President Donald Trump took exception Wednesday with a Democratic argument regarding Medicaid funding in the new GOP healthcare bill. 
 
 "Democrats purposely misstated Medicaid under new Senate bill - actually goes up," Trump tweeted with a chart. 
 
 Twitter/Donald Trump 
 
 One of the biggest criticisms of the Senate healthcare bill, the Better Care Reconciliation Act (BCRA), has been the projected cuts to future Medicaid spending under the legislation, which the Congressional Budget Office said would lead to 22 million fewer Americans being insured by 2026. 
 
 Trump's tweet echoes an argument from Republicans that says the legislation doesn't cut Medicaid spending. 
 
 But critics of the legislation note that the projected increase in funding from the federal government will be lower than the current projected rate of increase. This could have serious consequences for Medicaid recipients and state budgets. 
 
 Currently, the federal government provides states with a percentage of their Medicaid funding based on a formula of how much a state actually spends. Under the BCRA, states would receive a set amount of money based on the number of people on Medicaid in that state. 
 
 In other words, federal funding would grow in raw terms as the US population grows and the total number of people on Medicaid increases, but the amount per person would not be as generous as the current system. 
 
 The chart below shows the difference: 
 
 Andy Kiersz/Business Insider, Congressional Budget Office 
 
 Also, the BCRA would end the Medicaid expansion program under the Affordable Care Act, the law better known as Obamacare, which would represent another significant decrease from the current path of funding. 
 
 The Congressional Budget Office projected that federal funding for Medicaid would decrease by $772 billion over the next 10 years compared to the current system. 
 
 According to analyses from The Brookings Institution, The Kaiser Family Foundation, and the CBO, the formula for the Medicaid growth rate under the BCRA would lead to increased financial stress on states and detrimental outcomes for Medicaid recipients. 

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 Published on Jun 28, 2017 
 
 We finally got to see the text of the BCRA and unfortunately gross incompetence is the one thing not being defunded. 
 
 
 
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 File under, ‘only in Washington.’ 
 
 While Democrats are howling that the Senate’s health care bill would gut Medicaid, a closer look at the numbers shows the legislation actually would increase spending to the safety-net program—by tens of billions of dollars. 
 
 According to the latest ‘score’ from the Congressional Budget Office, Medicaid spending would rise from $393 billion in 2017 to $464 billion in 2026—that’s a $71 billion, or 18 percent, increase. 
 
 So how are Democrats describing this as a Medicaid cut? 
 
 Because even a $71 billion increase is considerably smaller than what taxpayers would see under current law. If nothing changes, the CBO predicts Medicaid spending in 2026 would be a whopping $624 billion. 
 
 All told, Medicaid spending under the Senate bill would be roughly $772 billion less over the next decade. 
 
 SENATE HEALTH CARE BILL WOULD LOWER DEFICIT, INCREASE NUMBER OF UNINSURED, ESTIMATE SAYS 
 
 But Ari Fleischer, former White House press secretary to George W. Bush, told Fox News that’s still not really a cut -- since spending rises. 
 
 “When I was at the White House in 2001, Federal Medicaid spending was $129 billion,” Fleischer told Fox News in an email. “My point is in Washington, spending only goes up. The issue today is how much should Medicaid spending increase—by a lot or by a huge amount? There are NO cuts.” 
 
 Fleischer took to Twitter to hammer that point, accusing the media of ignoring the $71 billion increase. He compared the situation to a worker who gets a lower-than-expected raise and tries to call it a cut: 
 
 “Your salary today is $50k. Your boss promises it will be $100k in 10 years. Instead, u get $75k. Did you get a $25k raise or a $25k cut?” 
 
 Critics of the Senate plan, though, zeroed in on the CBO's projection that enrollment (both in Medicaid and other programs) would plummet and on the $772 billion figure. 
 
 Senate Minority Leader Chuck Schumer, D-N.Y., released a statement saying “the bill cuts $772 billion from Medicaid.” 
 
