Melannie Bachman of Charleston, South Carolina, 39, is one of the patients who are closely following the already thorough Republican bill that has been brought to the House. She was diagnosed with triple-negative breast cancer in 2021, a radical and difficult-to-treat disease form. She said she had to apply for Medicaid multiple times until four months later, meaning she had to pay for multiple screenings while she was waiting.

Bachman no longer qualifies for Medicaid because she has no cancer. But she fears the proposed revision might make it harder for her or others to be covered in similar situations, and even make them abandon the process altogether.

Bachman is still within five years of diagnosis and her doctor told her that it is crucial that she must continue to monitor her if her cancer recovers.

“Beyond fighting for your life, this is one of the toughest parts of this journey,” Bachmann said. “The application process, figuring out how and when to find coverage, is the one with no coverage at all.”

As House Republicans dabbled in part of a bill Tuesday that proposed in-depth cuts and new restrictions on Medicaid, patients and doctors relying on the program said they were prepared for the worst, including overwhelming traditional Chinese tape and administrative barriers that could prevent many from getting the care they needed.

The legislation, introduced by the Energy and Commerce Commission on Sunday, proposes numerous changes to health plans, such as job requirements, co-payments from patients visited by doctors, stricter eligibility checks and citizenship verification. The group began tagging it on Tuesday and hopes to send it to the entire house this week with the goal of passing the entire bill before Memorial Day.

According to preliminary estimates from the Congressional Budget Office, the legislation could result in 8.6 million people losing Medicaid coverage. Currently, more than 70 million people have access to health coverage through the program.

These changes will make some people ineligible for coverage due to job requirements. Certain groups, such as people with disabilities, pregnant women and people in prisons or rehabilitation centers, will be exempted.

Others, especially those involved in the Affordable Care Act Medicaid expansion, may be forced to drop out as they face higher costs and additional paperwork to maintain their coverage.

Republicans say they have the new rules — including Senator Josh Hawley (R-Mo).

"As per job requirements, anti-fraud clauses - there will be coverage losses, I can accept them." Republicans have proposed cutting spending to countries that allow immigrants without proof of citizenship Medicaid.

"But for those who are eligible, who are able to be healthy and need Medicaid because they can't afford health insurance, I'm just against cutting the benefits of these people," he said.

Asked if he was concerned that the Traditional Tape Festival might eventually evacuate legal Medicaid recipient coverage, Hawley downplayed the prospect, saying his priority was “no benefits cuts.”

The Medicaid rule is expected to save the government more than $715 billion in 10 years, and Republicans intend to use it to pay President Donald Trump to extend the 2017 tax break before it expires late this year.

Democrats believe that the extra bureaucracy is a feature of the Republican plan, not a mistake.

Ron Wyden, a ranking member of the Finance Committee for Medicaid, said Republicans hope to abandon the program by having recipients pass “bureaucratic water torture” that many will not be able to navigate.

“To prevent people who are eligible to be covered, the entire Traditional Tape bureaucracy is being deployed,” Vadon said in an interview. “If they find patterns of fraud and abuse, it will be one thing and they are trying to take it root. But what they are doing is that they are targeting qualified people who are eligible for Medicaid.”

"I think it's really a mean thing," he said.

The bill had missed some more controversial ideas ahead of Tuesday's markup hikes -- ideas discussed by Republican leaders -- including limiting how much money each person can spend and making the state's expansion of the Medicaid Act under the Affordable Care Costs to an expanded coverage, which the federal government currently pays 90%.

Adam Gaffney, an intensive care physician and assistant professor of medicine at Harvard Medical School, said the proposed change in eligibility changes, even the possibility of other paperwork, could cause people to fall from cracks and lose coverage.

“You don’t need to be a doctor to realize that it’s dangerous,” Gaffney said. “If you’re facing multiple medical problems, the last thing you need to do is try to go through a lot of traditional Chinese tape festivals, skip basketball and bureaucracy, which is exactly what this legislation is going to do.”

Those who want to work may not be able to do so due to health issues, lack of parenting or limited transportation options.

When people lose coverage, they usually have no other choice, Gaffney said. He noted that in the early 2000s, when Tennessee implemented reforms to control Medicaid costs, thousands lost coverage.

“Most people who lose Medicaid don’t have insurance,” he said. “The reality is that Medicaid covers some of the lowest income people in the U.S. who may not be able to afford it when they lose coverage.”

Similarly, in Georgia, fewer people choose to participate after the implementation of Medicaid job requirements in 2023.

“It’s basically reporting and having to document the job you’re working on, even if you’re a group that may not be asked, it can sometimes be difficult to document that you might be one of those groups,” she said.

DN.J. Senator Cory Booker said the new rules are part of the “cruel” and “Craven” plot.

"Any increased bureaucracy will make it harder for those who have reasons to use these services to keep going, which will lead to loss of coverage - again for Americans with illness and illness," Booker said.

Rudowitz said the bill proposed a provision that requires patients to pay together, with a share of up to 130% to 130% to 138% of people with federal poverty levels, about $35,000 a year for a family of three each year. She said there is also a rule that would reduce states where the federal government provides coverage for undocumented immigrants.

If the bill clears houses, it will be handed over to the Senate, and some Republicans are paying attention to changes.

Tillis, RN.C., of the Finance Committee, said Republicans must carefully study the new Medicaid rules and coverage.

“That’s what we’re doing right now. A lot of it is related to year and year affirmation, and that kind of thing is related.

Tillis also said he wanted to review how many of the 8.6 million North Carolinas have lost coverage. “If you look at that distribution across the country, that could mean that North Carolina’s numbers are pretty large,” he said. “We’re going to collect the bill and do this wrong narrative on the proposed bill – we have a lot of work to do.”