It's never fun to stand up to a president in your own party. However, it’s often necessary to prevent your side from making mistakes they will come to regret. And Democratic leadership is now badly needed to help save the Biden administration from committing an egregious blunder that would harm millions of vulnerable Americans who rely on Medicaid for their health care.
In 2020, I joined Republican colleagues in writing to President Donald Trump's Department of Health and Human Services to express our opposition to a proposed Medicaid Fiscal Accountability regulation. We wrote that the rule could result in “total funding reductions of between $37 billion and $49 billion annually,” including a cut of “12.8% to 16.9% of total hospital program payments,” by empowering federal bureaucrats to micromanage the state management of Medicaid from Washington, D.C.
At the time, our concerns were echoed by a large chorus of Democratic leaders, including Joe Biden and Kamala Harris. In a letter with 26 of her Democratic colleagues, then-Sen. Harris called the rules not only “dangerous” but also “devastating to … vulnerable low-income patients.” The Biden presidential campaign put on its website that he would oppose it. The bipartisan outcry extended to the nation’s governors, who warned that “states may be unable to adequately fund their Medicaid programs.”
Trump administration backed off proposed Medicaid rules
Following this strong opposition, the Trump administration wisely forced the federal bureaucrats at the Centers for Medicare and Medicaid Services (CMS) to withdraw the plan.
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Unfortunately, that was not the last we heard of the cuts. In February, Biden’s CMS issued a federal bulletin reestablishing the regulations. In April, Texas Attorney General Ken Paxton sued CMS, arguing that it does not have the authority to issue these rules. However, since then, the agency has doubled down, incorporating the requirements into new rules that were proposed in May.
Democratic members of the Texas and Florida congressional delegations have urged the Biden administration to reverse course on proposed Medicaid rules.
Enacting severe cuts to Medicaid would not only be a disaster for vulnerable patients across America. It would also be politically damaging for President Biden as we move closer to the upcoming election, especially given his previous statements on the issue.
The president has launched constant attacks against Republicans, accusing them of seeking to cut Medicare, Medicaid and Social Security. Until his administration sends these proposed regulations into the dustbin, he is throwing stones in a glass house.
Democratic members of the Texas and Florida congressional delegations have urged the Biden administration to reverse course. "A policy shift of this significance threatens not only the most vulnerable citizens of our home state, but Medicaid beneficiaries across the country," Texas Democrats wrote in a letter to HHS Secretary Xavier Becerra.
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Democratic leaders have been quiet about Biden's Medicaid plan
But so far we’ve heard crickets from national Democratic leaders who were outspoken against the regulations when they were put forward under Trump’s watch.
Members of the federal bureaucracy often work to advance their own agenda. That is true regardless of what party the president comes from. The job of party leaders in these cases is not to just be yes men for federal bureaucrats. It is to consider what is in the best interest of their constituents, their party, their president and our country, and then speak out accordingly.
We were fortunate to have that relationship with the Trump administration, which responded to our call on this matter and did the right thing. Whether Democratic leaders are willing to do the same remains to be seen.
Tom Reed is a former Republican congressman from New York.