Alternative Headline: GOP Eyes Medicare, Medicaid Cuts
[MM Curator Summary]: Republicans, guided by Paragon Health Institute, are weighing further cuts to Medicaid and potentially Medicare as part of a new reconciliation package.
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The briefing will also cover the 340B drug discount program; proposals to even out Medicare payments for outpatient services, known as “site neutral” payments; plans for expanding tax-advantaged Health Savings Accounts for medical expenses; and arrangements that allow employers to reimburse employees for insurance premiums and medical expenses with pre-tax dollars.
Blase, who did not respond to a request for comment, served on the White House National Economic Council during Trump’s first term. He and other conservative health wonks launched Paragon in 2021, and it has rapidly gained influence in GOP policy circles. Former Paragon staffers are now top health aides to Speaker Mike Johnson and President Donald Trump.
Blase will be joined by two other Paragon officials at the RSC briefing: Demetrios Kouzoukas, who is the director of Paragon’s Medicare Reform Initiative, and Gabrielle Minarik, a program manager. Kouzoukas, a former executive in UnitedHealth’s Medicare arm, also served as chief executive of the Medicare program at the Centers for Medicare and Medicaid Services during the first Trump administration.
While Republicans reaped hundreds of billions of dollars of cuts from Medicaid in the One Big Beautiful Bill Act, they stopped short of the more ambitious changes that Blase and conservative lawmakers have advocated. Now, even senior Republicans acknowledge their options for new spending offsets are drastically limited, and both Medicaid and Medicare are likely to emerge as tempting targets as talks proceed. “It’s clear we’re scraping the bottom of the barrel for cuts,” said one Republican with direct knowledge of the early conversations around a second GOP-only package.
But any push to further slash federal health care spending — let alone the politically explosive issue of Medicare changes — is likely to be met by fierce pushback by vulnerable House Republicans as well as some more conservative-leaning members. Some Senate Republicans, meanwhile, are deeply skeptical a second reconciliation package would have enough support to pass — especially absent a major, unifying centerpiece akin to the tax cuts embedded in the first package.
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