 “The crushing Medicaid cuts will have an especially brutal impact on rural America, shuttering rural hospitals and an important source of good-paying jobs,” House Minority Leader Nancy Pelosi, D-Calif., said Monday. 
 
 The American Civil Liberties Union (ACLU) said the bill would “enact severe cuts to Medicaid that force people with disabilities into institutions.” 
 
 Related Image Expand / Collapse 
 
 The reductions compared against current law would result in millions fewer enrollees, according to the CBO’s projections. 
 
 But McConnell’s office insists the plan will make Medicaid stronger. 
 
 “Better Care will preserve access to care for patients with preexisting conditions, strengthen Medicaid, and allow children to remain on their parents’ insurance through the age of 26,” McConnell said. 
 
 It's a message McConnell is trying to get out to his own party, as several moderate and conservative Republicans hold back support. Democratic opposition is virtually unanimous. Some allies, though, are backing up the Senate GOP leader as he defends the Medicaid changes. 
 
 Sen. Pat Toomey, R-Pa., pointed out on CBS News' "Face the Nation" on Sunday that Medicaid will "grow" despite critics' claims. 
 
 "I would also point out, I think it's important to note, the federal government spending on Medicaid is going to grow every year. It's never going to be cut. It's never going to shrink," Toomey said. "It will eventually be growing at a slightly slower rate." 
 
 Brooke Singman is a Politics Reporter for Fox News. Follow her on Twitter at @brookefoxnews. 
 
 

 Under the House health care bill, Medicaid spending "actually goes up 20 percent over the next 10 years." 
 
 Former House Speaker Newt Gingrich said all the media coverage that declares the Republican health care bills would cut Medicaid is wrong, because he claimed the program actually gets a significant boost over the years. 
 
 Reports about both the House and Senate bills have pointed out the measures reduce funding for Medicaid, the joint state and federal health insurance program for the very poor. Using the House bill as an example, Gingrich said it’s really the opposite. 
 
 "After all the news media talking about cutting Medicaid in the House Republican bill, I did some research," Gingrich said June 27, 2017, on Fox & Friends. "It actually goes up 20 percent over the next 10 years." 
 
 Gingrich said Republicans had a "communications problem" for not pointing this growth out when discussing the bill, resulting in coverage focused on deep Medicaid cuts. 
 
 Those news reports mostly focus on analyses by the nonpartisan Congressional Budget Office. The bill before the Senate would reduce Medicaid spending by $772 billion over 10 years by 2026, the CBO said. A similar analysis for the bill that passed the House in May would winnow Medicaid spending by $834 billion in the same time frame. 
 
 So where is Gingrich getting his 20 percent increase in Medicaid spending from? 
 
 We reached out to his office and didn’t hear back. But it appears he’s talking about the rate at which Medicaid will grow over the next decade — something the program’s slated to do whether Republicans pass a health care law or not. 
 
 The GOP proposals, however, put major limits on future funding for that growth. 
 
 Medicaid costs keep going up 
 
 Medicaid originally was a program for low-income children, pregnant women, elderly and disabled individuals, and some parents, but it excluded other low-income adults. 
 
 As part of its efforts to provide health coverage options for as many people as possible, the Affordable Care Act allowed states to expand Medicaid and help pay for it with more federal dollars. Thirty-one states plus Washington, D.C., currently have extended Medicaid benefits to essentially all adults making up to 138 percent of the federal poverty level. The poverty line for a family of four is $24,600 in 2017. 
 
 That coverage is expensive, and it’s only going to cost more as the years go on. For calculating how the GOP bills may affect Medicaid spending, the CBO used baseline figures from March 2016 to draw estimates for how much the program would cost. 
 
 "There are two reasons Medicaid costs go up: More people are being served and the cost of serving them is going up," said Joan Alker, Georgetown University public policy professor and executive director of the Center for Children and Families. 
 
 Costs could rise due to increasing drug prices, inflation, an aging population with more older Americans, or any number of other considerations. 
 
 "CBO's baseline projects what Medicaid will need to account for these factors," Alker said. 
 
