AHIP, an advocacy organization for health insurers, is sounding the alarm over the potential impact of the 2025 budget reconciliation legislation, which includes significant cuts to Medicaid and the individual market.
“We are very concerned about the impact on coverage of some of the proposals, the impact on coverage for people in the individual market, the impact on coverage for people in Medicaid,” said Mike Tuffin, president and CEO of AHIP. “People served by Medicaid are clinically complex. Often these are people with real economic insecurity in their lives, people from working families, often doing really demanding jobs that don’t come with benefits. So we are advocating that Medicaid be kept stable for the people who count on it.”
Tuffin made these comments during a Tuesday press briefing at the AHIP 2025 conference held in Las Vegas. It comes after the Senate Finance Committee released its draft version of the bill on Monday, which includes even more significant cuts to Medicaid than the House legislation that passed in May. For example, the House bill would add work requirements for childless adults on Medicaid, but the Senate bill would expand this to parents of older children.
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Medicaid work requirements would mean that enrollees have to verify that they’re working, volunteering or going to school in order to receive coverage. This is a proposed change that AHIP takes issue with.
“That is a foundational shift to how Medicaid and the expansion work today … coupled with significant changes to the financing of Medicaid, with some changes to both provider taxes as well as state-directed payments. [These] do result in some really significant cuts to Medicaid that we feel will have a significant impact on coverage,” said Jeanette Thornton, executive vice president of policy and strategy at AHIP, during the briefing.
Tuffin added that most people on Medicaid are working already.
AHIP is also concerned about the budget bill’s impact on the individual market and the expiration of the Affordable Care Act enhanced premium tax credits, which is set for the end of 2025.
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“If the tax credits are allowed to expire, we’re really concerned that this market could be fundamentally disrupted,” Tuffin said. “That would come at a time when we potentially would have people losing eligibility for Medicaid, and they may be encountering an individual market that is disrupted and with higher premiums, with fewer choices.”
Many Republicans have argued that the proposed changes will address fraud, waste and abuse in healthcare. Thornton noted that while AHIP supports efforts to reduce fraud, waste and abuse, it’s “clear that this goes beyond” that and will instead result in significant coverage losses.
To prevent some of these changes, AHIP is doing a “lot of education and a lot of outreach,” Tuffin said. The organization is meeting with members of Congress, as well as partnering with patient advocates, healthcare providers, hospitals and employers. Some of its partners include the Modern Medicaid Alliance and Keep Americans Covered.
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