The national health institutes is the biggest federal money sponsor of medical research within the United States. The NIH funds promote research and innovation, which ends up in a greater understanding and treatment of diseases and improved health results.

The NIH provided greater than 35 billion US dollars in grants at over 2,500 universities and other institutions in 2023 to support biomedical research. So it was a shock for these institutions if the NIH on A New Politics of Trump managementPresent announced on February 7, 2025that it intends to scale back the financing that’s used to support the scholarships institutions annually by 5.5 billion US dollars.

On March fifth a US district judge in Boston provided a nationwide injunction Blocking the administration through the implementation of the proposed cuts to NIH financing and argue that the planned cuts are illegal. However, the white house will almost actually address.

We are a husband and woman team of immunologists who’ve been financed by the NIH for several many years. We imagine that our research has led to you higher understanding of inflammatory understanding And Autoimmune diseases. In addition, certainly one of us (Prakash Nagarkatti) was Vice President for Research on the University of South Carolina for over a decade and led all NIH subsidies to the university.

Although we imagine that such cuts have a drawback, they are going to violate the states disproportionately, which traditionally received very low NIH financial means, most of that are Red States who’ve supported Trump's election for a second term. This is because such states don’t lack resources for the event of advanced research infrastructure which might be required for the national NIH financing.

Have several Republican senators vocally rejected against the financing cutsIncluding Susan Collins from Maine, who said that they’d be “devastating, stopping the vital biomedical research and losing jobs”.

Support for cancer, Alzheimer's research

The NIH financing is crucial to advertise biomedical research, to enhance public health and to advertise innovation. It has a broad influence on different facets of society.

The agency funds biomedical research results that result in the event of vaccines or latest drugs to stop and treat infectious diseases and clinical disorders. The NIH played an important role in financing research on pandemics and global health crises brought on by HIV/AIDS And Covid 19.

In addition, the NIH supports advanced research in focused areas resembling cancer by organising specified centers that supply Cancer prevention, diagnosis, clinical studies and advanced treatment. Every 12 months 400,000 patients receive cancer diagnoses and treatment in such centers.

Similarly, NIH supports research in other focused areas resembling Alzheimer's disease by establishing the establishment of Specialized research centers.

The NIH also supports innovation research and transfer options for small company technologies. These programs stimulate technological innovations through the financing of small corporations Commeralize latest research ideas.

In addition, the agency offers funds for the training of the following generation of biomedical scientists, clinics and experts in public healthcare. Therefore, the NIH awards create jobs at universities, biotechnology corporations and related industries. Together, such Nih programs Promotion of local and national economies.

In 2024 Nih -Financing Generated estimated 92 billion US dollars in economic activity. All 100 million US dollars of NIH financing Creates 76 patentsWhich creates 598 million US dollars for further research and development, as reported by NIH.

Therefore, all cuts of the budget of the agency have far -reaching and significant consequences for the health results and the economy.

https://www.youtube.com/watch?v=vi4wjfix3h4

Upper limit for indirect costs

If the NIH Awards subsidies are divided into two separate categories: the direct costs that include expenses which might be vital for the pursuit of the proposed work and are made available to scientists and the indirect costs. These cover expenses resembling maintaining the laboratory room, the availability company, the subsidy management, compliance with the federal government, security and other different needs. These funds are made available on to the institution.

The indirect costs are negotiated between the institution and the Federal Authority and expressed as a percentage of direct costs. Since each institution has unique operating costs, the indirect cost rates are Vary from 30% to 70%.

The latest guideline that the NIH was introduced Fixed rate of 15%. In 2023, NiH spent 35 billion US dollars to support research at various institutions, of which 9 billion US dollars were used to cover indirect costs. So nih estimates it Could save $ 4 billion By limiting the indirect costs of 15%.

