each chamber, a small number of Republican defections could prevent the legislation’s enactment.
Medicaid is now within Congress’s crosshairs. With the resolution’s passage, the House committee with jurisdiction over the program, the House Energy & Commerce Committee, is developing legislation to reduce federal spending by $880 billion over 10 years. According to the Congressional Budget Office, only $135 billion in net 10-year spending within the committee’s jurisdiction is for non-Medicaid and Children’s Health Insurance Program (CHIP) spending. Thus, at least $700 billion in cuts to Medicaid and CHIP will be needed to meet the budget resolution’s target.
Medicaid cuts of this magnitude would substantially reduce Americans’ access to mental health services, as the program pays for roughly half of treatment for mental health and substance use disorders in the U.S. Behavioral health services are optional for state Medicaid programs, and states are unlikely to be able to replace the loss of billions of dollars in federal assistance to maintain their current coverage and reimbursement policies. The website of the Medicaid and CHIP Payment and Access Commission (MACPAC) lists the amount of federal Medicaid funding states received in fiscal year 2023opens in new window, showing the financial stakes involved.
The budget resolution also charges the House committee with jurisdiction over graduate student loan and assistance programs with reducing spending by $330 billion over the next 10 years, putting at risk an array of programs supporting graduate education. These cuts would make psychology training financially prohibitive for many students, exacerbating the nationwide shortage of qualified behavioral health providers, particularly in rural communities.
APA Services is working alongside a wide array of other organizations to try to prevent these deep spending cuts. As a member of the Modern Medicaid Allianceopens in new window, we joined more than 90 other national and state organizations in writing to Congressional leaders urging rejection of deep Medicaid cuts. Additionally, APA Services continues to work with the health professions education community to protect student financial assistance programs critical to the education and training of the psychology workforce. Despite the narrow approval of the budget resolution, the health and education communities are continuing to work throughout the coming weeks and months to stop these harmful cuts.
APA Services urges psychologists to contact their members of Congressopens in new window in both the House and Senate to ask them to vote against reductions in Medicaid and education programs as part of any tax and spending package this year.
For more information, contact Scott Barstow.