How are Trump and Republicans planning to make Medicaid cuts?

Each of conservatives proposed plans will involve draconian cuts to the healthcare program that serves approximately 80 million Americans, almost half of them children.

Trump and Republicans plan to cut taxes for the wealthy as well as cut healthcare benefits for low income people on Medicaid. This includes the elderly in nursing homes, pregnant people, children, the disabled and others.

Right now, the federal government helps pay for Medicaid by covering a set percentage of each state’s costs, no matter how high those costs are. However, under block grants, the government would give each state a fixed amount of money for Medicaid, even if costs are higher. Per capita caps would set a fixed amount of federal funding per Medicaid recipient, no matter the actual cost of their care.

Plans like Project 2025 and other Republican proposals suggest these funding caps, but they don’t explain how they would adjust for rising costs or emergencies like a recession or new medical treatments. These caps are likely to cut federal Medicaid funding over time, forcing states to find ways to cover the difference.

The plans also propose other major changes:

* Ending extra federal funding for Medicaid expansion under the Affordable Care Act, which helps cover nearly 20 million adults.

* Adding work requirements that could reduce Medicaid enrollment. (68% of covered adults in WI are already working and those who are not typically have medical restrictions that prevent them from being able to work)

* Banning certain state financing methods, making it harder for states to afford their share of Medicaid costs.

If these changes happen, states would likely have to make tough choices, such as cutting Medicaid coverage for children, people with disabilities, and seniors, or reducing benefits and payment rates for healthcare providers. States might also need to raise taxes or cut budgets for other programs like public schools.

Sources:

https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html

Congressional Republican Leaders Start to Show Their Hand: Draconian Medicaid Cuts on the Agenda for Next Year

https://files.kff.org/attachment/fact-sheet-medicaid-state-WI

Project 2025 Blueprint Also Includes Draconian Cuts to Medicaid

Latest House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts

This Year’s House Republican Budget Resolution Also Includes Severe Medicaid Cuts