Is Medicaid at Risk? And why?
Is Medicaid at risk, and why?
Yes, Medicaid is currently at risk as Congress debates major changes to federal spending.
Lawmakers are considering proposals that could significantly reduce Medicaid funding as part of broader efforts to extend tax cuts and manage the federal budget. In early 2025, the House Budget Committee voted to seek at least $880 billion in spending cuts affecting programs like Medicaid, which provides health coverage to roughly 79 million Americans, including low-income families, seniors, children, and people with disabilities.
Some of the proposals under discussion include:
Reducing federal funding for Medicaid expansion populations.
Changing Medicaid to block grants or per-capita caps, which would limit how much federal support states receive.
Introducing work requirements for some adult enrollees.
Supporters of these changes argue that reforms could help control government spending, reduce inefficiencies, and give states more flexibility. Opponents worry that these measures could lead to millions of people losing coverage, create funding gaps for hospitals and clinics, and shift significant costs onto states, especially during economic downturns.
Medicaid is a critical part of the U.S. health system — covering 4 in 10 births and more than 60% of nursing home residents. Any major changes to the program could have far-reaching effects on patients, providers, and state budgets across the country.
While there’s strong public support for Medicaid — about three-quarters of Americans view it favorably — its future funding remains uncertain as Congress continues budget negotiations in 2025.
