The Democrat says GOP spending cuts will lead to “sicker Virginians.”
The US Senate is set to take up a budget bill that’s become the legislative focus of President Donald Trump’s agenda this week after Congress returns from a Memorial Day recess. Before leaving, the US House of Representatives voted 215–214 to pass its version of a tax and spending bill. The legislation put restrictions on who will be eligible for Medicaid coverage.
Rep. Jennifer McClellan (D–4th) voted against the bill. She said it would put a heavy burden on some of the most vulnerable people in the state.
Coined the “One Big Beautiful Bill Act” by Republicans, it is the result of the second Trump administration’s first push for legislative change. The House bill would extend tax cuts passed in 2017, increase spending on defense and border security and reduce federal spending by $1.5 trillion over the next decade.
The budget proposal also makes historic changes to Medicaid — adding work requirements and forcing Medicaid recipients to renew their status twice a year. While it addresses Medicare physician payments, the bill could trigger about $500 billion in automatic cuts connected to the Pay-As-You-Go Act, which could have impacts on available services and provider reimbursements.
A preliminary analysis done by the Congressional Budget Office estimates the House’s budget would cut $698 billion in federal Medicaid subsidies and add $3.8 trillion dollars to the federal deficit.
The bill, which is being passed through a process called reconciliation, is expected to face changes in the Senate. Reconciliation is meant only to address budget-related issues. The Senate parliamentarian is tasked with deciding which items qualify, so some of the pieces of the bill passed by the House may have to be altered or removed to meet the Senate’s requirements.
In Virginia, about 1.9 million adults and children are enrolled in Medicaid, according to the Virginia Department of Medical Assistance Services. Early reviews of the legislation from the U.S. Congress Joint Economic Committee show roughly 160,000 Virginians could lose Medicaid coverage.
McClellan spoke with VPM News health care reporter Adrienne Hoar McGibbon about the legislation after the House vote.
This interview has been lightly edited for clarity and style.
Adrienne Hoar McGibbon: The Energy and Commerce Committee, which you’re a member of, was tasked with cutting $880 billion over the next 10 years from Medicaid. What do you think that could mean for Virginians?
Jennifer McClellan: Preliminary estimates show that not only were there cuts in Medicaid, but that the bill could trigger significant cuts in Medicare because of the Pay-As-You-Go law.
I think, between the gutting of the Affordable Care Act [and] the gutting of Medicaid, we will see hundreds of thousands of Virginians who will lose their health insurance, but they'll still get sick, and they will go to the emergency room when it's more expensive to treat — oftentimes when it's too late to treat. And those costs will be passed to the rest of us.
That's exactly why we expanded Medicaid in Virginia back in 2018 when I was in the Legislature, because we were worried about the impact of that uncompensated care. We were worried about our rural providers closing, and now all those worries are back on the table.
But on top of that, you have millions of Americans — a third of them children — who are losing food assistance, who are also going to be losing access to free and reduced lunch in schools, and so you'll have hungrier Virginians. You will have sicker Virginians. All so the top wealthy can get a little bit richer.
There were expectations that the legislation could impact Medicaid expansion by changing the amount that the government was providing and funding to states. That didn't happen, so how could people on Medicaid expansion be impacted?
If you're part of the expansion population and you make up to $300 a week, you will have to pay up to a $35 copay every time you go see a doctor, and what that means is somebody who also has to pay rent, pay utilities, put food on the table, who now probably won't have access to SNAP benefits — they're not going to go to the doctor and pay that copay. They're going to use that to put food on the table, and as a result, they're not going to get care, and when they show up in the emergency room, we will pay the rest.
The other piece is now you will have to prove that you are working and go through these red tape requirements that Virginia does not have a process set up for to do automatically. When the states were allowed to put work requirements in place, only two of them did it. Arkansas kicked 18,000 people who were eligible for Medicaid — who were working — off of the rolls, because they couldn't prove [they were] working through their cumbersome process. And Georgia has seen similar results.
So the expansion population is going to be hit very hard by this bill in ways that are going to devastate the entire health care system. And then when you're kicked off of Medicaid, you won't be able to get access to the subsidies to buy through the exchange, and so you're going to go uninsured, and we're going to have that same uninsured gap that caused rural hospitals to almost close and blow a hole in the state budget.
The state's going to have to decide: Does it put in the money to pay the difference when it's also seeing other cuts?
Now, for the first time, the state has to contribute to SNAP benefits and has to fill in gaps from other federal funding, as we're seeing the federal workforce, with Virginia [having] the second highest number of federal employees now no longer working and contributing to the tax base. So it's going to blow a hole in the state budget. It's going to leave many Virginians uninsured, and it's going to devastate our health care system.
Republicans have said that these cuts will help protect Medicaid for future generations. What's your response to that?
They did absolutely nothing to protect Medicaid, because all of the savings that they found went to fund the tax cuts — the bulk of which benefit the top, wealthiest few — and they did nothing to address the real cost of Medicaid, which is the fact that people are living longer and need more long-term care, the cost of prescription drugs going up.
They didn't do anything to address that. They didn't invest any of this back into the health care system to strengthen Medicaid. All of the money went to tax cuts.