How red states are most injured

There is a very important one Geographical inequality in NIH financing that the majority people don't know. There are 27 states within the United States that receive 94% of NIH financing, while the opposite 23 countries only receive 6%. In addition, the NIH financing received by the 23 countries has remained relatively unchanged up to now 20 years.

There are many the reason why the The latter states are less competitive. These include: lack of huge medical centers, hospitals and research -intensive universities; Thin and rural populations; less robust economies; And an absence of the most recent research infrastructure, which is because of less investments by states in research and development.

For these reasons, the Congress in 1993 was authorized to found a brand new program called Institutional Development Award or Idea to support the 23 countries plus Puerto Rico that traditionally have received low NIH financing. Such states are generally known as the thought states and mostly contain rural and medically under -provision communities.

These awards that form Less than 1% of the overall Nih budgetIt is predicted that these states are expanding their research infrastructure and making them more competitive nationally.

The ideas are: Alaska, Arkansas, Delaware, Hawaii, Idaho, Kansas, Kentucky, Louisiana, Maine, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Rhode Island, South Carolina, South Dakota, Vermaont, Vermont, Weest Virgin, Viria, and Wyoming, and Wyoming, in addition to South -Dakota, Vermaon, and Wyoming, in addition to all states, but Delaware, Hawaii, Maine, New Hampshire, New Mexico, Rhode Island and Vermont voted for Trump in 2024.

Indirect costs for state -of -the -art technologies

In addition to supporting the management of specific grants, the indirect costs are helpful to advertise the research infrastructure of the institutions.

The indirect costs help to accumulate and update state -of -the -art research devices and technologies. They help institutions to develop powerful computer facilities which might be of crucial importance for research missions and offer access to magazines and books via the library facilities. These costs also renovate old laboratories and contribute to creating latest state -of -the -art facilities resembling germ -free facilities for microbioma research.

Therefore, the indirect costs for ideas are of crucial importance that only have limited resources resembling state support for research.

After Research and development survey for university educationIn 2023, non-Idea countries resembling California invested $ 548 million and New York over $ 303 million in F&E.

Such data clearly show how difficult it could be that ideas are confronted with cuts in NIH financing and the progress of the research infrastructure.

In our view, it can be crucial that each one states have access to NIH research financing in order that the states can solve the unique challenges that they face, resembling: B. environmental issues and health differences within the population.

For example Black lung diseaseWhat occurs when coal dust is inhaled. This is an expert danger connected to the coal industry in West Virginia and Kentucky.

In an analogous way, Hawaii has mosquitoes together with his tropical climate that may carry a dengue virus in order that a dengue infection can Represent a singular healthy and economic problem that For this state in comparison with the others within the USA

The training of the biomedical workforce and the doctors within the Idea countries also helps to maintain health service providers within the state as a way to proceed to approach these local challenges, and prevents the brain drain for other non-idea countries.

States of ideas are strongly based on NIH means to pursue and promote their research skills and to address local and general health challenges. For such states, it could already be difficult to keep up NIH -Finanzgittel, and the reduction in indirect costs would further exacerbate their disadvantages and the chance increases that medical research, patient care and regional economic growth fall.

The prices were closely observed

Here is an economic prediction during which I actually have the total trust: there shall be fewer federal employees since the second Trump government is making its approach to a smaller bureaucracy.

Others can discuss how the White House achieves this goal, the logic behind this mission and what such a job means for governance and services. We will consider what these job cuts could mean for the economy, especially in California.

To see where Uncle Sam is an awesome employer, my trustworthy table handled job statistics for the 50 states and within the District of Columbia – using the federal government, including defense and general employment figures.

California, the country's largest labor market, also has 253,600 employees of the US government in 2024 no 1 for the federal government's employment.

According to California, Texas comes with 220,200 federal employees, Virginia with 191,900, the District of Columbia with 191,200, Maryland with 161,300 and Florida with 161,200. Few federal jobs are in Delaware (6,700), Vermont (6,800), Wyoming (8,200), New Hampshire (9.100) and North Dakota (9,300).

