The details of the president and the Republican Party’s budget are coming into view, and the news is not good for LGBTQ+ Americans, who disproportionately rely on Medicaid and other federally funded services that the budget seeks to cut.
The proposed reductions in funding were recently revealed in two documents: a budget draft released over the weekend by the House Energy and Commerce Committee and a reconciliation proposal published on Monday by the U.S. House Ways and Means Committee’s Republican majority. The budget includes work requirements for Medicaid recipients and changes to how states raise their portion of Medicaid funds. These changes would net billions in “savings” for the federal government — and possibly devastating state Medicaid programs.
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Medicaid is a crucial source of healthcare for LGBTQ+ Americans, covering a disproportionate share of low-income people, including 21% of transgender individuals and 40% of people living with HIV. Additionally, the federally funded health service is the largest payer for HIV care in the nation. Any cuts will likely jeopardize access to HIV care and undermine national efforts to end the spread of COVID-19.
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Provisions in the proposed budget bills would also forbid the use of federal dollars from Medicaid and CHIP (the Children’s Health Insurance Program) for medically-necessary health care for transgender youth under 19. Another provision would prohibit states from defining that care as “essential health benefits” for transgender people of all ages.
“These cuts pose significant threats to critical programs that disproportionately serve LGBTQ+ individuals, particularly those who are low-income, living with HIV, or facing food insecurity,” the Human Rights Campaign (HRC) said in a statement released Monday. “Anti-equality politicians are also hoping to sneak in provisions to cut off federal funding for medically-necessary care for many transgender people, attempting to strip them of the freedom to access the care they need.”
Anti-equality lawmakers drafted a handout for billionaires built on the backs of hardworking people – with devastating consequences for the LGBTQ+ community.
Human Rights Campaign President Kelley Robinson
Preliminary estimates from the nonpartisan Congressional Budget Office indicate 8.6 million more people will become uninsured as a consequence of the budget bill’s Medicaid and ACA marketplace provisions, with Medicaid driving nearly all of the coverage losses, the Georgetown University McCourt School of Public Policy reports.
Combined with the expiration of enhanced Affordable Care Act marketplace subsidies instituted under President Joe Biden, those cuts will drive the number of uninsured to almost 14 million people.
The changes add up to the largest cut in Medicaid’s history, with $715 billion in savings to offset the president’s oft-stated goal of massive tax cuts for the rich.
The budget bill also includes provisions that would bar certain health care providers from receiving federal funding, including Planned Parenthood, a longtime target of right-wing lawmakers opposed to reproductive rights. The group also provides STI testing and other services for the LGBTQ+ community.
“People in this country have been clear – they want policies and solutions that make life better and expand access to the American Dream. Instead, anti-equality lawmakers drafted a handout for billionaires built on the backs of hardworking people – with devastating consequences for the LGBTQ+ community,” said HRC’s president, Kelley Robinson.
Rep. Steven Horsford (D-NV), a member of the House Ways and Means Committee, said he expects plenty of “WTF moments” as members convene Tuesday to mark up the proposal.
A carveout in Senate filibuster rules means Republicans need only a simple majority to pass a reconciled budget bill.
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