Consider This from NPR
Republicans say Medicaid is safe. But budget math says otherwise
Mon, 10 Mar 2025
House Republicans have to get their spending bill passed by Friday to avoid a government shutdown. They can likely afford to lose just one vote. And that's the easy part. Then they'll have to get working on their plan to extend 4.5 trillion dollars in tax cuts passed under the Trump administration — a plan that will require huge cuts in government spending. Republicans are adamant that cuts to Medicaid are a non-starter. But the non-partisan Congressional Budget Office released a report last week that said Republicans' budget likely would require cuts to Medicaid or Medicare.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy
Chapter 1: What are the current legislative priorities of Congress?
Congress is acting on one of President Trump's top domestic priorities.
And the next phase of our plan to deliver the greatest economy in history is for this Congress to pass tax cuts for everybody.
But achieving that goal will require trillions of dollars in spending cuts, which will dramatically reshape the federal budget. And one big potential target for those spending cuts is Medicaid. That was Democratic Representative Al Green disrupting President Trump's address to Congress last week. After he was removed from the chamber, he spoke with reporters.
And I was making it clear to the president that he has no mandate to cut Medicaid.
Now, House Republicans have said that cuts to Medicaid are totally off the table. Here's Republican Representative Tim Burchett of Tennessee with NPR's Layla Fadl.
So what I think I hear you saying is that this $880 billion of proposed cuts... that people believe will hit Medicaid. You're saying it won't hurt people's coverage because that's really important to constituents.
No, ma'am. Yeah, I believe that is exactly what I'm saying, ma'am. That is exactly what I'm saying.
But that's a lot of money for it not to hit the actual health care coverage.
Ma'am, it's a whole heck of a lot of money, but we're finding that over and over and over again that there is waste, fraud, and abuse, and that's just the bottom line.
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Chapter 2: Why are Medicaid cuts a contentious issue?
That's Edwin Park, a health policy expert at Georgetown University's McCourt School of Public Policy. He says finding $880 billion in cuts over a decade simply cannot be done without touching Medicaid.
Unless you're cutting Medicare, and both Speaker Johnson, other House Republican leaders, and President Trump have said that they do not want to cut Medicare. So if you take Medicare off the table, Medicaid constitutes 93% of all mandatory spending that remains.
Consider this. House Republicans have claimed that spending cuts will not impact Medicaid coverage. But experts say that's just impossible. We'll explain the math coming up. From NPR, I'm Elsa Chang. . It's Consider This from NPR. Edwin Park is a health policy expert at Georgetown University's McCourt School of Public Policy, and he joined me to explain all of the math on this.
Now, the budget bill does not specifically mention Medicaid, but that's because the budget just gives instructions to lawmakers on the committee that oversees Medicaid to find $880 billion in cuts over the next decade. The legislation doesn't explain exactly where lawmakers should make those cuts.
So I started by asking Park very simply, can Congress find $880 billion in federal savings without cutting spending for Medicaid?
It cannot unless you're cutting Medicare, and both Speaker Johnson, other House Republican leaders, and President Trump have said that they do not want to cut Medicare. So if you take Medicare off the table, Medicaid constitutes 93% of all mandatory spending that remains under the jurisdiction of the Energy and Commerce Committee.
Okay, well, that argument has been floated, but Republicans say that they can cut spending without cutting any benefits in either Medicare or Medicaid because they're going to do this by eliminating waste and fraud. Here's another question. Is there $880 billion worth of waste and fraud in the system?
Simply no. If you look at the major Medicaid cut proposals that are under consideration, they're the same proposals that were included in the failed 2017 repeal and replace plans. And they all involve major cost shifts for the cost of Medicaid onto states because of the federal government and states sharing the cost of the program.
making it harder for states to finance their share of the cost of Medicaid, or imposing more red tape on those who are already working or who aren't able to work because they're disabled, have chronic conditions, they may be caregivers or in school.
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