Tax And Spending Bill, Medicaid Concerns, Gun Tracing Fund

0:02Senate Republicans got the president's budget bill over the finish line now goes back to the House, but polls show the bill is unpopular with a lot of Americans. So is it a political risk for Republicans? I'm Leila Falded, that's A. Martinez, and this is Up First from NPR News.

0:19One of the most controversial parts of the bill would make big cuts to Medicaid and leave millions of Americans uninsured. So we get into what the bill would do and why so many people would lose their coverage. And hundreds of jobs are being cut at the Bureau of Alcohol, Tobacco, Firearms, and explosives, mainly people who conduct inspections of gun dealers. So the people who shouldn't have guns don't have guns. Stay with us. We've got all the news you need to start your day.

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2:10It includes tax cuts and boosts border security and defense programs. Here's Senate Majority Leader John Thune after the vote. With this legislation, we're fulfilling the mandate we were entrusted with last November and setting our country and the American people up to be safer, stronger, and more prosperous. But it's expected to add$3.3 trillion to the U.S. budget deficit through 2034. The House is planning to vote today as Republicans try to get the package to the president's desk by July 4th. NPR congressional correspondent Deirdre Walsh is here now. So, Deirdre, how did the Senate GOP leaders finally get this thing over the finish line?

2:50You know, it really came down to the wire. Vice President J.D. Vance had to break a tie to pass it. GOP leaders could only lose three votes, and they did. Susan Collins of Maine, Rand Paul of Kentucky, and Tom Tillis of North Carolina all voted no. Alaska Senator Lisa Murkowski was the deciding vote. She supported the tax cuts in this bill. It makes the 2017 Trump tax cuts permanent, adds new temporary breaks like no tax on tips or overtime. But Murkowski raised big concerns about some of the spending cuts, especially the cuts to nutrition programs, and the nearly$1 trillion in cuts to Medicaid.

3:27That's the health care program for low-income, elderly, and disabled. This bill adds work requirements and changes tax provisions for states that's going to impact how much states get from the federal government. So what did leaders do to convince Senator Murkowski to vote yes? They doubled a fund to help rural hospitals from$25 to$50 billion over five years. They made changes for nutrition benefits targeted just to help Alaska. Plus, Murkowski got a tax break for whalers. She called the decision agonizing. She said she didn't like the bill, but said she did what she thought helped Alaskans. I needed help, and I worked to get that every single day.

4:06And did I get everything that I wanted? Absolutely not. All right, so the House now, Deirdre. Will this pass the House? I mean, they're aiming for, what, later today? Right. House Speaker Mike Johnson can't afford to lose more than three votes. He admitted last night weather is a factor. Flights have been delayed and canceled last night as members. come back into D.C. for a vote expected today. Conservatives are threatening to vote no because the bill, as you said, adds more to the deficit. Moderates oppose the deeper Medicaid cuts. But as we've seen before, House Republicans tend to get in line behind Trump under pressure.

4:42OK, but they're rushing to pass this bill. Public opinion polls, though, show it's unpopular. So is this a political risk for all Republicans? It really could be. So far, the message from Republicans is Congress has to pass this to avoid a tax hike since these tax cuts expire at the end of this year. But that's really a complicated message. Most people won't see big changes in their paychecks. But a lot of working class voters who voted for Trump could potentially lose their Medicaid coverage. The president argues that it's waste, fraud and abuse that's being cut. But a nonpartisan scorekeeper estimated that close to 12 million people could lose their health care coverage.

5:20Democrats are already making this issue the central issue in the upcoming 2026 midterms. They say Republicans campaigned on lowering costs. But independent analysis of this bill found that the benefits of the tax breaks are much bigger for those at the higher income levels than for working and middle class people. That's NPR's Deirdre Walsh. Thanks a lot. Thanks, A. As we just heard there, some of the most controversial provisions of the bill would make large cuts to Medicaid. That's the shared federal state health program that currently provides insurance coverage to more than 70 million Americans with low incomes.

5:55Republicans have long wanted to roll back expansions to Medicaid made by Democrats, especially those made by the Affordable Care Act. With us to talk about what the budget bill might mean for those on the program is Julie Rovner. She's the chief Washington correspondent for KFF Health News. Good morning, Julie. Good morning, Leila. So just, I mean, how big are the cuts to Medicaid? What are we talking about here? Well, according to the Congressional Budget Office, which is the bill's official scorekeeper, the Senate bill that passed Tuesday would reduce federal Medicaid spending by an estimated$930 billion over the next decade.

6:31That's about 10 percent of the program's total budget. And that cut is$100 billion bigger than the cut the House voted for back in May. OK, President Trump and House and Senate Republicans say this bill would not actually take Medicaid away from anyone who's currently eligible. It only deals with waste, fraud, and abuse. Is that the case? Well, again, this is according to the CBO. The Senate bill would increase the number of Americans without health insurance, including many who will technically still be eligible for the program. Right now, there are about 26 million Americans with no health insurance.

7:05That would go up by a third because of this bill, so an additional 12 million uninsured in 2034. 34. And that doesn't even count several million more people who could lose coverage as a result of changes to other insurance programs like the private plan sold on the Affordable Care Act marketplaces. Why would so many people lose coverage? Well, the primary way people will be separated from their insurance is increased paperwork. For example, right now, people need to prove their eligibility for Medicaid just once a year. This bill would double that to every six months. And it isn't just filling out a form.