 From 2017 through 2026, the federal government would spend more than $5 trillion on Medicaid under current law, the CBO projected. 
 
 Another way to measure that growth is to calculate the percent change from current spending levels to that estimated 2026 level. 
 
 If the Affordable Care Act stayed in place and nothing changed, the CBO said Medicaid spending would increase from $393 billion in 2017 to $624 billion in 2026. That’s a 58.8 percent increase. 
 
 Now come the semantics: The House and Senate bills both slow the rate of that increase in spending, although they do so in different ways and on different schedules. But they both assume major reductions in how high the dollar amount for funding increases. 
 
 Opponents of the GOP bills call that a cut. The CBO calls that "reductions in outlays." Gingrich is saying it’s an increase. How? 
 
 How the GOP bills slow Medicaid spending 
 
 It looks like Gingrich focused on the projection for how the House bill would affect future funding. 
 
 Starting with the $393 billion in spending in 2017, Medicaid spending would go up steadily each year to reach $474 billion in 2026, under the House bill. That’s a 20.6 percent increase. 
 
 The Senate’s plan would increase funding to $466 billion in 2026, or about 18.5 percent higher than 2017. The projections assume what would happen if the bills took effect, with reductions starting in 2018. 
 
 The CBO said that under the House’s bill, 14 million fewer people would be enrolled in Medicaid by 2026, relative to current law. The Senate bill would see 15 million fewer enrollees. 
 
 Keep in mind that Medicaid spending goes up under any scenario. It’s just at a far lower rate under the Republican health care bills. 
 
 Policy analysts told us it makes reductions to Medicaid with no allowance for how the program may need to grow in the future. 
 
 "If he's claiming that there's no cut in the (House bill) because Medicaid spending in 2026 would be higher than it is now, that's largely irrelevant," Ben Sommers, a Harvard University health policy and economics professor, told PolitiFact. "Given that this dramatically reduces spending to what would occur under current law, most people would call this a ‘cut.’ " 
 
 Such reductions also put new limits on how many people have access to Medicaid. The changes all but guarantee states will have to alter eligibility requirements and take away benefits — without regard to whether people actually need them. 
 
 "The bills restrain the rate of increase well below Medicaid’s actual rate of increase," said Sara Rosenbaum, a George Washington University health law and policy professor. "Of course it’s a cut. If federal growth is kept artificially low, the only choice is to spend more to make up the deficit." 
 
 Our ruling 
 
 Gingrich said under the House health care bill, Medicaid spending "actually goes up 20 percent over the next 10 years." 
 
 By any CBO projection and under any proposed legislation, Medicaid spending will increase over the next decade — because health care costs are increasing. The House health care bill limits that increase to 20 percent, while maintaing the status quo requires a 60 percent increase, according to the CBO. 
 
 Both the bills in the House and the Senate limit the growth of spending. 
 
 The statement is partially accurate but leaves out important details. We rate it Half True. 

 Counselor to the president Kellyanne Conway insisted this week that the Senate GOP health care bill does not include cuts to Medicaid. 
 
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 Meanwhile, Health and Human Services Secretary Tom Price said the health care proposal would not cause Medicaid recipients to lose their health coverage. The government "would not allow individuals to fall through the cracks," he noted. "We would not pull the rug out from under anybody.” 
 
 President Donald Trump promised during his campaign that he would not touch Medicaid, the federal health care program for lower-income Americans. This group includes expected mothers, children, seniors and disabled individuals. According to an April report from the Center for Medicaid and CHIP Services (CMCS), nearly 70 million individuals are currently enrolled in Medicaid. 
 
 But does the Senate Republican health care bill actually cut Medicaid funding and coverage? 
 
 While the estimated government spending on Medicaid would increase under the Senate health care bill gradually over time, it will spend less each year on the program than what the Affordable Care Act, also known as Obamacare, currently allots. 
 
 If Obamacare remains intact, the government would spend an estimated $415 billion next year on Medicaid, and $624 billion by the year 2026, according to the review of the bill from the Congressional Budget Office (CBO). 
 
