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GOP Ready Plan to Gut Medicaid to 'Pay for Tax Cuts for Billionaires'
Defeating Republican efforts to slash health coverage for the nation's poor, said one observer, is also an opportunity "to expose and deepen the fractures in Trump's coalition, and to shatter the illusion that he can't be stopped."
Feb 11, 2025
Defenders of Medicaid are sounding the alarm over plans by the Republican Party—led by President Donald Trump and House Speaker Mike Johnson—to eviscerate the nation's healthcare system used by low-income individuals and families, warning that the attack would jeopardize healthcare for tens of millions of the poorest Americans as part of an effort to give the wealthiest individuals and corporations massive tax breaks.
Internal divisions within the House GOP caucus have hinged on the overall size of cuts to federal spending in their yet-to-be-released budget blueprint, with competing proposals ranging from $1.25 trillion in cuts up to $2.5 trillion. Of that overall number, hundreds of billions in Medicaid cuts may come in the form of block grants to states, caps on per capita costs, and work requirements.
"For months," wrote Paul Heideman on Monday in Jacobin, "Republicans have said that their budget will cut spending in order to pay for making permanent Trump's tax cuts for the rich, which are set to expire this year."
One of the key targets of their austerity plan, he notes, is Medicaid, which Republicans, as reported by Politico on Tuesday, believe they can cut by an estimated $800 billion or more over the next decade.
"They are cutting healthcare to pay for tax cuts for billionaires."
Echoing the call of other progressive voices, Heideman argues that opponents should seize on the tensions within the GOP—where right-wing hardliners are openly calling for cuts while those in more swing districts have expressed increasing anxiety about what happens politically if they take the axe to a program that is resoundingly popular with voters.
CNNreporting on Monday about the behind-the-scenes maneuvering within the caucus quoted one unnamed Republican lawmaker who said that some members want "to cut to the bone" when in it comes to Medicaid and other programs. While the lawmaker said they were "willing to cut a lot" from the federal budget, "if you cut the essential stuff that affects people every day, you will lose the majority in two years. I can guarantee it.”
Meanwhile, Politico offered more evidence that Trump and House Republicans are still not on the same page:
GOP leaders told senior Republicans in a series of private meetings Monday that Trump wasn’t yet on board with the major Medicaid cuts it would take to secure up to an additional $800 billion in savings, according to three people familiar with the conversations who, like the others, were granted anonymity to describe the private talks.
Johnson and senior Republicans are wary of pursuing the Medicaid reforms only for Trump to publicly bash the move. GOP leaders indicated in private meetings Monday that "they need to work with Trump" on the Medicaid issue before proceeding, according to one of the people.
As Heideman notes, one can't fully understand the attacks on Medicaid—which could boot tens of millions of people out of the program—without recognizing the GOP's parallel strategy for massive tax giveaways for the rich and corporations:
Republicans are hoping to extend the tax cuts passed in Donald Trump's first term. These tax cuts, which were the only substantial legislative accomplishment of Trump's first term, were massively skewed toward the rich. The average household in the top 1 percent of income earners received about $60,000, while the average of the bottom 80 percent of households received only $762.
All of this largesse for the rich was expensive; estimates are it will cost the government nearly $2 trillion over ten years. Because of this, a number of Republicans in Congress insist that any extension of the tax cut must be accompanied by spending cuts to prevent it from adding massively to the deficit. With a razor-thin majority in the House, these deficit hawks could sink any attempt by Trump and the GOP leadership to ram the cuts through in spite of their impact on the deficit. Finding a way to substantially cut Medicaid spending has thus become central to the larger GOP budget plan.
On Tuesday, the Center on Budget and Policy Priorities (CBPP) detailed how one Republican approach to cutting Medicaid—a federal spending freeze that would cap per capita costs—would drastically increase financial pressure on the state programs that administer Medicaid programs.
"If federal funding drops sharply," warned Elizabeth Zhang, a CBPP research assistant, "states would be forced to scale back Medicaid by cutting people from the program, slashing benefits for remaining enrollees, reducing payments to hospitals and physicians—or a combination of all three. This would harm Medicaid enrollees across the program."
Pushing back against the proposed assault on a program that serves over 80 million people each year, all 47 members of the Senate Democratic Caucus on Monday sent a letter to Majority Leader John Thune (R-S.D.) saying he and his Republican colleagues should "reject proposals that use Medicaid as a piggy bank for partisan priorities and continue to defend the importance of this vital program." According to the letter:
Republicans are proposing cuts to the Medicaid program from hundreds of billions to multiple trillions of dollars. Cuts to Medicaid through drastically changing the program's financing structure or imposing additional barriers to coverage are dangerous to the millions of people who rely on the program. These proposals will also force states to make difficult decisions that will result in millions getting kicked off their coverage and providers struggling to keep their practices open. States simply cannot absorb these massive funding cuts without hurting children, seniors, people with disabilities, tribal populations, patients with chronic illnesses, and many other Americans who rely on Medicaid.
"The American people should be assured," the letter concluded, "that Medicaid will be protected."
