Medicare is in the GOP's crosshairs, too

While it hasn't made major headlines, the One Big Beautiful Bill contains major cuts to the program that provides health care for over 65 million seniors citizens and the disabled.

When it comes to health care, most public protests against the “One Big Beautiful” tax giveaway have focused on its vicious Medicaid cuts. More attention needs to be paid to how the House-passed legislation will also harm Medicare’s most vulnerable beneficiaries.

Despite repeated promises not to touch Medicare, the bill:

• Postpones until 2035 the Biden administration rule that automatically enrolls low-income seniors with disabilities in zero-premium Medicare drug plans with limited out-of-pocket costs. The Congressional Budget Office estimated over one million people will lose this coverage by not signing up due to onerous paperwork. A new study in the New England Journal of Medicine found low-income seniors who lose the IRS-administered subsidies increase their chance of premature mortality by at least 4%.

• Scraps the Biden-backed rule requiring minimal staffing at the nation’s 15,000 skilled nursing facilities. Nursing homes will no longer be required to have a registered nurse on duty 24 hours a day; nor will they be required to have adequate personnel on hand to help vulnerable seniors and the disabled in nursing homes with the basic tasks of daily life. (To read more on the nursing home rule and conditions in the nation’s nursing homes, see previous GoozNews posts here and here.) And,

• Terminates Medicare coverage for many visa-holding foreigners who for years have resided and worked in the U.S. and paid taxes to the government. This is a significant departure from current policy, which grants eligibility to legal immigrants who have paid into the Social Security and Medicare systems.

If one includes these and other Medicare cuts to the more than $800 billion slashed from Medicaid (nearly half of which will from come barring low-wage workers who fail to manage the bill’s work requirement’s paperwork), there will be nearly $1 trillion in cuts in health care to pay for a $4 trillion tax cut, which will go almost entirely to the well-off.

Providers at risk, too

The cuts won’t stop there. The bill, despite its massive cuts, increases the deficit by $2.3 trillion over the next decade. The Congressional Budget Office projects debt service payments under this legislation are on pace to become the single largest line item in the federal budget, larger than any health program, Social Security or the U.S. military.

There is a law designed to prevent that from happening. In 1997, with Bill Clinton in the White House and Republican majorities in charge of both houses of Congress, the government passed the Balanced Budget Act. It included a circuit breaker known as the sequester, which requires Congress to impose across-the-board program cuts whenever total spending exceeds total revenue. It could, of course, waive the requirement as it has done when passing budget bills for most of the past two decades.

But if Congress imposes the sequester, Medicare will have to cut payments to hospitals, physicians and other providers by about $490 billion over the next decade beginning in 2026, according to the CBO. The effects could prove disastrous: Fewer physicians and nurses working for lower pay; more closed hospitals, especially in rural areas; and severe labor shortages across the health care sector, which will soon feel the pinch from the Trump regime’s immigration crackdown if it hasn’t already. An estimated 350,000 undocumented immigrants work in health care, supporting the one in five U.S. physicians who are immigrants.

Let’s sum up. An estimated 15 million people added to the ranks of the uninsured. More rural hospital closings. More cuts to urban and rural hospitals whose clientele are disproportionately poor. Health care workers driven from the field. Fewer workers at nursing homes. Lower pay for doctors and nurses working at facilities dependent on public funding. Cuts in food stamps and other public programs aimed at helping the poor.

If the truth-in-advertising law (yes, there is one) was applied to this legislation, it wouldn’t be called the One Big Beautiful Bill Act. It would be called the Public Squalor Amid Private Plenty Act.

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