Will Republicans really slash  Medicaid?

Speaker of the House Mike Johnson (R-LA) at the Conservative Political Action Conference (CPAC) at the Gaylord National Resort and Convention Center in National Harbor, Maryland on February 20, 2025
Jack Gruber-USA TODAY

On Tuesday, House Republicans will vote on a budget measure that would fund an extension of President Donald Trump’s first-term tax cuts by taking an axe to one of America’s key entitlement programs: Medicaid.

What’s Medicaid? A joint federal and state program that funds medical care for low-income people. About a quarter of Americans are enrolled directly, and two-thirds say they or their family members have benefitted from the program.

What would the measure do? Slash $2 trillion from the federal budget over the next decade, including about $800 billion from Medicaid. The Medicaid cuts would come by placing per-capita limits on federal funding, narrowing states’ tax options for funding Medicaid, and imposing work requirements on recipients.

The debate: The GOP says these measures will root out waste and abuse, shift more of the burden onto states, which know their own needs better, and incentivize recipients to get off the dole.

Critics say the sweeping reductions would harm the poor by slashing their access to health care while funding tax cuts that disproportionately benefit the wealthy.

What’s Trump saying? He said he would “love and cherish” Medicaid, along with its related old-age benefit programs, Medicare and Social Security, which the GOP has said it wouldn’t touch. But Trump has also endorsed the budget resolution.

How the people see it: Strong majorities of Democrats, Republicans, and Independents view Medicaid favorably, according to recent polling by the Kaiser Family Foundation.

The GOP’s dilemma: The party is committed to cuts in taxes and spending, but several GOP districts with large populations of Medicaid recipients are up in arms. And given the GOP’s razor-thin House majority, and unified Democratic opposition, the Republicans can’t afford to lose more than a single vote in the House.

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