7:39People need to upload lots of documentation to prove that what they're claiming about their income or health status is correct. That's hard enough as it is, but it can be particularly difficult for people who are sick, either physically or mentally. And obviously, that's why many people are eligible for Medicaid in the first place. What about the work requirements we've heard about? Is that also expected to reduce the Medicaid rolls? Yes. The CBO estimates that about half the people who'd lose their Medicaid coverage would lose it because of the work requirements. And it's not that the requirements themselves are particularly onerous.

8:11Most adults on Medicaid who don't have young kids would only be required to work or volunteer or go to school 80 hours per month. But again, it's the paperwork, not the work. States that have tried work requirements have found that proving you've done these things can be quite difficult. And many, many eligible people end up having their coverage ended either temporarily or permanently because they can't navigate the reporting requirement. They'd have to report their activities once a month in many cases. I've heard it described as like having to file your income taxes every single month. You said the Senate bill would cut more deeply into Medicaid than what the House bill had proposed, but was there anything that the Senate pulled back on?

8:53Well, not on purpose, but the Senate parliamentarian said the bill couldn't ban Medicaid from covering care for transgender people, so that provision of the House bill got dropped. And while the House voted to ban Medicaid from funding any kind of medical care at Planned Parenthood for 10 years, not just abortion care, the parliamentarian also made senators reduce that to only a single-year ban. Still, according to Planned Parenthood, that could force the closure of hundreds of clinics where people get cancer screenings and contraception and other types of medical care. Julie Rovner of KFF Health News.

9:28Julie, thank you. Thank you.

9:36The Trump administration is restructuring the Bureau of Alcohol, Tobacco, Firearms, and Explosives. Officials say they plan to make changes to gun regulations and slash the agency's budget. NPR criminal justice reporter Meg Anderson is here to break down some of those changes. Meg, So what do we know about what's happening at the ATF? Yeah, well, first, as a reminder, ATF is the country's main regulator of the gun industry. They investigate illegal gun trafficking. They inspect gun dealers to make sure they're following the law. And we know that two weeks ago, DOGE began working with ATF on around 50 regulatory changes.

10:12Many of them aim to loosen gun regulations. That's according to people I spoke with who are familiar with the matter. They spoke on the condition of anonymity to avoid retaliation. The changes include things like making a background check for a firearm purchase valid for 60 days instead of 30. Another allows gun dealers to destroy records after 20 years rather than keeping them indefinitely. And the people I spoke to told me, you know, if you look at many of these changes in isolation, they might not seem huge. But taken together, a pattern of gun deregulation begins to emerge. Yeah, the Department of Justice, they oversee the ATF.

10:50They've also proposed a 25 % cut to ATF's budget next year. What would that do to the agency? One really big thing it would do is cut more than 500 investigators. That's according to the DOJ's proposed budget. Those are the people that conduct inspections of gun dealers. Pam Hicks was chief counsel at the agency until February when she was fired. She said those inspectors help ensure gun dealers are keeping accurate records. And that is key to solving violent crime. And the reason why it's critical that they be accurate is so that people who shouldn't have guns don't have guns. And if you can't trace the gun because of crappy records, then that's a problem for law enforcement.

11:35The agency declined my request for an interview, but in a statement, ATF said it is trying to reduce, quote, unnecessary regulatory burdens so it can focus its enforcement on violent criminals. How do police feel about these cuts? Yeah, well, ATF is the only agency in the country with the ability to trace guns involved in crimes. And so police use that information from ATF all the time. The agency keeps a database of the markings left on a bullet or a casing after it's been fired in a crime. It's basically like a gun's fingerprint. I spoke with Brandon Del Pozo about this. He used to be the police chief in Burlington, Vermont.

12:17The ability to show that a gun was involved in more than one crime, that a gun that appeared at this crime scene, then appeared on that rooftop, helps police conduct very effective investigations. We need that to be well-funded. Del Pozo said the administration's cuts to this agency are directly at odds with its claim that it's tough on crime. So what happens now? So the administration has said it's not done with its plans to transform the agency. And Congress is getting involved, too. The big tax and spending bill the Senate passed yesterday includes a provision that removes attacks on gun silencers.

12:55It's a move that gun control advocates strongly oppose. That's NPR's Meg Anderson. Meg, thank you. You're welcome.

13:09And a final story for you today. President Trump says Israel has agreed to a 60-day ceasefire in Gaza. He urged Hamas to accept it, saying, quote, it will only get worse. The announcement comes ahead of Israeli Prime Minister Benjamin Netanyahu's visit to the White House next week. And this doesn't mean a ceasefire will begin next week. It's just about setting the ground rules for entering ceasefire talks. And this comes nearly two years into Israel's war in Gaza. The deal is similar to one proposed by the U.S. months ago. It's a 60-day ceasefire in exchange for Hamas releasing 10 living hostages.

13:44That's half the number of living hostages Israel says are being held in Gaza today. The sticking point has been Hamas' insistence on guarantees that ending the war in Gaza must be a condition of the deal, and Israel has only agreed to a temporary ceasefire.

14:03And that's Up First for Wednesday, July 2nd. I'm Leila Faldil. And I'm Martinez. How about giving Consider This from NPR a try? We hear it up first. I'd like to give you the three big stories of the day. The team at Consider This does it a little bit differently. they dive into a single news story and what it means to you. Learn about a big story of the day in less than 15 minutes. Listen now on the NPR app or wherever you get podcasts. Today's episode of Up First was edited by Kelsey Snell, Carrie Fiebel, Gigi Duban, Jenea Williams, and Alice Wolfley. It was produced by Ziad Butch, Nia Dumas, and Christopher Thomas.

14:37We get engineering support from Zovane Ginhoven, and our technical director is Zach Coleman. Join us again tomorrow.

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