Republicans Propose Medicaid Cuts and Work Requirements: What It Means for Millions of Patients

Republicans are considering major cuts to Medicaid, which could leave millions of Americans without vital health coverage. This program serves around 80 million adults and children in the U.S. and is largely funded by taxpayers.

During President Biden’s term, many people signed up for Medicaid and the Affordable Care Act’s health plans. Democrats celebrate this as a major achievement. However, Republicans are now looking to reduce federal spending. They see Medicaid as a prime target because it costs almost $880 billion, with federal taxes covering up to 80% in some states. States have also mentioned struggling to keep up with the increased demand and the needs of sicker patients.

To cut costs, the GOP-controlled Congress is suggesting work requirements for Medicaid beneficiaries. They might also change how they reimburse states, moving to a fixed rate per person instead of covering costs as they currently do. These changes could take away billions in health coverage for the poorest Americans.

Even before Congress started discussing these changes, states like Arkansas, Ohio, and South Dakota were pushing to implement their own work requirements for Medicaid. The Trump administration had previously supported such measures.

On other fronts, the Republican administration proposed cutting the budget for the Affordable Care Act’s navigator program by 90%. Navigators help people sign up for health coverage, playing a significant role in boosting enrollment.

Speaker Mike Johnson suggested that linking work requirements to Medicaid could make a difference. He believes that work gives dignity and uplifts people. Yet, most Medicaid recipients are already engaged in work or other activities, with 92% of them either working, studying, or providing care.

Proposed work requirements mirror those for the Supplemental Nutrition Assistance Program (SNAP), which requires eligible individuals ages 16 to 59 to work or volunteer for at least 80 hours a month unless they meet specific exemptions. For many, benefits like SNAP are a lifeline, with average monthly incomes being quite low.

Some Republicans also propose setting limits on how much the federal government reimburses states for Medicaid, which could force states to decide whom to cover. Experts warn this shift wouldn’t eliminate health care needs; those needs would still exist even if coverage is reduced.

A poll shows that over half of U.S. adults believe the government spends too little on Medicaid. This sentiment reflects concern about cuts impacting those who rely on such programs.

While the Biden administration previously halted states from imposing work requirements, the landscape is changing under Trump, who has shown a willingness to allow states to pursue these measures. Governors in Arkansas, Iowa, and Ohio are seeking approval to implement new work requirements again.

During the Trump administration, Arkansas tried a work requirement that led to approximately 18,000 individuals losing their coverage. Many faced difficulties logging their hours due to technical issues.

In Idaho, discussions around work requirements and limiting Medicaid benefits are ongoing. Local physicians report that many of their patients depend on Medicaid, emphasizing that these individuals are hardworking members of their communities.

Democrats warn that cutting Medicaid could harm healthcare facilities, especially in rural areas where hospitals rely on Medicaid for patient payments. Cutting these funds could lead to hospital closures, affecting access to care for vulnerable populations, including children and seniors.