- House Republicans passed a budget plan that could include big cuts to Medicaid.
- Medicaid covers over 72 million Americans, with significant reliance in states like California.
- Mike Johnson said Republicans are focused on “rooting out fraud, waste, and abuse” within Medicaid.
Congressional Republicans are hotly debating their budget plans, and Medicaid cuts may be on the table. It could affect Americans across the country.
The committee that oversees Medicaid’s budget aims to cut $880 billion over a decade as part of the House’s narrowly passed budget outline. The math points to those cuts including Medicaid, since it and Medicare —which the Trump administration said it would not cut — make up the overwhelming majority of that committee’s budget.
In states such as New Mexico, California, and New York, over a third of residents receive Medicaid, per a Business Insider analysis of Medicaid enrollment data from October 2024 and Census Bureau population estimates from July 2024. The analysis found that about 23.3% of all Americans receive Medicaid or the Children’s Health Insurance Program, which is for children in families who make too much to qualify for Medicaid.
This map shows the percentage of each state’s residents who received coverage for Medicaid or CHIP.
Areas with higher percentages of Medicaid recipients included the West, Southwest, and Northeast, while parts of the Midwest and South relied less on Medicaid. Utah was least reliant at 9.7%, followed by Wyoming at 10.8%.
As of October, Medicaid provides health and long-term care coverage to over 72 million Americans of all ages, predominantly those with low incomes and few other resources. Another 7.2 million children under age 18 receive payments from CHIP. Medicaid is financed by federal and state governments.
House Speaker Mike Johnson has argued that the budget plan doesn’t explicitly call for Medicaid cuts.
Over the last few months, some Republican leaders have proposed per-capita caps on Medicaid, which would fix federal funding amounts per enrollee. A House Budget Committee proposal estimated this move could save up to $900 billion. Others have backed a proposal to install a Medicaid work requirement.
Tuesday’s House vote is only the first step in a long process. Senate Republicans have competing plans, which, unlike the House’s proposal, do not include an extension of Trump’s 2017 tax law or new proposals like ending taxes on tips. Both sides will need to reconcile their blueprints before they can move forward.
Most states have expanded their Medicaid coverage for those making under a given income threshold — for individuals, about $21,600 a year — an expansion included in the 2010 Affordable Care Act, also known as Obamacare.
Before the vote, Johnson said Republicans are focused on “rooting out fraud, waste, and abuse” within Medicaid. On Tuesday, he declined to tell reporters that House Republicans would not cut the program, arguing that making sure “illegal aliens” are not receiving Medicaid and eliminating other unspecified fraud will help the GOP save money.
“Medicaid is hugely problematic because it has a lot of fraud, waste, and abuse,” Johnson told reporters at the Capitol.
People in the US illegally are not eligible for Medicaid. Hospitals can be reimbursed for emergency care if a patient, regardless of their immigration status, is otherwise eligible for Medicaid. According to the nonpartisan Congressional Budget Office, $27 billion total was spent on emergency Medicaid for non-citizens from fiscal year 2017 through 2023.
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