Posted on 07/01/2025 9:17:54 PM PDT by SeekAndFind
With the passage of the BBB by the Senate today, one of the issues I was interested in was what happened to plans to eliminate Medicaid funding for illegal immigrants. And it's actually a bit difficult to figure out what is going to happen now.
So the backstory here is that the feds haven't agreed to directly fund Medicaid for illegal immigrants anywhere. However, some states have rolled out versions of Medicaid which cover some illegal immigrants using state funds. California in particular has expanded Medical to cover all immigrants who meet the income threshold. However, that expansion cost the state a lot of money, creating a big budget gap this year. So in the newly announced budget, Gov. Newsom cut off new enrollment in the program and required those immigrants who have already enrolled to start paying a monthly premium for the coverage.
In signing the budget, Mr. Newsom backtracked on his earlier pledge to insure all low-income residents, regardless of their immigration status. But it came as the state faced a $12 billion deficit, driven in part by a large cost overrun in the state’s insurance plan for undocumented immigrants, and it would have been politically difficult to cut programs for citizens without reducing benefits for undocumented immigrants...
The California budget for the fiscal year that starts Tuesday relies on prohibiting new enrollment of undocumented immigrants in the state’s Medicaid program, known as Medi-Cal, starting in January. Adults between the ages of 19 and 59 who were already enrolled will have to pay a new $30 monthly premium beginning in 2027.
But getting back to the BBB, there were actually two provisions in the bill dealing with illegal immigrants and Medicaid. As I understand it, one section of the BBB was intended to cut reimbursement for states that chose to use their own money to fund coverage for illegal migrants. In essence the feds were pushing the states to drop such coverage. There had been a lot of concern that this would work because the states would not be able to cover the shortfall.
The cuts, if approved by the Senate, would pose a tricky political and economic hurdle for the states and Washington, D.C., which use their own funds to provide health insurance to some people in the U.S. without authorization.
Those states would see their federal reimbursement for people covered under the Affordable Care Act’s Medicaid expansion cut by 10 percentage points. The cuts would cost California, the state with the most to lose, as much as $3 billion a year, according to an analysis by KFF, a health information nonprofit that includes KFF Health News.
Luckily for California, that portion of the bill was stripped out last week by the Senate parliamentarian.
Parliamentarian Elizabeth MacDonough determined that some of the megabill’s Medicaid provisions — including changes to federal funding for US states’ share of health care provider taxes — were not eligible for approval via the simple-majority gambit, known as reconciliation.
Other axed provisions eliminated some Medicaid eligibility for non-citizen adults and children and lowered Federal Medical Assistance Percentage (FMAP) funding percentages for states that let non-citizens obtain health care coverage from 90% to 80%.
However, according to Missouri Sen. Eric Schmitt there is still a section of the bill limiting eligibility for illegal immigrants.
Here's where the rumor came from: During yesterday's vote-a-rama, an amendment banning Medicaid for illegal immigrants was voted down.
The clip of that vote started circulating online—and folks took that to mean that the provision had been stripped from the bill altogether.— Senator Eric Schmitt (@SenEricSchmitt) July 1, 2025
The ban itself was ALREADY in the bill. It was never taken out.
And it wasn't just a ban on some Medicaid for illegal immigrants who commit heinous crimes—it applies to ALL Medicaid for ALL illegal immigrants. (And most noncitizens generally).— Senator Eric Schmitt (@SenEricSchmitt) July 1, 2025
According to the Congressional Budget Office, roughly 1.4 million illegal immigrants are currently on Medicaid, despite the fact that they don't meet federal enrollment requirements—because blue states have expanded their (federally funded) Medicaid programs to include them.— Senator Eric Schmitt (@SenEricSchmitt) July 1, 2025
The Big Beautiful Bill ends that arrangement by restricting Medicaid eligibility.
According to the official data from the CBO (see below), that kicks a whopping 1.4 million illegal immigrants off the Medicaid rolls.
pic.twitter.com/zTeutcnpIz— Senator Eric Schmitt (@SenEricSchmitt) July 1, 2025
That means blue states are left with a choice: Either send your illegal immigrants home, or you're going to be paying their bills yourself.
It's easy when you're doing it on the American taxpayer's dime. It's a lot tougher when it's all coming from your own constituents.— Senator Eric Schmitt (@SenEricSchmitt)
Here's what doesn't make sense to me about this. Most of the coverage being targeted here is in California because California was the first state to expand this coverage to everyone of every age who met the income threshold. But California was paying for that expansion of coverage, not the feds. That's why California had a massive budget deficit and why Gov. Newsom had to dial it back in the latest budget.
