WASHINGTON (AP) — Dr. Mehmet Oz promised senators on Friday to fight health care fraud and push to make Americans healthier if he becomes the next leader of the Centers for Medicare and Medicaid Services.
But the former heart surgeon and TV personality dodged several opportunities to say broadly whether he would oppose cuts to Medicaid, the government-funded program for people with low incomes.
Oz, President Donald Trump’s pick to be the next CMS administrator, also said technology like artificial intelligence and telemedicine could be a key in making care more efficient and accessible.
Now he has his sights on overseeing health insurance for about 150 million Americans enrolled in Medicare, Medicaid or Affordable Care Act coverage. As CMS administrator, he could wield significant power over most health companies operating in the U.S. because he can make decisions about who and what are covered by Medicare and Medicaid.
But according to the Miami Herald concerns are continuing to mount among some lawmakers and health advocates. Based on the proposed budget, health advocates say there are few options to avoid Medicaid cuts. They say slashing federal Medicaid funding would force Florida and other states to raise taxes or consider other alternatives, including scaling back how many people can be enrolled in the health insurance program that provides coverage to 80 million low-income adults and children in the U.S.
“Federal cuts to Medicaid will do nothing, let’s be clear, will do nothing to lower healthcare costs or improve quality and access to care for our residents,” Alison Yager, executive director of Florida Health Justice Project, a nonprofit that advocates for health equity, said during a news conference this week. ”Miami’s residents are already struggling to take care of our children and our elders and those with chronic conditions, and we cannot afford to lose this lifeline.”
Medicaid is a joint state and federal health insurance program that provides coverage to millions of kids, pregnant women, seniors and people with disabilities in Florida, including in Miami-Dade and Broward, home of the highest enrollments in the state.
Earlier this month, a group of House Republicans who are part of the Congressional Hispanic Conference and represent Hispanic-heavy districts in the country wrote a letter to House Speaker Mike Johnson expressing their concern over potential cuts to Medicaid and other social programs that their constituents rely on.
On Wednesday, Miami-Dade County Mayor Daniella Levine Cava sent a letter to Florida’s elected members of Congress urging them to oppose the “drastic and potentially disastrous” proposed cuts that could impact Medicaid and other programs that more than 720,000 Miami-Dade residents depend on, and instead “advocate for modernized, fiscally responsible reforms that maintain access to care while improving efficiency and reducing waste.”
What is Medicaid and who does it cover?
Medicaid is a medical lifeline for millions of people in the U.S., including 4.2 million Floridians. It provides coverage to one in five people in the U.S. and accounts for nearly $1 out of every $5 spent on healthcare, according to KFF, a nonprofit, nonpartisan organization that provides information and research on health issues and policies.
The Medicaid program is considered to be the largest payer of mental health services in the country, the largest funder for nursing homes and long-term care in the U.S., and the largest payer for substance abuse treatment, including opioid use disorder, according to health experts. It has also played a significant role in treatment and care during pandemics, including COVID, HIV and AIDS.
“The families I provide care for can get regular checkups, treatment for chronic illnesses, and prescription drugs because of vital insurance programs like Medicaid and the insurance they buy themselves on the Marketplace every year with the help of tax credits,” said Dr. Olveen Carrasquillo, a health policy expert at the University of Miami Miller School of Medicine. The programs “help my patients receive preventative care, which helps them stay out of the hospital for preventable causes. Stripping away health coverage will increase the likelihood of harmful health outcomes.”
In Miami-Dade County, more than 40% of kids and more than half of Miami-Dade seniors are insured by Medicaid, according to Leo Cuello, a research professor and Medicaid policy expert at Georgetown University’s Center for Children and Families. More than 50,000 people with disabilities under 65 in Miami-Dade also rely on Medicaid coverage, according to Yager. Medicaid brings billions in revenue to Florida hospitals, covers more than 40% of Florida births and pays for 58% of nursing home residents in Florida.
“For them, Medicaid isn’t just healthcare —it’s the difference between getting a check-up and letting an illness go untreated, between affording medication and risking serious complications,” said Abraham Frometa, community health manager at Catalyst Miami, a local nonprofit that works to address health and other inequities in the community.
Medicaid has helped South Floridians like Beyssa Buil have access to more affordable health care. Buil is living with multiple sclerosis, a chronic neurological disease that affects the body’s central nervous system.
The chaplain said she is occasionally hospitalized because of her condition and needs weekly and monthly infusions, as well as occupational and physical therapy. When she had Medicaid, the health insurance helped cut the cost of her monthly treatment to $3,856. Her medical debt has quickly ballooned without it.
What’s going on with the proposed federal Medicaid cuts?
While the House’s budget blueprint doesn’t mention Medicaid, it instructs the House’s Energy and Commerce Committee, which oversees Medicaid and other programs, to figure out how to cut spending by at least $880 billion over the next decade, according to the New York Times. The cuts are part of a plan to make $4.5 trillion in tax cuts a reality and slash $2 trillion in spending.
Here are some key things to know:
▪ The House’s Energy and Commerce Committee has the broadest jurisdiction of any committee in Congress and “has responsibility for matters including telecommunications, consumer protection, food and drug safety, public health and research, environmental quality, energy policy, and interstate and foreign commerce among others.” Its health bucket includes Medicaid, Medicare and the Affordable Care Act, also known as Obamacare, which Miami-Dade and Florida heavily relies on. Miami-Dade consistently leads the nation in Obamacare enrollments.
MORE: These Miami cities love Trump — and lead the U.S. in Obamacare enrollment. Here’s why
▪ Senate Republicans, who approved their own budget plan earlier this month, have indicated that they won’t accept the House’s plan as is and want to make changes, Politico reports.
