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The House reconciliation bill would change the benefits and cost sharing protections in federal Medicaid law. It would allow states to charge monthly premiums, enrollment fees and/or cost sharing to all Medicaid enrollees with incomes above the poverty level, except for children, pregnant women, terminally ill individuals receiving hospice care, and some individuals who qualify for Medicaid by spending most of their income on health care. The bill would allow states to use “benchmark” benefit packages, such as a commercial HMO benefit, for many people with Medicaid coverage, although it does exclude pregnant women, children with family incomes below poverty, low-income seniors who also receive Medicare, and other groups of medically fragile individuals from this change. Federal savings from these policies are being used, in part, to finance a set of tax policy changes that will overwhelmingly benefit the wealthy. The idea of using health care cuts for low-income children to finance tax cuts is wrong from a health, economic, and moral perspective. Analysis of these proposals suggests the following:
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