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cover of episode Understanding Republicans’ Proposed Cuts to Medicaid

Understanding Republicans’ Proposed Cuts to Medicaid

2025/2/20
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KQED's Forum
AI Deep Dive AI Chapters Transcript
People
C
Chiquita Brooks-LaSure
J
Joanne Kenen
K
Kristof Stremikis
L
Larry Levitt
Topics
Larry Levitt: Medicaid 与 Medicare 不同，它覆盖低收入人群、残疾人、老年人（Medicare 未完全覆盖部分）、药物滥用项目、养老院护理以及《平价医疗法案》中的其他护理项目。Medicaid 的实施方式因州而异，资金由联邦政府和州政府共同承担。它是一种权利计划，只要符合州的规定，就有资格获得保障，联邦政府必须匹配州政府的支出。Medicaid 提供全面的服务，包括家庭护理、养老院护理等，对残疾人和老年人至关重要。大多数 Medicaid 受益者通过私人保险公司获得医疗保障，州政府与这些公司签订合同来提供保障。《平价医疗法案》扩大了 Medicaid 的覆盖范围，将低收入成年人也纳入其中，但联邦政府的资助比例更高。大量研究表明，医疗保障可以改善医疗服务可及性、健康状况，甚至降低死亡率，并提供财务保障。Medicaid 是养老院护理的主要支付方，因为 Medicare 不覆盖长期养老院护理。对 Medicaid 的看法存在意识形态分歧，自由主义者将其视为迈向全民医保的工具，而保守主义者则将其视为仅供“应得的穷人”使用的福利。 Joanne Kenen: 共和党对 Medicaid 的削减提案存在分歧，特朗普的态度也摇摆不定，削减提案能否通过存在不确定性。共和党提出的 8800 亿美元的削减方案将需要对 Medicaid 进行根本性的重组，这在政治上将面临巨大挑战。 Kristof Stremikis: 削减 Medicaid 资金将导致覆盖人数减少、福利减少以及对医疗服务提供者的支付减少。Medicaid 支持加州大量劳动力，大多数受益者都在工作。提高 Medicaid 的效率需要考虑如何利用联邦政府的资金支持创新，而大幅削减资金可能适得其反。如果联邦政府停止提供资金，加州将难以弥补差额。 Chiquita Brooks-LaSure: Medicaid 的重要性日益增长，不仅体现在覆盖人数上，也体现在其对经济的影响上。Medicaid 不仅对低收入人群重要，也对中产阶级至关重要，尤其是在长期护理方面。大幅削减 Medicaid 资金将对医疗系统产生重大影响，不仅会影响 Medicaid 受益者，还会影响整个医疗系统。近年来，Medicaid 在提高医疗质量和效率方面取得了进展，但仍有改进的空间。大幅削减 Medicaid 资金不利于提高效率和创新。 John(Caller): 对 Medicaid 的攻击是几十年来持续不断的对“伟大社会”和新政的攻击的一部分。 Kevin(Caller): Medicaid 覆盖了 Medicare 未覆盖的许多医疗需求，例如牙科和视力保健，并且可以减轻因疾病造成的债务负担。 Matthew(Caller): Medicaid 仍有提高效率的空间，例如更快地采用仿制药。

Deep Dive

Chapters
This chapter explains what Medicaid is, what it covers (low-income children, single parents, seniors, people with disabilities, etc.), how it's financed (shared between the federal government and states), and how it interacts with private insurance. It also discusses evidence that Medicaid improves health outcomes and provides financial security.
  • Medicaid is distinct from Medicare, covering low-income individuals, the disabled, and those needing specific care types.
  • It's implemented differently across states, with varying names and funding structures.
  • Studies demonstrate Medicaid's positive effects on healthcare access, outcomes, and financial stability for beneficiaries.

Shownotes Transcript

Republicans are looking to cut as much as $880 billion from Medicaid, a federal program that provides healthcare for 72 million Americans. Distinct from Medicare, which covers seniors, Medicaid includes coverage for low income people, the disabled, substance abuse programs, nursing home care, and the Affordable Care Act, among other kinds of care. Nearly half of all births in the U.S. are covered by Medicaid, and polls show enormous support for the program across political parties. Donald Trump has said that cuts to Medicaid are off the table, but congressional Republicans’ proposed budget to pay for the president’s signature $4.5 trillion dollar tax cut relies on massive cuts to the program. We’ll talk to experts about the future of Medicaid.

Guests:

**Larry Levitt, **executive vice president, Kaiser Family Foundation

**Joanne Kenen, **journalist In-residence, Johns Hopkins School of Public Health

**Kristof Stremikis, **director of market analysis and insight, California Health Care Foundation, independent nonprofit focused on improving healthcare for Californians

**Chiquita Brooks-LaSure, **former administrator, Center for Medicare and Medicaid Services; served as administrator during the Biden administration from 2021-2025