Now, while California has a substantial variety of federal jobs within the event of risks, the US government's workforce only exists 1.4% of all Golden State. This is the thirteenth smallest piece among the many states and well below the nationwide share of federal employees 1.9%.

The most vital stocks – and probably the most distinguished economic risk – surround the country's capital. The United States employs 25% of employees within the Columbia district, 5.8% in Maryland and 4.5% in Virginia.

Federal employees are most difficult to seek out in Wisconsin, only one% of all jobs, then Connecticut, Minnesota, New Jersey and Iowa at 1.1%.

Incidentally, Californian economic rivals even have modest shares. Bundes jobs make up 1.6% of all employees in Texas and Florida.

Growth history ends

An economic shock shall be the lack of Uncle Sam's settings mode.

The US government added workplaces between the pandemic in 2019 to the previous yr 166,200. California had the ninth largest increase, 5,400 positions or 3% of the country's federal employment growth.

Florida had many of the U.S. government's attitude, over five years by 18,300 employees. Texas followed at 16,200, Maryland at 15,800, Virginia with 10,100 and Georgia with 9,200.

Conversely, there have been two declines within the federal jobs – DC had decreased to 4,100 since 2019 and Vermont.

Now consider this setting percentage point.

The five -year growth of California within the areas of federal tasks within the states was number 45 of the states and was far below the federal state's increase by 5.9% of the federal government.

The federal workplaces grew in Delaware and Tennessee, around 16%, Nevada, by 15.6%, Florida, by 13%and North Carolina, by 11%. Texas was No. 17 with 8%

The slowest hiring of the federal government – minus cuts in DC and Vermont – was in North Dakota, only 0.3%, New York since 2019, 0.9%and massacetts at 1.7%.

Conclusion

There shall be a whole lot of heartache amongst federal employees, California and all around the country, since bureaucracy gets a serious circumcision.

It is a pointy reversal, for the reason that federal positions were 6% of all jobs created within the period 2019 to 200.

But Uncle Sams 5,400 employees in California have only compiled 0.9% of the 620,100 jobs from all employers since 2019. The federal staff had less influence on the hiring in only six places: New Jersey, DC, Hawaii, Louisiana, Maryland and North Dakota.

And since 2019 the FEDs were only one.2% of the setting in Texas (No. 43) and 1.9% in Florida (No. 32).

Where could the best economic fears be?

Well, the US government has been 72% of West Virginia's employment growth since 2019, 17% of Vermont's attitudes, 16% of Wyoming, 15% of Illinois and 11% of Michigan.

Politically speaking

So are federal jobs a bigger piece of the business cake within the states that support Trump or elsewhere?

How many political questions there isn’t a easy answer.

These “red” countries had 1.56 million federal jobs with 117,000 since 2019. That is 8% growth. “Blue” states had 1.43 million federal jobs after 49,200 were added in five years, a bump of 4%.

In the Red States, the US setting of two% of 5.43 million jobs was in total in five years. In the Blue States, the federal settings have made 3% of the 1.63 million jobs since 2019.

Originally published: March 7, 2025 at 8:07 a.m. PST

policy

Elon Musk got here to the Capitol Hill on Wednesday on the weekly lunch of the Senate to ask questions on the work he for President Donald Trump on the Department of Government Efficiency, the office he formed, which he formed, which led to a bureaucracy, without input of the congress.

They had rather a lot.

Republican senators have raised only a couple of public complaints about Musk because he did mass shots throughout the federal government without consulting or informing them. But in the course of the almost two -hour meeting closed doors, the senators gently questioned him how they might share feedback, minimize the back swing from their voters and possibly finally vote on the cuts he made.

At one point in the course of the largely friendly exchange, Musk, who didn’t make his own presentation, shared his personal phone number with the senators and encouraged her to contact her directly.

“We receive feedback and want to react to our voters – how do we most effectively work for it?” Senator John Hoeven from North Dakota said after the meeting when he characterised the tenor of the questions of his colleagues.