In other words, the state wasn't being reimbursed for this already and now they still won't be reimbursed for it. The cuts to funding would have come from the other section of the bill which reduced they coverage amount by 10% for states who were offering coverage to illegal immigrants. But as I mentioned, that was ruled out by the parliamentarian before the bill was passed.
So as I said up top, it's actually difficult to figure out what is happening here. Will the new eligibility requirement force cuts and if so how will it work. I'm sure someone is going to write a story explaining what the remaining section of the bill does but so far I'm not seeing it. I'll try to update this today or tomorrow once it's more clear.
Come on man! Everyone knows you have to pass it before you find out what is in it! </S>
Let’s be honest here. If an illegal immigrant brings his cancer-ridden 5-year old to the ER, and they are not covered by Medicaid, the child will still be cared for and treated for the disease. I can’t tell you how or where the money will come from, but regardless, the child will not be turned away.
The so called medicaid cuts Democrats keep talking about is really NOT A CUT AT ALL. Medicaid spending actually goes UP 6% for couple of years, then 4% for following years.
In Washington DC if increase in spending is less than what the liberals want is called a cut!
Mr. Sexton can blame the parliamentarian all he wants, but Thune had the option to overrule her.
“ And it’s actually a bit difficult to figure out what is going to happen now.”
GOP / Chamber of Commerce typical Lie to start the conversation.
😄
They can’t stand losing to Trump.
I just hope that illegals will not get a single penny of Medicaid money, or any other benefit paid for by U.S. taxpayers. It was not intended for the benefit of any who did not pay into the system and should not be possible for them to get anything. Throw the grifting bums OUT!
Chicken or the egg when the situation cross references with laws still present. One example, everyone needs to be treated at ERs, no questions (Financially) asked. Who pays for illegals? The hospital systems forced to treat customers who can’t pay by the Federal government or the Federal government who who has failed to police the government? Keep in mind whatever the Fed government pays out is not 100% either, but hospital systems will take what they get because distributing healthcare to people that can’t pay is financially stressful.
Sorry, police the illegals but I will say Congress and administrations have not managed the government well either.
Plenty of sites to read what was in the bill...before it passed.
EMTALA ensures that illegals, and anyone else, can continue to use the ER for primary care.
And on the bleeping bill, some food for thought...
https://x.com/CynicalPublius/status/1931166853688422516
Unfortunately, the media has convinced the lasses that republicans are the boogie monster. Of course, I’ve seen a few republican politicians try to explain what actually is cut in Medicaid but hardly convincingly. I wish republicans knew how to fight.
True. Had thune done that, it would have triggered the filibuster which for now would be great. But the gates of hell would open if democrats ever got the trifecta again. For some reason, Americans have forgotten that the government is supposed to be slow and not really big on major changes.
I can’t tell you how or where the money will come from, but regardless, the child will not be turned away.>>>. The money is billed to all the other payers. It is added to the cost of ER for everyone who can pay. That’s one reason Hospitals separated ER into separate companies within the Hospital. It isolates the cost with the ER unit.
Yeah I was being sarcastic...I gave the Pelosi answer to their question. 😉
Sorry wrong one...I should have known...text of HR14 waaaay too short...here is “ H.R. 1” (869 pages):
https://www.congress.gov/bill/119th-congress/house-bill/1/text
“ That means blue states are left with a choice: Either send your illegal immigrants home, or you’re going to be paying their bills yourself.”
————————————
This sounds good. Except the law required that when a person walks into an Emeregency Room at a hospital they are to be provided with treatment to stabilize their condition—regardless of their insurance or ability to pay.
For example if they are in car accidents they have to be treated—including hospitalization. Of course, it doesn’t mean ‘rehab’ or follow up services. But nevertheless, the hospitals are on the hook for having to treat indigents when them walk in the door. This is why ERs are backed up for hours on end.
My point is that there are conflicting laws on the books. An illegal immigrant with an emergency medical situation MUST be treated, but they cannot pay. Even if the answer is to “call ice”, the patient will still be treated and the costs incurred.
The bad debt for hospitals in even small urban settings is in the tens of millions of dollars per year. It is causing a financial crisis that is usually passed off as “insurance company greed.” It causes the entire cost to be spread across all customers/patients.
Anyone thinking we don’t already have “socialized” medical care doesn’t understand how the system currently works. It’s just bad socialized medicine.
Regardless that all must be treated, if it scares some about being stuck with the bill, it will cut down the wait time in the ER and will be better for everyone.
That child will probably be stabilized but in most states deported with his family. He would probably not get the long term care.
There are medical visas for people who come here for medical treatment afaik but that would not be paid for with federal taxes.
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