WASHINGTON — House Republicans unveiled their proposal to make substantial cuts to Medicaid and other health care programs to help pay for President Donald Trump’s massive tax package.

The House Energy and Commerce Committee released its portion of the budget resolution late Sunday night that includes major changes to the insurance program that covers nearly 80 million Americans.

While the plan does not include some of the most controversial proposals initially discussed among GOP lawmakers, it contains several new requirements that are likely to cause millions of people to lose coverage.

One of the most significant changes proposed in the framework is to implement new work requirements for Medicaid beneficiaries. The bill would require able-bodied adults without dependents to work at least 80 hours a month or complete some other activity such as community service.

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The proposal carves out some exceptions, such as for pregnant women, and would only apply to those who are between 19 and 64 years old. Individual states would be responsible for enforcing those work hours.

The legislation would also include new restrictions on how Medicaid funds can be used, including bans on gender transition procedures for children under 18 as well as prohibitions on coverage for “for individuals whose citizenship, nationality, or immigration status has not been verified.”

Those changes, among several others, come after months of negotiations on how to reform the health insurance program and cut costs without losing support from moderate Republicans. Still, Democrats are likely to accuse Republicans of stripping millions of Americans of their health care coverage to secure Trump’s agenda.

“Democrats will use this as an opportunity to engage in fear-mongering and misrepresent our bill as an attack on Medicaid,” Energy and Commerce Committee Chairman Brett Guthrie, R-Ky., wrote in a Wall Street Journal op-ed ahead of the bill’s release on Sunday. “In reality, it preserves and strengthens Medicaid for children, mothers, people with disabilities and the elderly — for whom the program was designed.”

As part of budget instructions, the committee was tasked with finding at least $880 billion in spending cuts to help pay for the $4.5 trillion in tax cut extensions that Republicans hope to approve before the end of the year.

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With the proposed changes, Republicans on the committee have exceeded those numbers — finding more than $900 billion in savings, a source familiar with the details told the Deseret News.

But with those cuts in place, preliminary estimates predict at least 8.6 million people would lose their health insurance over the next decade with savings reaching at least $715 billion by 2034, according to the Congressional Budget Office.

That could cause some more moderate Republicans to vote against the proposal, such as Rep. Don Bacon, R-Neb., who previously told the Deseret News he would not support any framework that cut Medicaid by more than $500 billion.

The Energy and Commerce Committee is scheduled to formally mark up the proposal during a marathon hearing on Tuesday, which is expected to drag on for several hours.

Rep. Don Bacon, R-Neb., a Republican moderate, talks to reporters as he arrives to the Republican caucus meeting at the Capitol in Washington, Tuesday, Oct. 24, 2023. | Jose Luis Magana, Associated Press
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