House Republicans unveil bill to cut Medicaid spending, add work requirements for coverage
The House Republicans proposed bill includes strict eligibility checks, work mandates, and federal funding caps, drawing swift Democratic opposition and sparking intense debate on healthcare policy.
House Republicans released key legislative text on Sunday night as part of a broader partisan agenda, proposing significant changes to Medicaid, including spending cuts, eligibility restrictions, and work requirements for certain recipients. The 160-page section, part of a larger bill to advance President Donald Trump’s policy goals, will be debated by the House Committee on Energy and Commerce on Tuesday.
The bill calls for tighter citizenship verification, more rigorous eligibility checks, and new limits on federal Medicaid funding to states covering undocumented immigrants. It would also require able-bodied adults aged 19 to 64 without dependents to work at least 80 hours a month, perform community service, or participate in other qualifying programs—though exceptions are included for pregnant women and individuals facing short-term hardship.
Work requirements and federal oversight highlight Republican proposals
Supporters of the bill argue that the changes are necessary to preserve Medicaid for the most vulnerable groups, including children, seniors, and individuals with disabilities. Rep. Brett Guthrie (R-Ky.), chair of the Energy and Commerce Committee, defended the measure in an op-ed, stating that “Washington cannot afford to further weaken the program by subsidizing able-bodied adults who choose not to work.”
The legislation stops short of including more controversial provisions such as per-capita spending caps and increased state financial responsibility for the expanded Medicaid population under the Affordable Care Act. However, the new work requirements and federal oversight mechanisms represent a substantial policy shift that could impact millions of Americans’ access to healthcare.
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Democrats warn of widespread coverage loss and economic fallout
Democrats swiftly condemned the proposal, citing a Congressional Budget Office (CBO) analysis estimating that the healthcare portion of the bill would reduce federal spending by $715 billion and lead to at least 8.6 million fewer Americans having health insurance by 2034. Rep. Frank Pallone (D-N.J.) called the bill a “stealth attack” on public healthcare, warning that it targets essential services rather than addressing waste or fraud.
Sen. Ron Wyden (D-Ore.), the top democrat on the Senate Finance Committee, echoed the criticism, describing the legislation as “the largest Medicaid cut in history.” He argued the bill would harm children, seniors, and working families while failing to achieve meaningful reforms. The proposal has also sparked division within the Republican Party, with some GOP lawmakers, like Sen. Josh Hawley (R-Mo.), voicing concern over potential impacts on constituents and rural hospitals.
