But there’s a second, more indirect way that benefit cuts can happen, which is that states have a lot of latitude over how they design their Medicaid programs. It’s a very complicated law, and there are whole sets of benefits that people like you and me would take for granted—like prescription drugs, some forms of long-term care. And basically, when states get squeezed, when they don’t have enough money, sometimes they’ll react by pulling back on those benefits. And they might say, We’re no longer going to offer this, or, We’re no longer going to offer this optional benefit to certain classes of people.

And then there’s an even more indirect way they can cut benefits, which is that states have a lot of leeway over what they pay for services. Remember, Medicaid is an insurance program. So it’s paying doctors, it’s paying hospitals, it’s paying therapists. Well, if you’re a state and you’re trying to save money, sometimes what you do is you tell all the hospitals and the doctors and the therapists you’re paying them less. That’s fine, but if you do that, it’s going to be harder for people who get those benefits to find providers, to find their services. So that, to me, is also an indirect way of cutting benefits.

Sargent: Well, Senator Josh Hawley of Missouri really does think the bill does cut Medicaid benefits rather substantially. He recently wrote a New York Times op-ed urging the GOP not to cut Medicaid, saying, “Our voters support social insurance programs and depend on them.” On CNN, interviewer Manu Raju asked him about this claim and the current House GOP bill’s Medicaid cuts. Then this happened.