Republican Sen. Josh Hawley says he won’t support Medicaid cuts as the Senate considers the GOP’s One Big Beautiful Bill Act. But what counts as a cut is unclear.
The bill’s main cost-saving measure — new work requirements for able-bodied adults — would lead to millions losing coverage. The Congressional Budget Office (CBO) estimates 10.9 million fewer people would have insurance, including 8 million fewer on Medicaid. About 5.2 million of those would lose coverage because of the work rules.
“I know that will reduce the number of people on Medicaid,” Hawley said. “But I’m for that because I want people who are able-bodied but not working to work.”
Republicans argue the plan doesn’t cut Medicaid but removes waste and fraud. Still, Democrats warn the bill threatens health coverage gains and could hurt hospitals and local services.
What’s in the Bill
House Republicans aimed to cut $880 billion, mostly from Medicaid. The plan would reduce Medicaid spending by about $793 billion, according to the Kaiser Family Foundation. It also freezes a tax that helps fund rural hospitals — a move that worries some Republicans.
House Speaker Mike Johnson says the bill protects Medicaid for those who truly need it. But Democratic leader Hakeem Jeffries calls it an “assault on the healthcare of the American people.”
Who Would Lose Coverage
The bill requires non-disabled adults under 65 to work, study, or volunteer 80 hours a month. Yet over 90% of Medicaid recipients already meet such requirements. The plan would also block states from using Medicaid funds for immigrants without confirmed legal status.
Public Opinion
Most Americans oppose major Medicaid cuts. Polls show 56% disapprove of Trump’s handling of health policy, and 60% want more government involvement in health care. About 70% fear Medicaid cuts would hurt nursing homes, hospitals, and local care.
Hawley says the priority is protecting benefits for workers and rural communities. “Medicaid benefits for people who are working or otherwise qualified — I do not want to see them cut,” he said.
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