Over the next 10 years, the House bill would cut at least $800 billion from the Medicaid program (the largest in American history) and remove at least 10.7 million people from health insurance coverage. 

While the House bill has some redeeming qualities, it is overwhelmingly harmful to older adults and our mission-driven nonprofit providers who serve them. It must be opposed on the Senate floor. The bill’s significant negative impacts include: 

• Reducing state flexibility, which will lead to lower provider Medicaid reimbursement rates or closures, reductions in optional benefits like home and community based services, and further increase access to care barriers.  
• Decreasing states’ ability to respond to budget constraints by freezing health care taxes and limiting new ones.
• Reducing retroactive Medicaid coverage, which will increase uncompensated care, medical debt, and decrease access to care.  
• Enacting administrative and structural barriers to accessing care for the Medicaid expansion population up to age 64 through mandatory work requirements and increased eligibility checks that will impact older adults such as those in affordable senior housing and other community-based settings. 
• Drastically reducing or eliminating coverage for legal immigrants currently eligible to receive Medicare and/or Medicaid.
• Imposing worrisome requirements for the use of artificial intelligence (AI) by instructing that AI be used by the Department of Health and Human Services (HHS) to recoup Medicare A and B payments and by proposing a 10-year moratorium on state and local laws governing AI, including laws already being enforced. 
• Increasing the tax rate applied to the net investment income of all private foundations with $50 million or more in total assets, and extending the unrelated business income tax for most types of charitable nonprofits to include amounts spent to provide transportation-related benefits for employees, and requiring that a corporate taxpayer must donate at least 1% of its taxable income in order to deduct charitable contributions.

LeadingAge opposes policies that raise taxes on charitable nonprofit organizations, which can diminish the ability of these organizations to serve their communities, or that limit incentives to donate.

The House's bill would place a 10-year moratorium on the implementation of the nursing home staffing rule, which LeadingAge supports. The House bill also includes policies LeadingAge supports, including provisions that benefit the development of affordable housing through the Low-Income Housing Tax Credit program, incentivize charitable giving by creating a temporary deduction for taxpayers who do not itemize, and expand the use of 529 education savings plans to cover expenses related to workforce training and credentialing programs. 

Despite some positive proposals, this House bill is, overall, incredibly harmful to older adults and the providers who serve them. 

Please join LeadingAge in asking senators not to enact the House-passed bill's damaging proposals.