As Trump Budget Looms, NJ Poised for Intensified Healthcare Crisis
President Donald Trump's so-called big, beautiful bill would cut health insurance coverage for nearly 12 million Americans and dramatically deepen a healthcare crisis in New Jersey, widening the gap between rich and poor.
Specifically, the bill places significant restrictions on Medicaid, government-sponsored health care for low-income and disabled Americans, while rewarding households making between $200,000 and $500,000 a year and those who own property.
"The bill is clearly an instrument of class warfare," said longtime NJ activist Larry Hamm. "It will bring about one of the greatest upward transfers of wealth, from the vast majority of society to richest among us, in recent times. This in turn will increase inequality in a country that is already vastly unequal. And that will increase social tensions and possibly lead to upheavals greater than those we have already seen in recent decades."
The federal drama took on added significance in New Jersey, one of two states home to a gubernatorial election in November, where state lawmakers today raced to meet a midnight deadline with their own state budget, which pivots - but inadequately, according to some state budget hawks, like the New Jersey Policy Perspective (see below) - in anticipation of federal impacts on residents here.
As Trenton wrangled with one eye on Washington, Washington wrangled with its eyes on New Jersey and Virginia.
Within the intensifying national pressure cooker, at least one Republican cried "no mas."
From the BBC:
"The assessment from the Congressional Budget Office, a non-partisan federal agency, could complicate Republican efforts to pass President Donald Trump's One Big Beautiful Bill Act in the coming days.
"The spending plan narrowly cleared a preliminary vote in the Senate late on Saturday after party leaders scrambled to arm-twist hesitant members of their rank and file.
"One defector, Senator Thom Tillis of North Carolina, announced he would not seek reelection after voting against the president's signature legislation."
Closer to home, another Republican in a battleground district, decided to back Trump's bill, despite participation requirements for Medicaid.
One of 215 representatives voting "yes" on a reconciliation bill, U.S. Rep. Tom Kean, Jr. (R-7) earlier this month told the New Jersey Hills Media Group:
“My Republican colleagues must justify their votes to cut healthcare for 700,000 New Jerseyans on Medicaid in order to pay for a $4.5 trillion tax cut for the super rich and corporations. They need to explain their votes to their constituents at public town halls. I will be happy to travel to Tom Kean’s district, Chris Smith’s district, or Jeff Van Drew’s district to help them explain their vote to their Constituents.”
“All of those things [including extension of the 2017 tax cuts and toughened immigration laws] will allow us to turbocharge our economy, and ensure that we have the most competitive economy in the world. These are extraordinarily important things for the future growth of this country.”
But U.S. Senator Andy Kim (D-NJ) strongly disagrees, speaking out against Trump's bill this morning, and citing its deep cuts to Medicaid.
“I want you to know to the people in New Jersey, the people in this country, this budget represents an abandonment by their government," said Kim. "This will hurt everyone we are supposed to be helping.
“After a gun accident when he was 11, Tom is a total quadriplegic...Medicaid helped him go to school and then college, and in his own words has given him dignity. When talking about this bill that we are debating here today, he said, ‘If I lose Medicaid, I feel like I’m getting shot in the head again. This time it’s not a bullet, it’s legislation. I want his words to echo through this chamber today for everyone to hear.’
“With all the challenges we are dealing with right now, it’s painful to think through what will happen if this bill goes into effect. The fact that these healthcare cuts will increase our gaps, worsen conditions, for our vulnerable communities, including our children. If we can’t stand up for them, our children, who are we willing to stand up for?”
Vulnerable communities stand to sustain other big hits from the budget.
The Senate bill still shifts the costs of the Supplemental Nutrition Assistance Program, also known as SNAP, or food stamps, to some states. The program is currently fully funded by the federal government.
The federal government would continue to fully fund the benefits for states that have an error payment rate below 6%, beginning in 2028. States with error rates above 6% would be on the hook for 5% to 15% of the costs. States are also given some flexibility in calculating their share.
This went on while healthcare fairness advocates here in New Jersey condemned the state Legislature’s budget, which includes a proposal that would divert $45 million in opioid settlement funds to four hospitals with no strings attached or information on how the funds will be spent.
"In just one year, this diversion would give away 10 percent of the state’s share of remaining settlement funds through 2038. If the raid is continued in future years, it would deplete all remaining settlement funds for the state with no money left for anything else, including the funds that the state’s opioid advisory council already directed to harm reduction, housing, legal service, and wrap-around support programs.
"Even with the recently announced Purdue settlement, the state expects to receive roughly $540 million over the next 12 years, averaging $45 million per year.
“This is a blatant, shameful misuse of opioid settlement funds. We're talking about literal blood money from the drug companies that profited from the overdose crisis, and they’re stealing it. This settlement was never meant to be a slush fund or go to big hospital systems with no strings attached,” said Jenna Mellor, Executive Director of the New Jersey Harm Reduction Coalition and member of the New Jersey Opioid Recovery and Remediation Fund Advisory Council. “If this money is taken, the state will not be able to pay for the life saving harm reduction services it’s already committed to.”
And here, from the New Jersey Policy Perspective:
"Lawmakers continued to ignore federal revenue cuts coming for Medicaid and food assistance and failed to protect the much-needed cash reserves to help the state protect its residents. While other states build up their savings to help smooth the potentially devastating cuts, the state's political leadership chose instead to conduct business as usual in Trenton."
