The debate over potential cuts to Medicaid has sparked intense discussions in Congress, with leaders from both parties accusing each other of dishonesty. House Democratic leader Hakeem Jeffries recently claimed that a Republican budget proposal could lead to the largest Medicaid cuts in U.S. history, asserting that Republicans are not being transparent about the consequences of their plans. He urged them to prove him wrong, stating plainly, “Republicans are lying to the American people about Medicaid.”
In response, Republican leaders pushed back, arguing that Democrats are misrepresenting their budget. Representative Steve Scalise noted that the term "Medicaid" does not even appear in the Republican bill. House Speaker Mike Johnson echoed this sentiment, insisting that Republicans do not intend to cut Medicaid and accusing Democrats of spreading falsehoods.
The backdrop to this debate is the Republican Party’s goal to find significant budget savings, aiming to extend tax cuts originally enacted under former President Donald Trump in 2017. This effort is separate from the urgent need for Congress to pass a continuing resolution to prevent a government shutdown by March 14.
The House Republican budget plan, approved on February 25, seeks to cut at least $880 billion over the next decade. While the plan does not explicitly mention Medicaid, it assigns the House Energy and Commerce Committee the task of identifying ways to reduce the deficit. This committee oversees Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP), which provides affordable health coverage for children in families that earn too much to qualify for Medicaid.
With Medicare cuts off the table due to their political sensitivity, Medicaid becomes the primary target for achieving the proposed savings. Experts have pointed out that if cuts to both Medicare and CHIP are avoided, significant reductions in Medicaid are likely unavoidable. According to the Congressional Budget Office, Medicaid accounts for 93% of the funding under the committee’s jurisdiction after excluding Medicare.
Allison Orris, a Medicaid policy expert, stated that it is unrealistic to think that federal Medicaid assistance will not face deep cuts. Larry Levitt, a health policy executive, emphasized that without substantial cuts to Medicaid, achieving the $880 billion savings goal is impossible.
The proposed cuts are not finalized. While the House has passed its budget plan, Senate Republicans are considering a different approach that does not include such drastic cuts. Some Senate members, like Senator Josh Hawley, have openly opposed significant reductions to Medicaid.
The discussion has also turned to the issue of Medicaid fraud, with Republican leaders suggesting that eliminating fraud could help address budget concerns. However, experts argue that simply targeting fraud will not solve the larger budget issues, as the amount lost to fraud is a small fraction of the proposed cuts.
As this debate continues, it remains to be seen how congressional negotiations will unfold and what the final budget will look like. Both chambers will need to agree on a budget, and any changes will require the president’s approval. The stakes are high, as these decisions will impact millions of Americans who rely on Medicaid for their health care.