Last week, as Common Dreamsreported, a separate CBPP report estimated that a GOP proposal to institute work requirements for Medicaid recipients could result in 36 million people being axed from the life-saving program. Predictions such as this could be why, as Politico noted, "Trump and his team are worried those cuts will invite political blowback."
The problem for progressives is that Republicans have discovered that while cuts to Medicaid are demonstrably unpopular with the voting public, the implementation of so-called "work requirements" has received more traction in opinion polls. As such, GOP leaders, including House Majority Leader Rep. Steve Scalise (R-La.), may believe they have a new way to trick people into helping them undermine or destroy the program.
This is why Heideman argues it is key for Medicaid defenders to be adamant in their opposition and clear in their messaging when it comes to work requirements or other deceptive messaging about Republican intentions.
Work requirements for Medicaid, Heideman argues, should be called exactly what they are: cuts. As he explains:
During the first Trump administration, states were granted waivers to institute work requirements. Only Arkansas actually implemented the policy, and the results are instructive. About a quarter of Medicaid recipients subject to the requirement (about 18,000 people) lost coverage while the waiver was in effect. Yet the requirement produced zero effect on employment. People kicked off Medicaid were no more likely to have jobs than they were while they were on it.
The reason for this is simple. Most people on Medicaid are already working. Among those that aren’t, most are either disabled, taking care of a family member, or going to school. There simply aren’t that many people on Medicaid who could go get a job, even if their health care is cut off. Moreover, work requirements often lead to people who technically shouldn’t be removed from the program being kicked off because they haven’t supplied the proper paperwork establishing their employment. Work requirements do nothing to make people work more. They simply kick people off the rolls.
Larry Levitt, executive vice president for health policy at Kaiser Family Foundation, pointed out last week that "92% of Medicaid adult enrollees are working, or are not working due to caregiving, an illness or disability, or school attendance."
So while Speaker Johnson and other Republican leaders have tried to say they are not proposing cuts to Medicaid in their pending budget blueprint, informed critics are pointing out that this a blatant falsehood.
Heideman says that the battle to defend the program is important in its own right but also has broader political implications.
"Defeating Medicaid cuts is an urgent priority over the coming months," he argues. "It's an opportunity to reestablish the popularity of the welfare state as a principle of American politics and to hand Trump and the GOP a much-needed defeat. Because of the GOP's disarray, it also has the potential to hamstring the party's only substantive legislative priority. Finally, this kind of work can provide some balance and ability for longer-term coordination amid the daily outrage that the administration is committing. The Left should not let this opportunity slip by."
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'Crystal Clear' Polling Shows Voters Oppose Trump's Tax Cuts for Rich
"Voters are clear about what they want: lower prices, better jobs, vital programs protected and expanded, and for the wealthy to pay their fair share in taxes."
Feb 11, 2025
The Republican Party is intent on permanently extending the 2017 tax cuts which primarily benefited the wealthiest earners and corporations—a priority that would cost an estimated $4.6 trillion and which has sent lawmakers searching for potential spending offsets including cuts to Medicare, food assistance, and renewable energy programs.
But polling released Tuesday suggested the GOP is likely to face widespread outcry—and potential opposition from vulnerable Republicans who don't want to risk angering voters—as a majority of Americans are vehemently opposed to paying for tax cuts for the wealthy by slashing public programs.
The new poll, taken by Data for Progress on behalf of the progressive advocacy groups Groundwork Collaborative and the Student Borrower Protection Center, found that although Republican lawmakers have demonized efforts to provide relief to student loan borrowers, the party's potential overhaul of the income-based repayment program isn't popular among voters of any political ideology.
Nearly two-thirds of respondents said they don't want the repayment plan eliminated, including 56% of Republican voters and 70% of Independents who said they oppose funding cuts for federal student loans and grants.
The GOP's plan would save an estimated $127.3 billion over 10 years by forcing the average student loan borrower to pay nearly $200 more per month.
"Most people don't have an extra $200 a month to throw toward their student loan bill," Michele Shepard Zampini, senior director of college affordability at the Institute for College Access & Success, toldCNBC on Monday.
"Voters overwhelmingly reject efforts to cut critical supports that working families rely on."
Despite that fact, said Aissa Canchola Bañez, policy director for the Student Borrower Protection Center, the GOP's budget proposals would "cut taxes for their billionaire buddies by raiding the pockets of Americans with student debt and families already struggling to pay for college."
"This polling makes it crystal clear," she said. "Voters overwhelmingly reject efforts to cut critical supports that working families rely on."
Republicans can also expect to see pushback if they attempt cuts to Medicare and Medicaid, the survey found. Ninety percent of respondents said they want Medicare funding to increase or remain the same; 87% said the same for Medicaid. Republicans are planning to unveil the first-ever work requirements for Medicaid, which provides healthcare coverage for low-income people and those with disabilities, in an upcoming budget bill.
As Politicoreported Sunday, Republican lawmakers are "increasingly alarmed" that Rep. Jodey Arrington (R-Texas), chair of the House Budget Committee, "keeps raising Medicare reforms as a potential spending offset."