 If the Senate bill is passed and goes into effect in 2018, the government would spend an estimated $403 billion on Medicaid that fiscal year. That number increases to $466 billion by the year 2026, according to the CBO. 
 
 The CBO also estimated that federal spending on Medicaid from now until 2026 would be $772 billion less than what is projected to be spent under the current law. The Senate bill, however, leads to more government spending on Medicaid in that amount of time than the House GOP bill. 
 
 The CBO's latest analysis was done using its March 2016 baseline. 
 
 States that opted into Medicaid expansion under the ACA by March 2017 would see government funding reduced starting in 2021. 
 
 The bill phases out funding at a lower rate for Medicaid expansion under Obamacare by 2024. 
 
 If the current version of the Senate GOP bill becomes law, states can choose whether to receive funds by a per capita cap, determined by the number of people enrolled, or a block grant. 
 
 The CBO report makes one thing clear: the amount of federal revenues collected and the amount of spending on Medicaid “would almost surely both be lower than under current law," and the number of uninsured people under the Senate health care bill “would almost surely be greater than under current law.” 
 
 Under the GOP bill, Medicaid would see 15 million fewer enrollees over the next decade, the CBO said. Enrollment would decline from two groups – people who are currently eligible for Medicaid and people who, under the ACA, would be eligible in the future as more states continue to expand Medicaid. 
 
 The CBO estimates that almost 40 percent of adults between the ages of 30 and 49, and who earn just above about the national poverty line (approximately $24,000 for an individual), would not have insurance by 2026 under the Senate bill due to the roll back of the Medicaid expansion. 
 
 Senate Majority Leader Mitch McConnell announced earlier this week that a vote on the bill would be delayed until after the Fourth of July recess. 
 
 Shelley Moore Capito, R-W.Va., one of the senators to publicly oppose the bill, argued that the bill hurts those who benefit from Medicaid, specifically those who need opioid addiction treatment. 
 
 “We have a large per capita Medicaid population and we have an enormous and growing opioid issue,” Capito said in an interview on CNN this morning. “And it’s very troubling to me. So it’s important to me they get this right.” 
 
 She went on, “I can see in my Medicaid expansion population the availability of treatment and how well it's working both how they're accessing preventative care and their primary care doctors. I want to preserve that. So I think Medicaid does preserve that.” 
 
 ABC News' MaryAlice Parks contributed to this report. 

 There "are not cuts to Medicaid" in the GOP health care proposals. 
 
 Politics and math don’t always get along, and counselor to the president Kellyanne Conway raised a common complaint about how people talk about the future of Medicaid spending under the Senate Republican health care bill. 
 
 In an interview Sunday, ABC news host George Stephanopoulos brought up the bill’s projected $800 billion in Medicaid savings and asked Conway if that undermined the president’s campaign promise to spare Medicaid from cuts. 
 
 "These are not cuts to Medicaid, George," Conway said on This Week on June 25. "This slows the rate for the future." 
 
 Conway was weighing in on a long-running debate over what qualifies as a cut. 
 
 And on one level, she has a point, we at PolitiFact found. Future savings are not always "cuts." But in the case of the GOP health care bill, there are indeed cuts that go beyond dollars spent. 
 
 The math on Medicaid 
 
 To first vet Conway’s statement that there are no cuts to Medicaid, we need to begin with a few basic numbers. 
 
 The Congressional Budget Office estimated that under current law, from 2018 through 2026, the federal government would spend about $4.62 trillion dollars on Medicaid. 
 
 For the Senate bill, the CBO estimated that total Medicaid spending would be about $770 billion less. 
 
 But you can also compare how much Washington spends in 2018 — the first year a health care bill would take effect — and what it would spend in 2026. 
 
 If things stay as they are, spending goes from $415 billion to $624 billion. 
 
 Under the Senate Republican bill, spending goes from about $403 billion to about $460 billion. 
 
 Point being, spending increases under either scenario, it just increases at a far slower rate under the Senate bill. 
 
 This graph from the CBO shows the trajectories for both. 
 
