House Republicans on May 11 floated a bill that would impose up to $715 billion in Medicaid and ACA cuts over the next decade — reductions that hospital leaders warn would leave millions without coverage and put essential hospitals at risk of closure.
The 160-page bill outlines several Medicaid provisions aimed at curbing federal spending, including:
- Implementing stricter eligibility requirements.
- Increasing the frequency of eligibility redeterminations.
- Establishing work requirements for able-bodied adults aged 19 to 64 without dependents.
- Prohibiting the use of Medicaid and CHIP funding for gender transition procedures for minors.
- Penalizing states that fail to verify the citizenship or immigration status of enrollees by withholding federal funding for those benefits.
While the legislation stops short of implementing per capita caps or a complete overhaul of Medicaid expansion funding, it includes measures to penalize states that provide Medicaid benefits to noncitizens by reducing their ACA expansion matching rate.
Rick Pollack, President and CEO of the American Hospital Association, described the cuts as “a devastating blow to the health and well-being of our nation’s most vulnerable citizens and communities.”
“These proposed cuts will not make the Medicaid program work better for the 72 million Americans who rely on it. Instead, it will lead to millions of hardworking Americans losing access to health care and many of our nation’s hospitals struggling to maintain services and stay open for their communities,” Mr. Pollack said in a May 12 statement. “We urge Congress to reject efforts to dismantle this vital program.”
Bruce Siegel, MD, president and CEO of America’s Essential Hospitals, warned that essential hospitals — which often operate on thin margins and serve low-income populations — would be hit hard by the proposed cuts.
“Slashing Medicaid funding is not just a numbers game — it is an action that will rip health care access from communities across America, disproportionately harming low-income individuals, rural populations, and hardworking Americans who rely on Medicaid for access to lifesaving care,” Dr. Siegel said. “These hospitals, which already operate on thin margins, cannot absorb such losses without reducing services or closing their doors altogether.”
The bill also targets how states fund their Medicaid programs, placing restrictions on taxes levied on providers, including hospitals and nursing facilities. Carmela Coyle, president and CEO of the California Hospital Association, argued that hospitals may be forced to significantly cut services or close.
“The legislation proposed by the House Energy and Commerce Committee to enact massive Medicaid cuts is a devastating blow that will be felt by all who need hospital care,” Ms. Coyle said. “Cuts of this magnitude cannot be absorbed. Hospitals will have no other choice but to reduce patient care services or, in the worst cases, close entirely.”
Chip Kahn, president and CEO of the Federation of American Hospitals, also underscored the broader implications of the cuts, noting that they would undermine health coverage for millions of Americans who rely on Medicaid.
“Over 70 million Americans depend on Medicaid for care from the doctor’s office to the hospital to the nursing home, and critical providers in between. The drastic cuts in this bill slash health coverage for millions of these hardworking families, children, and seniors,” Mr. Kahn said. “The ill-conceived policies target states and tie their hands, leaving them unable to pick up the slack and effectively cutting patients’ Medicaid coverage based on their zip codes.”
Mr. Kahn added that the effect of the proposed cuts would reverberate beyond Medicaid patients, potentially destabilizing entire communities.
“The consequences of these cuts extend far beyond the millions of Medicaid patients impacted directly; they threaten health access for entire communities across the country,” he said. “Congressional Republicans and President Trump rightly pledged to protect Medicaid benefits and coverage — this bill fails that test. It is imperative Republicans go back to the drawing board; too many lives depend on it.”
The legislation is set for markup in the Energy and Commerce Committee on May 13 and will need to pass in both the House and Senate before it can head to President Donald Trump’s desk to be vetoed or signed into law.