Other Republicans said they only tried to learn the way they were successful and Trump may very well be successful.

“There was only a general discussion about how we can make its cuts permanently,” said Senator John Kennedy from Louisiana. “There were general discussions about how we, as senators, can better explain what he is doing.”

The assembly has emphasized the puzzle that Doges Slash-and-Burn-Approach created various republican legislators. Many of them really imagine that the Federal Government and the workforce ought to be reduced, and most hesitate to criticize Trump or Musk, who has a preference for using its social media platform X, to unleash a flood of abuse against its critics, including the Republican legislature.

But in addition they face intensive setbacks from member groups at home which might be affected by extensive cuts and layoffs.

In some cases, this has heated up an unpleasant two -stage for the Republicans who’ve praised the work that does the mastiff, and at the identical time tacitly after exceptions and special considerations for the financing that helps their very own voters.

“People endeavored to have more feedback opportunities,” said Senator John Cornyn from Texas, who praised Musk's efforts within the Senate before the meeting.

According to the legislators present, Musk accepted a largely determined tone. When a senator stood and asked who he contacted with questions on the efforts of the group, one among Musk's high -ranking consultants voluntarily reported. Musk threw in and said senators could contact him directly, said a one who experienced the exchange.

While he told the senators that a fundamental goal within the Pentagon disappeared – often a spot where the Republicans of the Senate refused to entertain outputs – he began to pass on an anecdote, the Senator Susan Collins of Maine, the chairman of the appropriation committee, shared with him. In the story of this story that he previously discussed, he said that Collins gave the marine money for more U -boats, but no latest u -boats were produced.

The senators said they were excited about being targeted by Musk's group – a step that will support Doges's actions and at the identical time recapture the ability of the congress within the wallet.

Senator Randrand Paul von Kentucky suggested that the legislators should ultimately vote on the cuts which have instructed the mastiff with the withdrawal procedure with which the President calls on the congress of terminating certain funds.

Paul suggested that the choice of the Supreme Court on Wednesday, by which a majority of the judges Trump's emergency proposal for freezing almost 2 billion US dollars in abroad, rejected that using the withdrawal process can be more fruitful than one -sided attempts by the chief to rent the financing.

“This is a bigger argument than just one person,” said Paul in an interview.

He added: “Either the cuts and all the great things I think that she evaporates Elon – they are short -lived – or we put them in a withdrawal package, they send them back to us and we tune up or down to get rid of them.”

Musk appeared to support the concept, in keeping with several senators who were present.

“At some point he said:” You needed to act here to do anything about this constant, “said Senator Josh Hawley from Missouri.

Musk later discovered on Wednesday evening in Capitol, in one other meeting with closed doors, which lasted about two hours, also the Republicans of the home in Capitol. The message that the legislator sent him from South Carolina, in keeping with Rep. Ralph Norman: “Do not accelerate, slower.”

This article originally appeared in .

The reserve bank Lower official rates of interest On Tuesday, the primary decline has loosened in 4 years, by which the inflation pressure “a little faster than expected” loosens.

However, the central bank said that the prospects for economic activity and inflation remain uncertain, with the danger that budget expenses are slower than expected.

The reduction of the Cash rate of interest destination will include a mortgage as a relief for the third of households. It will aid you reduce the price of living for you.

The reduction from a 13-year high from 4.35% to 4.1% was expected from economists and from afar Financial markets.

The rate of interest can assist to call the federal government an early selection. However, the newest opinion polls indicate that the federal government still has to do to place yourself in a profit position.

announcement his decisionThe reserve bench said that it has “more confidence that inflation will be moved sustainably at the center of the focus 2-3% destination”.

All 4 large banks quickly passed on The official rates of interest for mortgage owners. The Average recent housing loan is 666,000 US dollars. The reduction of the rate of interest by 0.25% implies that the repayments mean $ 110 less monthly (assuming an ordinary loan of 30 years).

