Senate Finance Committee Endangers Even More Medicaid Patients

[Passages]

The Senate draft makes changes that will annoy House moderates and conservatives. But on Medicaid, it goes further than the House, threatening the lives of more Americans.

by David Dayen June 17, 2025

The Senate Finance Committee released the text of its critical portion of the Big Beautiful Bill late Monday afternoon. The big thing to note is that the Senate does pick fights with two motivated House factions: the “SALT Caucus” that wants bigger tax breaks for high-income earners who deduct state and local taxes, and the Freedom Caucus that wants quicker phaseouts for clean-energy tax credits. But in the health care title, the bill actually got worse, and will be more immiserating for patients, hospitals, and states, particularly blue states.

Here’s what we know so far while we continue to dig into it:

Health care: As we reported on Monday, the brief flirtation with tackling the biggest source of waste and fraud in the entire health care budget, Medicare Advantage overpayments, was quickly extinguished. Instead, we have a health care title that, against all expectations, is actually worse on net than the House version.

The only Medicare policy change is a limitation on coverage for certain immigrants. (Specifically: refugees, aliens granted asylum, aliens granted parole for at least one year, abused spouses, victims of trafficking, and Haitian entrants. Cuban entrants, in a nod to Cuban Republicans, still get coverage.) Other House provisions that cost money, like inflation adjustments on doctor reimbursements, and the Accelerating Kids’ Access to Care Act, were stripped out. In addition, all the health savings account (HSA) changes that the House put in to allow older workers and some Medicare recipients to gain the tax advantage were stripped by the Senate.
https://prospect.org/politics/2025-06-17-senate-finance-committee-endangers-even-more-medicaid-patients/