A Medicaid bill promoted by the Republican Party proposes major cuts to health insurance plans for low-income Americans. But U.S. President Donald Trump claims that the legislation will change Medicaid in a way that can only combat "waste, fraud and abuse", a phrase that was repeated seven times in a few minutes.
"We're not doing anything meaningful," the Republican president said. "The only thing we cut is waste, fraud and abuse. … We're not changing Medicaid, and we're not changing Medicare, nor Social Security."
The House passed the bill on Thursday and now moves to the Senate where it can be changed. The home version is not directly targeted at Social Security or Medical Insurance. But it changed the way Medicaid includes aligning with Republican priorities.
Congress’s nonpartisan Congressional Budget Office expects at least 8.6 million people to lose coverage due to changes.
"The bill is relatively fewer about trying to reduce fraud or error," said Leighton Ku, director of the Center for Health Policy Studies at George Washington University. "There are some smaller provisions on finding dead people who have been admitted to school or checking addresses. However, the main provisions are not fraud, waste or error in any way. They are things that reflect the policy preferences of Republican architects."
Robin Rudowitz, vice president and vice president of the uninsured program at the Health Policy Research Group, agreed that the bill's changes are far beyond what Trump said. “The reduction in federal spending and loss of coverage are far beyond the root causes of fraud and abuse,” she said.
The main provisions of the bill can be removed before the final vote and formulation, while others can add.
The White House did not respond to this fact-check inquiry.
The federal agencies operating Medicare and the Medicaid Services Center provide official definitions of these three terms:
One provision in the bill requires states to confirm recipients’ Medicaid eligibility under current laws at least every six months. Another will set more stringent requirements to verify the registrant's address and other information.
Such efforts can save on unqualified individuals and can be classified as a waste prevention measure.
Other regulations are more ideological than focusing on waste, fraud and abuse
The highest visibility provisions of the bill are more ideology-the breadth of the program and what types of people should benefit.
One of these regulations involves people in the United States without documents.
Because the law has been violated and Medicaid funds are used for undocumented people, the bill takes another approach: It tries to make it harder for states to rely solely on state funds to cover immigration in the U.S. Currently, regardless of their immigration status, 14 states and the District of Columbia cover children, and seven states, as well as Washington, D.C., covering at least some adults living in the United States, without documents.
For these states, the bill reduces the federal government's share of Medicaid payments from 90% to 80%.
In other words, if a state wants to continue covering undocumented people, it will face cuts in federal reimbursement rates to cover U.S. citizens, not just immigrants without documents. Budget pressure in these states may mean that some citizens have also lost some of their benefits or all of their Medicaid coverage.
Another provision involves work requirements. The bill would require individuals who receive Medicaid under the Affordable Care Act passed by former President Barack Obama during the democratic administration of former President Barack Obama, who engage in or participate in qualifying activities at least 80 hours a month (such as having a disability, becoming a family member or attending school).
The study found that the vast majority of people who need to work under similar requirements have been hired or qualified exemptions – but many have been abandoned by Medicaid for being unable to keep up with mandatory paperwork.
"Job requirements have nothing to do with waste, fraud and abuse. They fundamentally change the rules of who is eligible for the program, and they are adding a series of huge bureaucratic barriers and traditional Chinese tape festivals to keep qualified people covered."
A KFF analysis in March found that fraud occurs in Medicare and Medicaid, mainly by providers. "There are checks on fraud, waste and abuse at the federal and state levels," KFF wrote.
Another bill prohibits Medicaid funds spent on nonprofits that primarily engage in family planning or reproductive services, which will affect planned parenting and other organizations that provide abortion.
Finally, at least two regulations focus on saving money. For the first time, people will demand $35 sales to impose on many types of care. Another will limit it to one month before 90 days after applying for Medicaid. These provisions do not specify how they address waste, fraud and abuse.
"The 'Medicaid Savings' in this bill mainly comes from reducing the enrollment rate of the program," Sommers said.
Trump said the House bill “didn’t change Medicaid” but simply reduces “waste, fraud and abuse.”
The legislation includes provisions that can improve beneficiaries’ discovery that do not meet coverage.
But other regulations will change Medicaid to fit Trump's ideology and Republican priorities. The bill would incentivize states to stop using their own funds to cover undocumented people in the United States; it requires people to work or conduct other approved activities to ensure benefits; and prohibit Medicaid payments to nonprofit organizations, such as Family Planning, which provide abortions in other services.
Other changes are designed to reduce spending, including imposing sales and shorter retrospective coverage windows. These regulations do not state how they reduce waste, fraud or abuse.
We rate the statement Wrong.