More than 80% of respondents also don't want Republicans to make cuts to the Supplemental Nutrition Assistance Program (SNAP), commonly known as food stamps, which the GOP is also planning to make subject to expanded work requirements.
Those who want funding for SNAP to increase or stay the same include 67% of Republicans and 75% of Independents.
The polling may leave Republican leaders wondering what programs they will be able to cut without facing outcry from angry voters who rely on public services—but Elizabeth Pancotti, managing director of policy and advocacy for Groundwork Collaborative, suggested in a statement Tuesday that the answer is simple: The GOP must abandon its plan to dole out more tax breaks for the rich.
"Voters are clear about what they want: Lower prices, better jobs, vital programs protected and expanded, and for the wealthy to pay their fair share in taxes," said Pancotti. "And yet, Republicans in both chambers of Congress are working overtime to achieve the exact opposite."
President Donald Trump has called on the GOP to advance his taxation, immigration, and energy agenda in "one big, beautiful bill," while Senate Republican leaders have begun work on two separate bills, with taxes dealt with later in the year.
"Whether one bill or two," said Pancotti, "House and Senate GOP members are aligned on wanting to cut lifesaving programs in order to enrich their billionaire friends and donors, and voters are taking note."
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Medicaid Work Requirements Could Boot 36 Million People Off Their Health Coverage: Report
"Work requirements are simply another way to cut Medicaid," wrote the authors of an analysis from the Center on Budget and Policy Priorities.
Feb 07, 2025
As right-wing lawmakers pursue imposing conditions on Americans' ability to access Medicaid and other social services, the Center on Budget and Policy Priorities this week published analysis warning that work requirements for Medicaid recipients could put 36 million Americans, or 44% of all Medicaid enrollees, at risk of losing their health insurance.
"Research shows that work requirements do not increase employment," according to the authors of the CBPP report, which was published on Wednesday. The authors argue that these types of requirements are based on the premise that Medicaid enrollees do not work, when data shows that they do.
"Nearly 2 in 3 adult Medicaid enrollees aged 19-64 already work, and most of the rest would likely not be explicitly subject to the requirement based on having a disability, caring for family members, or attending school," the report states.
The group estimates that of those 36 million people who could be impacted, 20 million are enrolled through the Affordable Care Act's Medicaid expansion.
While almost all Medicaid enrollees either work or would qualify for an exemption under most Medicaid work requirement proposals, according to CBPP, the report points to multiple past examples that indicate many enrollees still lose coverage with the imposition of work requirements due to "administrative burden and red tape."
For example, when Arkansas in 2018 temporarily implemented a policy that placed work requirements on Medicaid recipients, about 25% of enrollees subject to the requirements, some 18,000 people, lost coverage before a federal court paused the program seven months later.
As another example, New Hampshire implemented a short-lived Medicaid work requirement program in 2019 with more flexibility in reporting requirements and "more robust outreach efforts" in order to avoid Arkansas' mistakes, according to CBPP, but 2 in 3 enrollees who had to comply with the requirements "were likely to be disenrolled after just two months, amid reports of widespread confusion among enrollees about how to comply with the requirements."
The analysis—which the authors say is not an estimate of the number of people who will be impacted by a specific policy proposal—defines the population at risk of losing their coverage as adults between ages 19 and 64 who are not enrolled in Medicaid through disability pathways, i.e. a wider net of people than are specifically targeted in some recent GOP proposals.
The 36 million number is a larger group of enrollees compared to a previous CBPP estimate that was in response to a specific proposal whose work requirements would have targeted fewer people.
Multiple recent GOP proposals regarding Medicaid work requirements target "able-bodied" workers, though they vary in other specifics.
The far-right policy blueprint "Project 2025" calls for the Centers for Medicare and Medicaid Services to "clarify that states have the ability to adopt work incentives for able-bodied individuals" on Medicaid. And in late January congressional Republicans passed around a list of ideas for how to fund a bill full of GOP priorities that included imposing Medicaid work requirements for "able-bodied" adults without dependents, modeled after the Limit, Save, Grow Act, a bill passed by the House in 2023.
On Thursday, Sens. John Kennedy (R-La.) and Eric Schmitt (R-Mo.) reintroduced the Jobs and Opportunities for Medicaid Act, a bill that would require "able-bodied adults without dependents who receive Medicaid benefits to work or volunteer for at least 20 hours per week."
Because the Kennedy and Schmitt bill includes an exemption for adults with dependents, it would impact a smaller number of people than the CBPP's Thursday analysis. But still, as a general matter, "work requirements are simply another way to cut Medicaid," according to the authors of the analysis. Republicans' January list of cost cut options estimated that adding Medicaid work requirements along the lines of what was specified in the Limit, Save, Grow Act would yield $100 billion in 10-year savings.
In a Friday letter to Senate Majority Leader John Thune (R-S.D.) and House Speaker Mike Johnson (R-La.), all 47 members of the Senate Democratic Caucus wrote: "We urge you to reject proposals that use Medicaid as a piggy bank for partisan priorities and continue to defend the importance of this vital program."Keep ReadingShow Less
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