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How can Congress cut $2.4 trillion? Here are three places to start.

Finding $2.4 trillion in spending cuts is not easy, but Congress's search is beginning to show some signs of promise. In particular, three programs long protected by big, bipartisan majorities in the past now appear vulnerable.

- Staff writer

Sen. Orrin Hatch (R) of Utah seeks to trim the costs of Medicaid by turning it into a block-grant program. (Jacquelyn Martin/AP/File)

2. Medicaid

As Democrats dig in to defend Social Security and Medicare, focus in bipartisan negotiations is shifting to finding savings in Medicaid, the $400-billion-a-year federal program to support health care for the poor and disabled, as well as long-term care for seniors.

Republicans and many of the nation’s governors are pushing for changes that will ease requirements on the states, which disburse the funds. GOP lawmakers also see proposed Medicaid cuts as a way to find big savings for deficit reduction.

In a speech at the Heritage Foundation on Wednesday, Sen. Orrin Hatch (R) of Utah, the top Republican on the Finance Committee, proposed giving states more flexibility to decide who qualifies for assistance, much as welfare reform in 1996 began with experimentation at the state level. Senator Hatch would end a mandate that requires states to maintain current Medicaid eligibility – some 68 million Americans – until 2014.

"The bottom line is that those who are the biggest advocates for Medicaid, and most criticize conservatives for seeking to reform the program, are happy to consign America’s poorest and sickest patients to a health-care gulag," said Hatch, who supports converting Medicaid to a block grant program.

Democrats are preparing to defend certain aspects of the Medicaid program, but they have signaled a willingness to consider compromises on others. “It’s very important to us that home subsidies and health care for those with disabilities not be disrupted," says Rep. Robert Andrews (D) of New Jersey, a spokesman for the Democratic caucus. But he suggests that there might be "other creative ways to provide help to low-income people.”


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