Congressional Democrats are fiercely criticizing Republican-led efforts to reform Medicaid, alleging the proposed changes in President Donald Trump’s “one big, beautiful bill” will “devastate” the program. This comes despite fiscal projections indicating federal Medicaid spending is still set to increase over the next decade.
The House-passed version of the bill aims to reduce federal Medicaid spending by approximately $700 billion over ten years, according to the Congressional Budget Office (CBO).
However, budget experts clarify that these proposed savings do not constitute “cuts” but rather a slowdown in the rate of future spending growth.
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Senate Democratic Leader Chuck Schumer (D-NY) lambasted Republicans, calling it “the largest cut in history” and demonstrating “the callousness of the Republican senators when it comes to health care.”
Conversely, analysis from experts and congressional scorekeepers suggests that federal spending on Medicaid is not anticipated to decline, but instead grow at a slower pace than previously projected. The House Budget Committee found that federal Medicaid spending will still increase by 30% by 2034, even with the proposed $698 billion in savings.
Hayden Dublois, data and analytics director at the Foundation for Government Accountability, a right-of-center think tank, stated, “There aren’t real cuts; it’s just identifying opportunities for savings, so it’s not growing as fast or as much as it would in the absence of any reforms.”
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He also refuted claims that the reforms target the poor, suggesting savings are concentrated in areas like addressing “illegal aliens receiving Medicaid, rampant waste, fraud and abuse in the program, and able-bodied adults who can work but are refusing to.”
Medicaid spending today is already 51% higher than in 2019, and even after accounting for medical inflation and population growth, it is projected to exceed 2019 CBO projections.
Republican Rep. Brett Guthrie (R-KY), who chairs the House committee overseeing the reforms, emphasized that despite cost-saving measures, Medicaid expenditures are still forecasted to rise by over $1 trillion above inflation by 2034.
“Only Washington Democrats would characterize increased funding as a cut,” Guthrie said.
House Speaker Mike Johnson (R-LA) affirmed, “We’re not cutting Medicaid. What we’re doing is strengthening the program. We’re reducing fraud, waste and abuse that is rampant in Medicaid to ensure… that it’s available for the most vulnerable.”
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While the House-passed bill includes provisions like work requirements for certain able-bodied, childless adults, which have broad Republican support, the fate of all proposed Medicaid reforms in the Senate remains uncertain.
Some moderate Republican senators, including Sen. Josh Hawley (R-MO), have expressed opposition to a House provision establishing a freeze on provider taxes, citing concerns about their potential impact on rural hospitals. Sources
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