In his explanation of opposing the bill, Rep. Smith singled out its proposed cuts to Medicaid and to the Medicaid expansion, noting that according to a Congressional Budget Office report, it would cut Medicaid funding by $839 billion over ten years.
It would also eventually curtail the expansion of Medicaid, a key part of the Affordable Care Act. Under current law, the federal government has increased Medicaid funding to states on the condition that they expanded the Medicaid rolls. It has been credited with expanding Medicaid coverage by 14.5 million since 2013, according to a March 2016 HHS report.
The House plan phased out that Medicaid expansion and would ultimate have cut almost a trillion dollars from Medicaid in ten years according to the CBO, Smith pointed out.
"For years, I have supported Medicaid expansion as a meaningful way of providing access to health care for struggling individuals and families living above the poverty line but still poor despite being employed," Smith stated, noting that "80 percent of all Medicaid enrollees in New Jersey are families with at least one working adult in 2017."
He added that in New Jersey, where his congressional district is located, "the bulk of Medicaid funds are spent assisting the disabled and the elderly," and that most of enrollees in the state were new.
"These people are in need and deserve our support," he said, pointing to opposition to the AHCA Medicaid changes from the U.S. bishops' conference and disability advocate groups.
He cited the Consortium for Citizens with Disabilities, a coalition of over 60 groups who wrote that states, when left with the bill for Medicaid, would start cutting costs beginning with programs benefitting the disabled.
The consortium stated that "people with disabilities are particularly at risk because so many waiver and home- and community-based services are optional Medicaid services and will likely be the first services cut when states are addressing budgetary shortfalls."
Smith also opposed the bill because it "cancels essential health benefits such as maternity and newborn care, hospitalization, pediatric services, and mental health and substance use treatment." The Affordable Care Act mandated these services.
All this, he said, "will likely hurt disabled persons, the elderly and the working poor."