Republicans Attack Medicaid: Update

Here is what you can do about it.

Last week, I wrote about looming Republican efforts to cut Medicaid to help fund $4.5 trillion in tax cuts, most of which benefit the wealthiest Americans. To deflect criticism, GOP leaders are framing these cuts as “reforms” to eliminate “fraud, waste, and abuse.” This week, the House Energy and Commerce Committee passed its plan to reduce Medicaid spending by approximately $880 billion over the next decade.

Here’s how they propose to make those cuts:

Increased Co-Pays for the Working Poor

People earning between 100% and 138% of the federal poverty level would face new out-of-pocket costs: capped at $35 per service or 5% of their monthly income. For a family of four earning between $2,600 and $3,583 per month, that could mean up to $130–$180 in new costs, when housing, food, and utilities are already stretching budgets thin.

Eligibility Verification

The bill would require Medicaid participants to verify their income and residency more frequently. These bureaucratic hurdles have a history of pushing eligible people off the rolls, especially older adults and people with disabilities. Additionally, the bill delays implementation of two final rules designed to simplify enrollment and renewal until 2035.

Work Requirements

Most Medicaid enrollees already work, go to school, or care for family members. In Arkansas, 18,000 people lost coverage under work requirements, many due to paperwork errors, not because they didn’t meet the rules.

Punishing States That Help Undocumented Immigrants

Several states use their own funds, not federal dollars, to cover undocumented immigrants, often children, pregnant women, and seniors. This bill would penalize those states by reducing their federal Medicaid funding across the board by 10%.

Shifting Costs to States

Many states fund Medicaid by taxing hospitals and other healthcare providers. This bill freezes existing provider tax arrangements and prohibits new ones, undermining a critical financing tool and forcing states to cut services or absorb the difference.

Banning Planned Parenthood from the Medicaid Program

Planned Parenthood and other large abortion providers would be banned from Medicaid reimbursement, including for essential health services like cancer screenings, STI testing, birth control, and gynecological exams. For many communities, Planned Parenthood is the only provider of these services, meaning many women could lose access to critical care.

None of this will help reduce fraud, waste and abuse.

• Shifting costs to families or states? Not fraud.

• Penalizing states for using their own funds? Not fraud.

• Creating paperwork that kicks off eligible people? Not fraud.

• Banning Planned Parenthood from delivering essential healthcare? Not fraud.

Let’s be clear: these aren’t reforms. They’re just cuts so Republicans can pay for tax breaks for billionaires.

One More Thing

At the same time, Republicans are also proposing to roll back subsidies for health insurance on the ACA marketplace. Combined with the Medicaid cuts, these changes would leave 8.6 million more Americans uninsured over the next decade, according to the Congressional Budget Office.

Why This Is So Important

First, if enacted into law, these changes would have a devastating impact on millions of Americans. You don’t need to be on Medicaid to be affected. Medicaid keeps hospitals open, funds school-based services, and covers long-term care for seniors. If it’s weakened, the entire system suffers.

Second, this is a bellwether. If Republicans succeed in dismantling Medicaid, they’ll likely turn next to Social Security and Medicare. They’ve long viewed Medicaid as the easiest target.

But they may have misjudged public support. A recent Kaiser Family Foundation poll found that 65% of Trump voters want Medicaid funding increased or kept the same. Only 19% support cuts.

We need to make sure no one is fooled by the word “reform.” These are cruel cuts. And they’re coming at the expense of real people, so billionaires can get a tax break they don’t need.

Take action by sending a letter to your representatives using the Center for American Progress’ form.

Sources:

1. CBPP – Republican Budget Proposal and Medicaid Cuts
https://www.cbpp.org/research/federal-budget/house-republican-budget-plan-cuts-essential-programs

2. KFF – Medicaid Cost-Sharing and Premiums
https://www.kff.org/medicaid/issue-brief/medicaid-cost-sharing-out-of-pocket-costs/

3. KFF – Medicaid and CHIP Eligibility and Enrollment Policies
https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-renewal-policies/

4. KHN – Fallout from Arkansas Medicaid Work Requirements
https://khn.org/news/article/arkansas-medicaid-work-requirements-trump-administration-health-care/

5. Politico – Republican Plan Penalizes States Covering Immigrants
https://www.politico.com/news/2025/05/11/energy-and-commerce-unveils-its-megabill-plans-00339830

6. KFF – Medicaid Financing: The Basics
https://www.kff.org/medicaid/issue-brief/medicaid-financing-the-basics/

7. CBO – ACA Subsidy Expiration Projections
https://www.cbo.gov/publication/58885

8. Medical Economics – 13.7 Million More Uninsured Under GOP Plan
https://www.medicaleconomics.com/view/medicaid-cuts-democrats-pan-republican-plan-to-change-major-payer-in-u-s-health-care