Major Medicaid Cuts Proposed – Act Now!

Last week, we reported on five ways that Congress is considering cutting Medicaid. However, we have since received even more information about what these Medicaid changes might look like.

Let’s review what the Congressional Budget Office said last week, as well as the more recent proposals that were revealed in the budget reconciliation text.

Five Strategies Discussed by CBO

At the time, we based our video on a report from the Congressional Budget Office (CBO), showed how the federal government could slash up to $880 billion from Medicaid over the next decade—and how that would affect real people.

We broke down five devastating options:

• Rolling back the enhanced federal match for ACA expansion adults, which could leave 5.5 million people without coverage.
• Eliminating state “provider tax” programs, which could drop 8.6 million people from Medicaid.
• Capping federal Medicaid spending per enrollee, regardless of health needs. This would be a disaster for people like my brother who are dependent on Medicaid for their 24/7 nursing care.
• Restricting spending specifically for ACA expansion populations.
• Repealing recent eligibility and enrollment simplification rules, which make it easier for older adults and disabled individuals to keep coverage.

Each of these options would disproportionately harm the most vulnerable members of our communities—children, seniors, people with disabilities, and low-income working families.

Strategies Revealed in the Budget Text

On Sunday, House Energy and Commerce Committee Chair Brett Guthrie (R-Ky.) released formal budget reconciliation text that spells out exactly how the Republican-led House plans to cut Medicaid.

This proposal isn’t just a vague idea—it’s a concrete plan described over 160 pages of legalese, and the CBO estimates that it would leave at least 8.6 million more people without health insurance nationwide.

The latest budget proposal includes dozens of new Medicaid restrictions. Some sound reasonable on the surface—like reducing fraud or keeping records up to date—but others would make it much harder for people to get and keep their health care.

We’ve grouped some of the most relevant changes below—especially those that are likely to impact low income individuals and families. This is not a complete list of every change in the bill, but it highlights the proposals most likely to affect our readers.

Fraud Prevention

These sections aim to improve data accuracy, but they could also cause wrongful terminations and delays in care.

• Address verification: States would be required to use data from USPS, the National Change of Address database, and Medicaid contractors to make sure recipients aren’t enrolled in multiple states. (Section 44103)
• Deceased enrollees: Quarterly checks against the federal Death Master File would be required to remove people who’ve passed away. (Section 44104)
• Provider eligibility checks: States would need to run monthly and quarterly screenings to ensure Medicaid providers are still eligible and alive. (Sections 44105–44106)
• Semiannual verifications: Adults who gained coverage through the ACA Medicaid expansion would have their eligibility reviewed every six months starting October 1, 2027. (Section 44108)

Eligibility Rules

These sections add more frequent reviews and stricter documentation rules that could increase disenrollment—even among people who still qualify.

• Work requirements: By 2029, states would be required to enforce work, education, or volunteer requirements for some Medicaid recipients. Exemptions include minors, elderly people, pregnant individuals, and those experiencing hardships like hospitalization or natural disasters. (Section 44141)
• Citizenship verification: Federal funding would be denied if a person’s immigration or citizenship status isn’t verified during the “reasonable opportunity” period—unless the state opts out. (Section 44110)
• Home equity rule update: States could raise the Medicaid asset limit for home value up to $1 million—but only for non-agricultural homes. (Section 44109)

Coverage Changes

These sections limit what Medicaid will pay for, who can provide care, and which states receive extra funding.

• Retroactive coverage reduction: Medicaid and CHIP would only cover medical bills from one month prior to the application date (instead of the current three months), starting October 1, 2026.(Section 44122)
• Ban on gender-affirming care for minors: Medicaid and CHIP would be barred from covering gender transition procedures for individuals under 18, except in very limited medical circumstances. (Section 44125)
• Restrictions on abortion providers: Medicaid would not be allowed to directly reimburse providers that offer abortion services (with exceptions for rape, incest, or life-threatening conditions) for 10 years. (Section 44126)

These aren’t just policy tweaks. They represent a fundamental shift in how Medicaid operates—and could drastically reduce who qualifies, what care they receive, and how that care is funded.

The Good News

With all of these proposed cuts and changes, it’s easy to feel overwhelmed—but there is a silver lining.

One of the most devastating proposals we talked about last week was the idea of capping federal Medicaid spending per enrollee. That means each person would have a set dollar amount the government would cover—no matter how sick they were or how much care they needed. For people with chronic conditions, disabilities, or intensive medical needs (like my brother, who needed 24/7 care prior to his passing), these caps would be absolutely catastrophic.

The good news? That kind of per-person spending cap was not included in this latest round of proposals. It’s a major relief—and a sign that our voices are being heard.

Now is not the time to back down. It’s time to double down on our advocacy and make sure lawmakers know just how vital Medicaid is to millions of Americans.

What You Can Do

We know these kinds of proposals can feel out of reach—like they’re happening in a different world. But the truth is, your voice matters. Especially right now, when these issues are still being debated.

Contact your lawmakers. Go to Congress.gov to find your senators and representative. Call, email, or write to them.

When you contact them, make sure to set the stakes and help them understand what Medicaid means to you. Something like, “I’m a voter in your district, and I strongly oppose any cuts to Medicaid. Please protect this essential program for people in our community.”

If Medicaid has helped you or someone you love, let your lawmakers know. Real-life stories are powerful—and they’re hard to ignore.

Relief Recap

Medicaid isn’t just a line in the budget—it’s a lifeline for millions of people. It helps our parents get nursing care, our kids see doctors, our neighbors access mental health treatment, and our loved ones face terminal illness with dignity. Please reach out to your elected officials and let them know how you feel about these proposed Medicaid changes.