 The GOP changes 
 
 The Senate bill takes several steps to restrain Medicaid spending. 
 
 It rolls back who is eligible. Before Obamacare, Medicaid covered low-income children, pregnant women, elderly and disabled individuals, and some parents, but excluded other low-income adults. Under the Affordable Care Act, 31 states and the District of Columbia exercised the option to make Medicaid available to anyone making up to 133 percent of federal poverty. For a family of three, that would be about $27,000 a year. The Senate bill eliminates that option as of January 2018. 
 
 This shuts out the Medicaid option for over 2.5 million people in states that didn’t expand eligibility. 
 
 The bill also makes federal payments to expansion states less generous. Under Obamacare, Washington covers at least 90 percent of the cost of covering people in the expansion group. That’s a better deal than the regular match, which can be anywhere from 50 to about 70 percent. The Senate bill phases out the higher rate for expansion states and by 2024, the match falls back to the regular rate. 
 
 The bill further ends Medicaid’s days as an open-ended promise to cover a certain percentage of a state’s costs. Instead, the bill shifts the program to a capped amount. The cap might apply on a per-person basis, or states might opt to take their money as a block grant. In either case, the amount would rise each year, but using a lower inflation factor than is used today. 
 
 Rhetoric: Medicare and Medicaid 
 
 It’s the specific nature of those changes that are more important than the total dollars spent. 
 
 When Democrats passed the Affordable Care Act in 2010, it included less money for Medicare over the years. In a mirror image of today’s debate, Republicans, notably House Speaker Paul Ryan, accused Democrats of cutting a vital health care program for the elderly. Democrats argued back that spending increased. 
 
 We did a series of fact-checks about the back-and-forth and generally rated the Republican attacks Half True. 
 
 Then, Democrats reduced payment levels to health care providers. Now, Republicans propose reducing payments to states. But at least in terms of the money trends, both situations follow the same general outlines -- with one key difference: 
 
 The Democrats didn’t change the eligible population, and the Republicans do. 
 
 That’s a cut. Fewer people will have access to Medicaid no matter how much money is spent. 
 
 Conway, in fact, highlighted the Republican goal. 
 
 "Medicaid's imperative, its founding was meant to help the poor, the sick, the needy, the disabled children, some elderly women, particularly pregnant women," she said on ABC. "We are trying to get Medicaid back to its original moorings." 
 
 Our ruling 
 
 Conway said that Republicans are not cutting the Medicaid program. The Republican health care proposals would slow the rate at which Medicaid spending increases, but spending would still increase. 
 
 However, the proposals include policy changes that will leave fewer people eligible for Medicaid. That’s a cut. 
 
 Conway’s claim has an element of truth but leaves out critical facts that would give a different impression. We rate the claim Mostly False. 

 Trump accuses Democrats of lying about Medicaid cuts. Not quite 
 
 CLOSE Right now, GOP senators are trying to gather enough votes to pass their Obamacare replacement plan, but even fellow Republicans are having a time a hard time accepting the health care bill. USA TODAY 
 
 WASHINGTON – President Trump accused Democrats of lying about the projected Medicaid cuts in the Republican health care plan, but they didn't. 
 
 They're just counting different things. 
 
 As Senate leadership struggles to find on a way forward for the controversial health care plan after coming up short of the votes it needed to pass before July 4 recess, Trump defended the proposal, tweeting that "Democrats purposely misstated Medicaid under new Senate bill - actually goes up." 
 
 President Trump (Photo: Andrew Harnik, AP) 
 
 While Trump's correct that the overall Medicaid budget would continue to rise under the GOP plan, the spending increase Trump is touting is far less than what's projected under current law. 
 
 The independent Congressional Budget Office estimates the Senate Republican plan would hack $772 billion from projected spending under Obamacare from 2018 and 2026. The projections take into account policies that would be changed by the bill, as well as factors such as how much the population is expected to grow and age, and how quickly medical costs are rising. 
 
 Democrats argue that the Senate plan should be compared to current law – and that reductions in planned spending amount to cuts. 
 
