A sweeping new bill from House Republicans seeks to reshape the United States’ healthcare landscape by enacting £880 billion in reductions to Medicaid funding. Framed as part of a broader cost-saving initiative to sustain tax breaks introduced in 2017, the proposal has reignited partisan tensions over access to healthcare.
The legislation—presented as the financial backbone of former President Donald Trump’s “big, beautiful bill”—has been described as the most significant political confrontation over healthcare since the failed attempt to repeal the Affordable Care Act in 2017.
Work Requirements and Eligibility Changes Lead Cost-Saving Efforts
At the heart of the bill are proposed changes to Medicaid, a program that currently provides near-free health insurance to over 70 million Americans.
According to the Congressional Budget Office (CBO), the proposed reforms would reduce the federal deficit by £912 billion over the next decade, with £715 billion of that resulting from healthcare-related provisions.
The legislation includes a new “community engagement” mandate requiring most able-bodied adults without dependants to complete at least 80 hours of work, education, or service each month to remain eligible.
Eligibility verification would also double in frequency—from annually to twice a year. Supporters argue this will ensure the program serves only those who qualify, but critics warn that it could lead to a rise in administrative barriers and disenrolment.
States would also lose the 5% federal funding bonus granted during the COVID-19 pandemic, and new restrictions would prevent federal payments for individuals whose citizenship or immigration status remains unverified.
Additionally, the bill would freeze the use of so-called “provider tax” used by some states to secure higher federal contributions—practices Republicans view as financially exploitative.
Political Divisions Deepen as Healthcare and Tax Policy Intersect
According to Rep. Brett Guthrie, chair of the House Energy and Commerce Committee, the proposed changes aim to address “runaway growth” in Medicaid spending, which he says is on track to exceed £790 billion annually in the coming decade.
The committee was tasked with identifying £880 billion in savings, primarily by targeting healthcare expenditure and revising green energy investments enacted under President Joe Biden.
However, the bill faces opposition not only from Democrats, who label the cuts “shameful,” but also from moderate Republicans concerned about the potential impact on their constituents.
Rep. Frank Pallone of New Jersey, the ranking Democrat on the committee, warned that the reforms “hospitals will close, seniors will not be able to access the care they need, and premiums will rise for millions of people if this bill passes.”
While former President Trump has publicly promised not to cut Medicaid, the details of his involvement remain ambiguous. The legislation, being advanced through a budget reconciliation process, allows Republicans to bypass a Senate filibuster, raising the stakes for a rapid vote ahead of Memorial Day.
