Medicaid Cuts in Republican Bill Would Charge Poor People More for Coverage

[Passages]

The cost-sharing requirements on beneficiaries above the federal poverty line is the most notable item in a menu of Medicaid cuts seen by the Prospect.

by David Dayen May 7, 2025

Medicaid recipients with earnings at or above the federal poverty line would have to pay significant out-of-pocket expenses for their health care coverage, and work requirements would be placed on the program, according to a menu of items in the emerging Republican budget reconciliation proposal seen by the Prospect.

The Medicaid cuts, part of the giant tax and spending package Republicans are readying using the reconciliation process to avoid a Senate filibuster, would also roll back Biden-era rules that improved staffing at nursing homes. And they would alter a number of eligibility and enrollment provisions that would make Medicaid harder to navigate for its 71 million-plus enrollees, a common tactic to reduce enrollment.

“A lot of these policies will add administrative costs for the states, burdens for people, the potential for more improper payments and errors in processing,” said Allison Orris, director of Medicaid policy at the Center on Budget and Policy Priorities (CBPP). “All of this shifting of the ball can result in people losing coverage.”

Sources told the Prospect that the list of Medicaid cuts in the menu do not appear to reach the $880 billion over ten years required in budget reconciliation instructions for the House Energy and Commerce Committee. Even with proposed changes to the Affordable Care Act that could increase health care costs for millions of recipients, as well as unspecified cuts to the remnants of the traditional welfare program, known as Temporary Assistance for Needy Families (TANF), and the Social Services Block Grant (SSBG), the total estimate of savings is about $600 billion. That would lower the amount of tax cuts available under reconciliation instructions, which hard-line Republicans might reject as insufficient.

https://prospect.org/health/2025-05-07-medicaid-cuts-in-republican-bill-would-charge-poor-people/

[Skittles]

1. someone has to pay for those tax cuts to the rich