 What's more, there's no doubt the program itself is being cut. Medicaid is jointly funded by the federal government and states. The Senate bill as written would overall reduce the federal level of support for Medicaid, and health care experts say the reductions are too big for states to make up the difference. 
 
 CLOSE A new USA TODAY/Suffolk University poll shows low support among Americans for the GOP healthcare bill. Susan Page, USA TODAY Washington bureau chief, explains the findings. USA TODAY 
 
 Democrats have also said that the Republican plan would allow states to change the eligibility requirements for Medicaid – flexibility that, if states take advantage, would mean millions of people could lose coverage. 
 
 Fact-checking website PolitiFact rated as "mostly false" previous claims by Trump adviser Kellyanne Conway that the Senate health care plan would not reduce Medicaid. 
 
 "Conway said that Republicans are not cutting the Medicaid program. The Republican health care proposals would slow the rate at which Medicaid spending increases, but spending would still increase," the site said. "However, the proposals include policy changes that will leave fewer people eligible for Medicaid. That’s a cut." 
 
 The Democratic group American Bridge said the Republican plan backed by Trump would "structurally end the program as we know it." 
 
 Contributing: Eliza Collins 
 
 Read or Share this story: https://usat.ly/2tZrw4N
– The weird new fight regarding the Senate GOP's health care plan is one of semantics. Democrats insist that Republicans are slashing Medicaid, while Republicans say that Medicaid is actually increasing. Witness President Trump's tweet on Wednesday: "Democrats purposely misstated Medicaid funding under new Senate bill - actually goes up," he wrote. Kellyanne Conway and Newt Gingrich have made a similar case. So who is right? In the wonky world of budget parlance, both sides can make a case. Explanations: He's right, but ...: "In a literal sense," Trump is correct, explains a Wonkblog post at the Washington Post. Under the GOP plan, the total amount spent on Medicaid would grow, slowly, from 2017 to 2026. "But the accounting he uses to show Medicaid spending is wildly divergent from the way budget analysts, policymakers and many lawmakers account for spending levels." It's all about what is considered "baseline." The numbers: The CBO says that under current law, the federal government would spend $4.62 trillion on Medicaid through 2026. Under the Senate bill, spending would be $770 billion less. "Opponents of the GOP bills call that a cut," says the fact-checking blog Politifact. "The CBO calls that 'reductions in outlays.' Gingrich is saying it’s an increase." After a lengthy assessment, the site rates Gingrich's claim "Half True." It previously gave Conway a "Mostly False" rating. Reductions vs. cuts: The CBO projections "take into account policies that would be changed by the bill, as well as factors such as how much the population is expected to grow and age, and how quickly medical costs are rising," notes USA Today. "Democrats argue that the Senate plan should be compared to current law—and that reductions in planned spending amount to cuts." One analogy: A story at Fox News calls attention to this tweet by former White House press chief Ari Fleischer: "Your salary today is $50k. Your boss promises it will be $100k in 10 years. Instead, u get $75k. Did you get a $25k raise or a $25k cut?" Fewer enrollees: ABC News explains one reason why Medicaid costs would be lower under the GOP plan: "Medicaid would see 15 million fewer enrollees over the next decade, the CBO said. Enrollment would decline from two groups—people who are currently eligible for Medicaid and people who, under the ACA, would be eligible in the future as more states continue to expand Medicaid." Change in allotment: As things stand now, the "federal government provides states with a percentage of their Medicaid funding based on a formula of how much a state actually spends," explains Business Insider. Under the Senate bill, "states would receive a set amount of money based on the number of people on Medicaid in that state. In other words, federal funding would grow in raw terms as the US population grows and the total number of people on Medicaid increases, but the amount per person would not be as generous as the current system." One view: Samantha Bee offers a primer on Medicaid on her Full Frontal show, one that is decidedly anti-Republican. "That's not ObamaCare repeal, that's JohnsonCare repeal," Bee said, adding, "Please don't kill Medicaid—it's only 52 years old." See the video (with the usual warning on language).