It is the primary change in money set since November 2023 and marks the primary small reversal of 13 rate of interest increases. The central bank had quickly increased the rates of interest from the emergency level near zero in the course of the Covid epidemic and the Lockdowns.

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Why has the reserve bank shortened now?

The rate of interest is reduced to 2.4% inside the bank of the bank in 2024 after the relief of the heading inflation in 2024 2-3% inflation goal range.

The preferred measure of the bank of underlying inflationThe “trimmath value”, which excludes temporary aspects comparable to the federal government's electricity discounts, rose by 3.2%in 2024. This is just above the goal area, but just a little lower than 3.4%that the bank had predicted.

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“We cannot yet explain the victory for inflation,” said Michele Bullock, governor of the Reserve Bank, after the choice to a press conference. “It is not good enough so that it is temporarily back in the target group. The board must be confident that it will return to the target group sustainably.”

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The RBA and the selection

In its first session of the 12 months, the reserve Bank Board declined the concept they need to change because a selection is approaching.

While the reduction in rates of interest is suitable for a side of politics, this might not must be reduced from the opposite. The impartial approach is to make the identical decision as if there is no such thing as a selection.

Like then RBA -Gouveerneur Glenn Stevens said In 2007 after you increased prices during an election campaign:

I don't think we could ever accept the concept you can not change rates of interest in an election 12 months – which is one 12 months of three years.

How does the reserve bank in comparison with other central banks?

Some central banks in comparable economies had already began reducing rates of interest and reducing them greater than the RBA. But it’s because most of them had increased the rates of interest by more.

The reserve bench passed a method to be more patient to return inflation to its goal to be able to limit the rise in unemployment.

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The strategy worked. Unemployment in Australia reached a maximum of 4.2% and is now 4.0%. In contrast, in New Zealand it’s over 5% and within the euro area and Canada over 6%.

The reserve bank has not received the loan that it deserves for this strong performance.

Where from here?

This is the last meeting of the present reserve Bank Board. It is replaced by a brand new monetary policy committee and a separate governance board as a part of a revision of the bank. Two recent members replace two members of the present board for his next meeting on April 1.

In the reason of the RBA board, it states that “she is careful for the further relaxation of politics”. This is the central bank, which doesn’t rush into further interest reductions.

The RBA also found that “geopolitical and political uncertainties are pronounced”. This is a sign of the economic effects of the US presidents, Donald Trump's guidelines for trade and impending jobs.

His proposed tariffs and deportations increase inflation within the USA and make us rates of interest higher than usual.

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However, this doesn’t mean that rates of interest should be higher here. In fact, a trade war would weaken the worldwide economy, which may lead to a lower inflation in Australia.

The reserve bank also published its Updated forecasts. These show the underlying inflation rate, which is able to drop to 2.7% by June after which stay there until 2026 and 2027.

Unemployment is 4%low and under what the bank previously considered “full employment”. But it doesn’t result in a rise in wage growth.

In fact, the bank noticed that the expansion of wages was somewhat lower than forecast. The inflationary expectations are also well contained.

This offers hope that there could also be at the very least one further rate of interest in the midst of this 12 months (and the forecasts of the reserve bank assume that). However, borrowers shouldn’t hope that rates of interest will visit the deeps from the Covid era again. That is not possible.

Peneptigon-a Big East Bay Tech Company warned on Wednesday that it wants to gather well over 1,000 jobs to make use of the fast-expanding opportunities within the young AI sector.

“We made the difficult but necessary decision to eliminate about 1,750 positions or 8.5% of our current workforce,” said Carl Eschenbach, Chief Executive Officer from WorkDay, to the corporate's employees in a note.

The Workday Day based in Pleasanton describes the layoffs in a submission to the US Securities and Exchange Commission.

