Potential Medicaid cuts spark debate over health care in federal budget

© Postmodern Studio - stock.adobe.com

Medicaid advocates say congressional Republicans will gut the program in the new federal spending plan.

But a key committee leader says Democrats are fear-mongering with false claims about a federal budget.

The House Energy & Commerce Committee is scheduled to meet May 13 for the “Full Committee Markup of Budget Reconciliation Text.”

“Through the reconciliation process, the Committee on Energy and Commerce is working to end wasteful government spending, unleash American energy and innovation, and strengthen Medicaid for mothers, children, individuals with disabilities, and the elderly,” Committee Chair Rep. Brett Guthrie (R-Kentucky) said in the hearing announcement. “We are committed to delivering President Trump’s agenda and eliminating waste, fraud, and abuse, so the most vulnerable Americans can reliably access the care they need.”

Scoring political points

Democratic lawmakers held a press conference on May 12 to discuss looming cuts to Medicaid. The same day, Guthrie issued a statement claiming the Dems have mounted a “fear campaign” with incorrect claims about policies not even in that bill.

“From the moment a budget reconciliation bill was on the table, Democrats began their fear campaign to scare Americans without any of the details,” his statement said,

“This bill refocuses Medicaid on mothers, children, people with disabilities, and the elderly — not illegal immigrants and capable adults who choose not to work,” Guthrie said. “It is reckless that my colleagues on the other side of the aisle claimed an artificially high number in alleged coverage loss just so they can fear monger and score political points.

“This reconciliation is a win for Americans in every part of the country, and it’s a shame Democrats are intentionally reflexively opposing commonsense policies to strengthen the program,” he said.

‘Health care is not a luxury’

Even so, health organizations have been sounding the alarm about drastic changes in store if the nation’s next budget won’t cover health care via Medicaid. As of December 2024, more than 78.5 million people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The Congressional Budget Office has estimated the spending plan could increase by 13.7 million the number of people without health insurance by 2034, according to an analysis published by Rep. Frank Pallone, (D-New Jersey), the ranking member of the House Energy & Commerce Committee.

The congressional action is a sweeping attempt to dismantle the Affordable Care Act, said Mona Shah, JD, MPH, senior director of policy and strategy at Community Catalyst, a nonprofit health care access advocacy organization based in Boston, Massachusetts.

“Politicians are rushing to terminate coverage for millions of people to pay for tax breaks that only benefit the wealthy and big corporations,” Shah said in a statement. “The end goal is clear: Slash the programs that keep our communities healthy while doing nothing to rein in the corporate profiteering driving up costs. The result? Closed hospitals, more medical debt, and worse health outcomes — especially in communities already facing deep inequities. These consequences will hit red and blue districts alike.

“We won’t let them divide us,” Shah said. “Across the country, people are uniting to defend care, reject corporate greed, and demand a health system that puts people over profit. Now is the time to strengthen Medicaid and the Affordable Care Act — not tear them down. Health care is not a luxury — it’s a right.”

‘People will lose access’

The budget reconciliation will have measurable consequences for access to obstetric and gynecologic care across the country, said Stella Dantas, MD, FACOG, president of the American College of Obstetricians and Gynecologists (ACOG). OB/GYN physicians are concerned the cuts will threaten the 12 months of postpartum coverage that physicians have advocated for pregnant patients, she said in her official statement.

“Because roughly 40% of births in the United States are covered by Medicaid, it’s natural to associate Medicaid cuts with harm to pregnant people,” Dantas said. “But as physicians who provide care to our patients throughout their lifetimes, we know what will happen if these Medicaid cuts are put into effect: People will lose access to the preventive care that keeps them healthy and facilitates access to treatment when conditions emerge.”

‘A devastating blow’

American Hospital Association President Rick Pollack said the budget will dismantle Medicaid and he urged Congress to reject that.

“The magnitude of the proposals contained in the Energy and Commerce reconciliation text represents a devastating blow to the health and well-being of our nation’s most vulnerable citizens and communities,” Pollack said in a statement. “There is no avoiding the real-life consequences they will create for hospitals serving our most vulnerable and hard-working families.

“These proposed cuts will not make the Medicaid program work better for the 72 million Americans who rely on it,” he said. “Instead, it will lead to millions of hardworking Americans losing access to health care and many of our nation’s hospitals struggling to maintain services and stay open for their communities.”