Medicaid cuts: Republicans’ plan for Trump’s “big, beautiful bill” is becoming clearer.

Proposed Medicaid Cuts

House Republicans are planning substantial cuts to Medicaid, amounting to $880 billion, to offset the cost of President Trump's legislative agenda. These cuts primarily target the Affordable Care Act's Medicaid expansion, which provides coverage to 20 million people.

Methods of Cutting Medicaid

Two main approaches are being considered:

• Reducing the federal match rate: Lowering the federal match rate from 90% to the traditional Medicaid rate (50-75%) would save $561 billion over 10 years. Republicans argue this addresses the disparity in funding between the expansion and traditional Medicaid.
• Implementing per capita caps: This would limit funds per expansion enrollee, controlling costs and preventing an “open-ended checkbook.”

Republicans claim these cuts won't directly remove people from Medicaid, but it's expected that states may reduce coverage due to the funding changes.

Political Ramifications

The proposed cuts face significant political hurdles. The argument that the cuts are merely administrative efficiencies or targeting “waste, fraud, and abuse” is unconvincing. The potential loss of health coverage or reduced benefits for millions of low-income individuals is a major political risk for the Republicans.