House Republicans are moving forward with ambitious plans to implement significant changes to Medicaid, despite facing mounting pressure from Democrats and even some moderates within their own party. These proposed overhauls to the essential health care program, which supports lower-income Americans and individuals with disabilities, are part of a broader initiative to slash federal spending. The House GOP has set a target of cutting $2 trillion from the federal budget over the next decade.
In a recent statement, Florida Republican Rep. Byron Donalds, who is also running for governor of Florida—a state with millions of Medicaid recipients—expressed his support for reforms aimed at making Medicaid sustainable. “I support any plan that helps Medicaid be sustainable. And the current trajectory of Medicaid is not,” he stated. Donalds emphasized that Medicaid should primarily serve individuals who are disabled, children, and single parents with several children. He warned that if the program expands to include an ever-growing number of beneficiaries, the federal government may struggle to maintain its matching funds.
Moderate Republican members of the Congressional Hispanic Conference have voiced their concerns in a letter to Speaker Mike Johnson, warning that slashing Medicaid could have severe repercussions, especially in rural and predominantly Hispanic communities. When asked how he would address fellow Republicans who fear that cuts to Medicaid could negatively affect lower-income Americans, Donalds suggested that such worries stem from a “fear-based” narrative. He pointed out that Democrats are already campaigning against the proposed changes, labeling them as harmful, which he believes is misleading.
Some GOP members have proposed introducing new work requirements for Medicaid recipients and capping the funding that states receive for their Medicaid programs. These measures could significantly reduce the number of individuals enrolled in Medicaid and limit the financial resources available for beneficiaries. Rep. Ralph Norman from South Carolina commented, “I don't consider that a cut,” referring to the proposed work requirements and block-granting to states. He criticized the Democrats for framing these changes as cuts, asserting that it’s a misrepresentation of the facts.
The specifics of the proposed plan remain unclear as the approval of the House budget blueprint on Tuesday night marks merely the initial step in a lengthy budgeting process that could extend into the summer. New York Rep. Nicole Malliotakis, a moderate representing a Staten Island district with a considerable number of Medicaid recipients, advised caution. “Maybe you should wait until we actually do the work and highlight what we're going to do,” she suggested, emphasizing the need for thorough consideration before any drastic measures are taken.
Republicans are optimistic that a significant portion of their proposed spending cuts can be achieved by targeting fraud in Medicaid and Medicare. However, experts agree that eradicating all fraud and waste may only marginally contribute to the ambitious financial goals set by the GOP. Malliotakis acknowledged, “There’s about $50 billion a year in fraud, just within the Medicaid program,” but questioned whether the party could achieve their target numbers solely by eliminating fraud. She indicated that further examination of loopholes created by states is also necessary.
Meanwhile, Democrats are gearing up to challenge the Republican plans. An internal memo from the Democratic Congressional Campaign Committee, obtained by ABC News, reveals that Democrats are strategizing to make the potential Medicaid cuts politically dangerous for House Republicans in the upcoming November 2026 midterm elections. The memo critiques the Republican agenda, stating, “Rather than delivering on their campaign promises to lower the high cost of living, Republicans are poised to pass an extreme budget scheme that would decimate affordable health care and take food off the tables of millions of American families.”
As the situation develops, the fate of Medicaid and its beneficiaries hangs in the balance, with significant implications for the future of health care access in America.