▪ The House and the Senate will now need to negotiate until they can agree on a finalized budget plan. Once a budget blueprint is finalized, a group of committees will be ordered to draft legislation on how to implement the proposed tax cuts and spending reductions. These policies will then have to be voted on by Congress, and if passed by lawmakers, will head to the president for approval.
▪ Based on the current budget proposal, the New York Times reports, there are few options to avoid Medicaid cuts, including considering cuts to Medicare and cutting everything else the committee oversees.
What are the Medicaid cuts?
Republicans have floated imposing work requirements or changing the way the federal government provides Medicaid money to states, according to the AP. Currently, the federal government covers 57% of Florida’s Medicaid costs, which fluctuates depending on need.
On Wednesday, Republican House Speaker Mike Johnson told CNN that lawmakers have ruled out two of the biggest potential cuts to the program, one of which would have impacted the most Floridians.
Johnson said Congress would not put “per-capita caps” on Medicaid, which would give states a fixed amount of federal funding per Medicaid recipient, regardless of how much care costs. The Florida Policy Institute, a nonprofit nonpartisan public policy research center, said this proposal would have resulted in about $900 billion in cuts and would have been “the largest impact on Floridians among all of the floated proposed cuts to Medicaid.”
This cap, Cuello said, would have hurt Florida and other states that have rapidly rising healthcare costs the most because it would not keep up with the cost of care for Miami-Dade and Florida’s aging senior population.
Cuello compares the situation to eating with someone at a restaurant, and when the check arrives, the person walks out and leaves you with the bill. The person saved money, but you didn’t.
It’s “a terrible deal for Florida,” he said.
Johnson also ruled out changing match rates, which could have led to states needing to pay more of the Medicaid costs.
“We’re talking about finding efficiencies in every program, but not cutting benefits for people who rightly deserve them,” Johnson said, noting that lawmakers want “to cut the fraud, waste and abuse out of Medicare.”
Johnson may have eased some of the concerns of lawmakers and health advocates. But there’s still a lot of questions, skepticism and confusion over Medicaid’s future.
“Where are they going to get these cuts from?” That’s what Holly Bullard, the chief strategy and development officer at Florida Policy Institute, and other policy experts and health advocates want to know. Based on Congress’ own numbers, Bullard and Cuello told the Miami Herald on Thursday that there’s no way to slash $880 billion without “dramatically cutting Medicaid,” which in turn will affect those who rely on the health insurance for coverage.
“The issues being raised here in Florida are the concerns that are playing out across the entire country because there is a major threat to health coverage in front of us, and there are a lot more concerns and questions that we have than we do answers,” Cuello said.
“To be clear, no one has said how they could make a cut this large and protect beneficiaries,” Cuello said. “$880 billion is such a large number that there’s no way to avoid devastating cuts. … There are no proposals that have been released that actually are targeting cutting waste. The proposals all slash the Medicaid funding that states use to provide Medicaid services.”
On Thursday, Cuello reiterated his concerns.
“The numbers don’t add up and the state is still at extreme risk and I don’t think anyone should assume the state is not at risk until they tell us exactly what are the policies that they are going to do to cut $880 billion out of the program,” Cuello said.
How would Medicaid cuts affect your care in Miami and Florida?
Since 1965, the federal government has shared the costs of Medicaid with the states, and Medicaid is the largest source of federal funding to Florida. Lawmakers still need to finalize a budget before they can actually create a game plan to target spending.
This means it’s still too soon to know what the actual cuts will be or how soon people in Miami-Dade could feel the impact.
Here’s what Cuello and Bullard do know:
If Medicaid cuts happen, Florida will quickly realize that a “huge budget hole is coming” and will likely have to consider three options:
▪ Reduce how many Floridians can be enrolled in Medicaid.
▪ Reduce the types of services the health insurance will cover.
▪ Slash provider rates, which means fewer doctors, if any, will want to provide care to people enrolled in Medicaid.
Experts say Florida could also choose to redirect money away from other programs to fund Medicaid services, but that could be difficult. The state, without the possible Medicaid cuts, already has a projected deficit of $2.8 billion for fiscal year 2026-2027, according to Bullard.
“Florida doesn’t have the money to cover this … In Florida, historically, we’ve not gone into our coffers to make up a difference,” said Bullard, who is also concerned Congress’ push to slash spend will likely lead to them not renewing Obamacare tax credits that are set to expire at the end of 2025.
KFF, the health policy nonprofit, estimates Florida would see a 7% increase in state Medicaid spending over a 10-year period if the federal cuts happen and the state wants to maintain its current Medicaid spending and eligibility. If Florida’s response to federal cuts is to reduce Medicaid spending and eligibility, KFF estimates the state would see a 12% decrease in Medicaid enrollment in 2034.
“For the people we serve, Medicaid is more than just a safety net — it’s a critical tool for health, financial stability, and community well-being,” said Frometa of Catalyst Miami. “Losing Medicaid would be devastating. It would lead to more preventable illnesses, greater financial strain — including job and housing loss — and more people forced to go without the care they need.”
Cuello, Yager and other health advocates also agree Medicaid cuts will lead to worsening health in Floridians.
“These massive cuts would make our healthcare problems worse by sharply increasing costs, medical debt and financial insecurity for families, and people’s healthcare needs aren’t going to change. States will just have far less money to cover them, “ Yager said. “If the cuts go through, they’ll shift costs from the federal government to the state, and ultimately, the state will shift costs to the people who can least afford them at a time when healthcare costs are already skyrocketing. We will all pay the price for these Medicaid costs, not just individuals governed by Medicaid.”
THIS STORY WAS CONENT COMING FROM AP AND THE MIAMI HERALD
