When is a Medicaid cut not actually a cut?

That's the $800 billion question facing Senate Republicans as they write their own version of the sweeping House-passed tax and spending bill.

Administration officials and senators defending against attacks on the bill have coalesced around a message that there will be no cuts to benefits, and the only people who will lose coverage are the ones who never deserved it to begin with: namely immigrants without legal status and “able-bodied” individuals who shouldn’t be on Medicaid.

“This bill will preserve and protect the programs, the social safety net, but it will make it much more commonsense,” Office of Management and Budget Director Russell Vought said during a recent CNN interview. “That’s what this bill does. No one will lose coverage as a result.”

Among many provisions, the House bill would require states to deny Medicaid to people who can’t prove they are working, looking for work, in school or volunteering for 80 hours a month. It would prohibit states from using their own money to cover immigrants without legal status and would deny coverage to other lawfully present immigrants who are currently eligible.

According to the nonpartisan Congressional Budget Office (CBO), the legislation will result in nearly 11 million people losing health insurance coverage over the next decade.

The Medicaid provisions alone would result in 7.8 million people losing their insurance. Those coverage losses would equate to hundreds of billions of dollars in savings for the federal government.

However, GOP lawmakers and administration officials insist the legislation will protect Medicaid for “deserving” people such as the elderly and disabled, while forcing others to prove they aren’t........

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