As President Trump pushes for sweeping tax cuts, it's left Republicans considering an overhaul of the federal-state health insurance program. And not all are on the same page. Some argue the federal-state health insurance program is growing out of control and needs an overhaul, while moderate and battleground-district Republicans are more wary of touching a program that affects so many Americans.
Kentucky receives billions in federal support through Medicaid, with more than a quarter of the population on the rolls. Democrats, including Kentucky Congressman Morgan McGarvey, say the ideas under consideration on Capitol Hill would gut health care for the most vulnerable.
"These cuts are going to be devastating — from our kids to our seniors to even our veterans who who help get mental counseling, PTSD counseling through Medicaid services," he said. "So we are pushing and fighting tooth and nail to keep those cuts from hurting kids."
But two of Kentucky's top Republicans, House Speaker David Osborne and Senate President Robert Stivers, are taking a wait-and-see approach. Osborne said, at this stage, dire predictions coming from critics amount to "fearmongering."
"At least have the details before you criticize it, because it may be something that will be very difficult for us to manage, which then at that point we may be very critical of it, but at least at that point, we'll know what we're being critical of," he told reporters in Lexington Tuesday. "We may be very happy with it by the time it comes down. So it's just way too premature."
Stivers also pushed back on the idea that the changes would necessarily be "cuts."
"Do you really know that that's what vein they're speaking in, or is it to control spending over the next ten years to where you find a trillion dollars worth of savings by not allowing the actual growth to be greater than the medical index for inflation?" he said. "They're wanting to call it a net cut when it may not actually be a net cut because they wanna create a political diatribe."
An analysis by the nonpartisan Congressional Budget Office in March showed that budget goals outlined in the House GOP plan could not be reached without reducing spending on Medicaid.
Gov. Andy Beshear, a Democrat, has been raising alarms about the issue for weeks, stressing potential effects on healthcare systems outside of Kentucky's larger communities.
"The threats the federal government is making on Medicaid would be disastrous. They would harm coverage for our families and they would close most all of our rural hospital systems" he said during a press briefing in April.
Kentucky Congressman Brett Guthrie oversees the House Energy and Commerce Committee, which has jurisdiction over Medicaid. Guthrie has said he wants to see work requirements and "get control of the growth" of the program.