“We are in a crucial moment,” said Eschenbach within the post office. “Companies everywhere find out how the work is done and the increasing demand for AI has the potential to drive a new era of growth for working day.”

The working day commissioned an unspecified variety of employees to think about AI initiatives which might be considered promising for the technology company.

Artificial intelligence offers a “massive chance” for working day, said Eschenbach. However, “some changes” are vital to align the corporate's workforce to what customers are searching for.

“This means investing strategically, helping teams better work together, marketing innovations faster and making it easier for our customers and partners to work with us,” said Eschenbach within the open letter.

Currently and the working day – and its staff – need to navigate in a forbidden landscape of layoffs and reductions in the corporate's work areas.

The work day last orchestrated massive job cuts about two years ago.

In 2023, Workday announced a call to cut 196 jobs in Pleasanton.

It was not immediately clear if the present wave of cuts could begin on the working day.

“We will soon meet the employees concerned to achieve as many as possible today, subject to local requirements in which a consultation period is required,” wrote Eschenbach to company staff.

It also seems that the working day could attempt to sell or vacate an unknown variety of existing work centers. The company has announced within the SEC.

“Workday expects to leave certain office space,” said the corporate within the SEC submission.

The company didn’t announce the true estate that may clear it. In 2021, nonetheless, the working day paid $ 172.5 million for six office buildings within the Stoneridge Mall Road, including the headquarters of the Tech company.

In the twelve months that resulted in October, Workday won a profit of 1.62 billion US dollars for sales of $ 8.16 billion, because the financial cards website.

Job cuts are on the horizon, despite an apparently rosy winning search for the working day.

“Workday expects his financial results for the fourth quarter of 2025 in the fourth quarter and the year in line with his instructions in the third quarter in the third quarter,” said Workday within the SEC submission. The company's 2025 financial yr resulted in January 2025.

The company made it clear that the layoffs is not going to contain its efforts to rent people as required.

“While we will remove some positions, we will continue to stop in important strategic areas and locations,” said Eschenbach in an open letter to employees.

Originally published: February 5, 2025 at 12:40 p.m. PST

In 2017, Republicans who controlled Congress made an enormous try to cut federal spending on Medicaid, the government-funded health program for low-income families and individuals.

But the Republican effort failed – embodied iconically by Republican Sen. John McCain of Arizona, affected by terminal brain cancer, who gave his decisive thumbs down earlier that morning.

More than seven years later, it's that point again.

As Donald Trump prepares to maneuver back into the White House, supported by Republican majorities in each houses of Congress, expectations are high that Republicans will quickly revive their long-sought goal of cutting Medicaid.

Republicans need to fund big tax cuts, and that GOP platform under Trump guarantees not to the touch Social Security or Medicare. Of course, this isn't set in stone. But for now, like mine KFF colleagues have noticedMedicaid looks quite a bit like low-hanging fruit. (KFF is a nonprofit health information organization that features KFF Health News.)

Health officials in California and across the country are concerned about the opportunity of major Medicaid cuts as early as next 12 months. Such cuts would have an outsized impact on Golden State, whose 14.7 million Medi-Cal enrollees exceeds the overall population from all but three other US states. Medi-Cal provides medical insurance for over 40% of the state's children and pays for nearly 40% of births. It is a critical source of funding for safety net hospitals and community clinics.

And over 60% The bulk of this 12 months's $161 billion budget comes through Washington.

The possibility of great federal cuts to Medicaid could have been a think about Democratic Gov. Gavin Newsom's decision to make the decision a special session of the state parliament this week.

California could attempt to offset a pointy decline in federal dollars through higher taxes or cuts to other state programs. But each options might be politically untenable. That's why many health experts imagine leaders in Sacramento would almost definitely have to contemplate reducing Medi-Cal.

That could mean cutting any variety of them optional services corresponding to dental services, optometry and physical therapy. It could also mean you could have to roll back a few of the ambitious Medi-Cal expansion you've undertaken in recent times. That could include some elements of California Advancing and Innovating Medi-Cal, a $12 billion program with services that address patients' social and economic needs along with their medical needs.

