Matt Sinovic is the executive director of Progress Iowa. -promoted by Laura Belin

This week, the Trump administration released its proposed budget for fiscal year 2020, which revives a call to repeal the Affordable Care Act and lays out massive cuts to Medicaid, Medicare, and the Department of Health and Human Services. The administration’s budget reveals just how steadfast it remains in trying to take away Americans’ health care.

Here are five things you need to know about Trump’s Health Care Sabotage Budget:

1. President Trump’s Budget Revives The Failed Graham-Cassidy Repeal Bill That Would Repeal Medicaid Expansion And ACA Subsidies Only To Replace Them With Inadequate Block Grants, Ultimately Cutting Medicaid By More Than $1 Trillion.

By shifting to a block grant program and eliminating funding for Medicaid expansion, the administration would cut Medicaid by more than $1 trillion over 10 years.

[Editor’s note: The U.S. Senate never voted on Graham-Cassidy, but Governor Kim Reynolds endorsed the legislation.]

2. The Budget Would Impose Onerous Work Requirements On Medicaid Enrollees Nationwide, Which Is Estimated To Cause Up To 4 Million People To Lose Coverage.

This unprecedented move would completely alter Medicaid as we know it, requiring people nationwide to meet onerous work and reporting requirements in order to maintain their Medicaid coverage. The Kaiser Family Foundation has estimated that a national Medicaid work requirement would cause up to 4 million people to lose coverage, most of them losing coverage due to paperwork and red tape.

3. The President’s Budget Could Impose Premiums On Up To 4.2 Million Low-Income Uninsured People Who Are Currently Eligible For A Plan That Requires $0 In Premiums.

As CQ’s Mary Ellen McIntire noted, “The budget proposes all exchange enrollees who are eligible for subsidies ‘contribute something’ to their coverage, meaning people who currently pay $0 in premiums would have to make some sort of payment. Kaiser found that could apply to 4.2M uninsured.” (Click here for the Kaiser report.)

4. Trump’s budget would slash funding for the Department of Health and Human Services, the department responsible for administering the Affordable Care Act, by 12 percent.

As Caitlin Emma and Jennifer Scholtes reported for Politico, the budget request “assumes that Congress will succeed in repealing and replacing Obamacare.”

5. The Budget Proposes Cutting More Than $800 Billion From Medicare Over A Decade.

Although Trump repeatedly promised not to cut Medicare, his budget would cut roughly 10 percent of Medicare’s funding over the next ten years to help pay for tax cuts to insurance and big drug companies.