Patients begin to line up before dawn in Border health processAn annual health clinic for five days in the Rio Grande Valley in Texas. Many population in this mostly Latin and Latin region It lacks the Mexican border to insurance, making the health exhibition a major source of free medical care in South Texas for more than 25 years.
So this year. Trump administration plan to strip More than 550 million dollars In federal public health funds and the epidemic from Texas, she helped claim Cancel the event Before the start of July 21, the scheduled.
“Some people come every year and rely on it,” said the director of health and humanitarian services in Hidalgo Province. “Some people do not hurt outside the health of the border so that they can be the first thing that is in a queue to receive services. This event is very important for our society.”
The states and local governments have discounts in painful programs in the wake of the major discounts in the federal health financing that already entered. Now, they are developing the upcoming financial visits – some until late next year or after – from “from” from “from”A single beautiful invoice workRepublican legal taxes and spending were approved in July, which enacted many of President Donald Trump’s local agenda.
Texas expects, for example, you will see Medicaid’s federal funds decrease as much as it is $ 39 billion Over the course of 10 years due to the new barriers in front of joining, such as repeated eligibility checks, according to the analysis of the month of KFF.
Completely, the discounts reach a seismic shift in how to provide state health programs and pay for them. Administration, in fact, pays a large amount of health costs to countries. This will force their leaders to make difficult choices, as many state budgets are already tense through lower tax revenues, slowdown in federal spending, and economic uncertainty.
Revenue predictors In more than ten countries You have reduced expectations for the next year, according to June Report Pio.
“It is almost inevitable that countries have enacted a number of discounts in health services due to financial pressure,” said Wesley Thabar, the chief consultant for government tax policy in the left -wing financial pressure. Budget and Politics Priorities Center.
Some are proactively trying to influence.
Hawaiian lawmakers are looking to help non -profit organizations that are already competing with federal financing discounts. They are Get rid of $ 50 million In granting health, social service and other non -profit organizations that struck federal financing discounts. To get money, non -profit organizations must show finish or decrease in financing, or have been damaged from the discounts.
“It is not fair for organizations to be forced to support the Hawaiian people to expand due to federal financing discounts.” He said in a statement.
Other countries are expanding the range of projects to counter discounts. Dilayer governor Matt Mayer, a democratic, received a notification in March that the Trump administration was Reducing 38 million dollars In financing public health from the state. The following month, the state’s legislative leaders stopped a plan for the promotion and expansion of the Capitol complex as a result.
“We have realized that the reckless federal discounts of the social safety networks of thousands of Dilawari David SukolPresident Pro Tempore of the Senate Delaware.
In New Mexico, the country with The highest percentage of the registered population in MedicaidA group of legislators from the two parties voted to create a receptive fund to enhance the funding of the program. About 10 % of more than 800,000 state residents Medicaid and the health insurance program for children with relevant may lose health coverage under the Federal spending law, based on Some estimates.
Some state leaders warn of voters that the worst may come yet.
At an event on August 18 at a hospital in the South Bronx department in New York City, the New York Governor Cathy Hochol, a democracy, stood on the stage among workers in the field of health care in white coats to rid the new Trump law.
She said: “What Republicans in Washington did through the” Best Bill Bill “that I have ever seen is the tension of the New York residents.” The state’s health system is preparing for Almost $ 13 billion In annual discounts.
In California, legislators were weighing the impact of the discounts coming from the federal law in the General Assembly The committee’s listening session on August 20Where some democratic lawmakers said that the state’s efforts to protect reproductive health services and other programs were in danger.
“We have prepared for this reality: the so -called” the big and beautiful draft law “which is now called is a law,” Democratic legislator, Greg Hart, said in the hearing.
“Unfortunately, the reality is that the state does not have the ability to postpone all these cuts in federal financing in the current budget,” said Hart. “We cannot simply write a check and make this disappear.”
The sweeping budget law, which was approved without any democratic support, will reduce federal spending on Medicaid at about 1 trillion dollars During the next decade, based on estimates from Congress Budget Office. Discounts of spending largely comes from the imposition of a Work requirements The people who obtained Medicaid must expand the sponsorship law at reasonable prices, as well as other new barriers in front of coverage.
The law will mean that more than 7.5 million people will lose Medicaid coverage and become unbelievable, according to the Congress Budget Office, with the expansion of the tax cuts of wealthy people who, the Democrats say, do not need it. Republicans and Trump said that the package of spending and lowering the accompanying programs is necessary to prevent fraud and waste, and to preserve the Medicaid program, a government program, I know for persons with disabilities and low income.
The White House said in a June 29 Statement.
Medicaid discounts will not start until after the mid -term elections in November 2026, but other discounts have already been hit.
The Trump administration sought to return 11 billion dollars in federal public health funds Devoted to countries because of the epidemic, which prompted a Legal battle With the alliance of democracy -led countries. also Reducing about 1 billion dollars in Federal grants For mental health services in schools, grants from the National Health Institutes of Health have been suspended that provided money to more than 90 public universities.
Emily Heilard’s press secretary at HHS Emily Heilard said the agency gives priority to investments that provide Trump’s authorization to counter chronic diseases. She defended some discounts and said, by mistake, that the spending law does not reduce medical aid.
She said: “The Covid-19s are over, and HHS will not be lost billions of dollars in the taxpayer who responded to a crisis that the Americans have moved years ago.”
State leaders say that the financing of the epidemic that the administration wants has been allocated to other public health measures, such as tracking emerging diseases, fascism, and employees. State lawyers won in May A temporary restriction order Against administration.
“What we see now is that the countries expect the major discounts in Medicaid, but they also deal with a full range of federal discounts in public health programs smaller but still meaningful,” he said. Larry LevittKFF, a non -profit health information that includes KFF Health News.
Part of the challenge of countries is simply an understanding of changes.
“I think it is fair to say that there is anxiety, confusion, and uncertainty,” said Catherine Costanza, a Midikid expert at the National Conference of the State Legislative Councils.
Countries are struggling to sort everything, and formation Consulting groups this Track federal changesProsecute to try to prevent discounts, and re -customize funding.
In Colorado, legislators An invoice passed To allow Medicaid to pay for the care of non -abortion in family planning clinics in America after the Trump law banned federal funding for such care. Whether the ban is in court He still should be seen.
Louisiana Legislative Council Send 7.5 million dollars To countries that compensate for discounts for financing federal research, many of which go to health related research.
In South Dakota, the largest food bank in the state He asked legislators to spend $ 3 million To compensate for financing discounts to the US Department of Agriculture.
Countries must balance their budgets every year, so the discounts endangered many services if legislators in the states are not ready to raise taxes. Work will start seriously in January, when many states start new legislative sessions.
Difficult options are likely to continue. Republicans in the House of Representatives think of Congress Bring more discountsIncluding by reducing the generous costs that share the federal government, the federal government provides for 20 million adults who joined Medicaid under Medicaid’s expansion in ACA.
Some states will decrease their Medicaid expansions and reduce more health programs as a result.