Some observers worry that federal cuts could have an effect on the economy about 1.5 million Immigrants living within the U.S. without authorization and enrolling in Medi-Cal incur annual costs of greater than $6 billion, almost entirely funded by the federal government. But others say a more likely path could be to chop payments to managed care plans across the board cover 94% of Medi-Cal participants reasonably than targeting specific groups of individuals.

“Medicaid is at stake, and I don’t think that’s speculation,” said Gerald Kominski, a senior fellow on the UCLA Center for Health Policy Research. “It is widely viewed by potential members of the Trump administration as a program that is too broad and needs to be brought under control.”

Whether they’ll succeed this time stays to be seen. But more on that later.

People who’ve followed previous GOP efforts to shrink Medicaid say quite a few previously tried methods might be back on the table this time. They could include total caps on federal Medicaid dollars; Eliminate the Affordable Care Act's core policy under which the federal government would pay 90% of the price of expanding coverage to a bigger group of low-income adults; a piece requirement that would affect enrollment; and rule changes designed to make it harder for states to acquire federal Medicaid dollars through using taxes on medical insurance, generally known as MCOs.

The first Trump administration proposed changes to the foundations for such taxes but later dropped them. If similar changes were made this time, it could cause financial problems in California, which frequently uses MCO taxes to offset medical expenses from state coffers.

Proposition 35, recently approved by California voters, may be in danger. The initiative calls for the MCO tax to turn out to be a everlasting fixture in 2027, pending federal approval, with the goal of funding billions of dollars in latest medical spending, primarily to extend funding for doctors and other providers. A change in federal rules could undermine these intentions.

Ending the federal government's 90 percent coverage of the ACA-Medicaid expansion would create a gaping hole within the Medi-Cal budget. Medi-Cal spent greater than $34 billion in fiscal 12 months 2023 to serve the roughly 5 million people enrolled because of this of the expansion, and nearly $31 billion of that quantity was paid for by the federal government.

If the federal government's share were to revert to the regular Medi-Cal rate of fifty%, California would must fork out nearly $14 billion more to cover expansion enrollees – and that's only for one 12 months.

A more ambitious Republican push that features each spending caps and a rollback of federal support for Medicaid expansion could put California officials in real trouble.

In 2017, the state Department of Health issued one Analysis shows that a bill introduced by a bunch of Republican U.S. senators to limit Medicaid spending and end increased funding for the ACA expansion, together with another cuts, would end in California losing nearly $139 billion in federal funding from 2020 to 2027 US dollars lost.

“There are almost unlimited changes state leaders could make to Medi-Cal if forced to,” said David Kane, a senior attorney on the Western Center on Law & Poverty. “And we fear that this burden will almost certainly harm poor people and immigrants the most.”

But major cuts to Medicaid should not a given. After all, when Trump was within the White House in 2017, the Republicans also had majorities within the House of Representatives and the Senate and still didn’t achieve their goal. This time the political stars might be different, but Republicans only have a razor-thin majority within the House of Representatives.

A decade after the ACA's Medicaid expansion, some 21 million people across the country are covered, making this system more embedded within the country's healthcare landscape. According to a Study 2023 From Georgetown University, Medicaid and its associated children's medical insurance program cover a bigger share of the population in rural counties than in urban ones. And as we all know, rural America leans heavily Republican.

Faced with a vote to chop Medicaid, will Republican members of Congress defy their very own constituents?

Edwin Park, one among the authors of this Georgetown study, believes there may be a possibility that giant cuts might be detected. “A large number of Americans are either on Medicaid, have family members who are on Medicaid, or know someone who is on Medicaid,” said Park, a research professor on the McCourt School of Public Policy at Georgetown. “Hopefully its popularity and importance will prevail.”

Originally published: December 13, 2024 at 4:19 am PST