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Proposed measures by Republican lawmakers could put Medicaid access at risk for millions of Americans. While no final decision has been made, the question isn't if cuts will happen-but when. A recent Congressional Budget Office (CBO) analysis has pinpointed a definitive timeline for one of the most significant health policy shifts in years.
Medicaid, a t federal-state health insurance program for low-income individuals, was expanded under the Affordable Care Act in 2014. Since its inception, funding debates have reflected broader tensions over the federal government's role in healthcare and state-level autonomy.
Republican leaders argue their proposals aim to combat waste, fraud, and abuse rather than reduce benefits. However, the CBO's findings suggest that even provisions like stricter eligibility checks and work requirements-both currently under consideration-would result in millions losing their coverage.
When could beneficiaries lose their health coverage?
Five different proposals are on the table to scale back federal Medicaid funding over the next decade. No matter which approach is chosen, government spending reductions would be phased in gradually, with cuts reaching their full effect by 2034-potentially forcing millions of beneficiaries out of the program.
Although Republican lawmakers insist their plans won't deliberately strip individuals of health insurance, the CBO estimates that by the end of the adjustments, anywhere from 2.3 million to 8.6 million recipients could be removed from Medicaid, while 600,000 to 3.9 million would be left uninsured.
This analysis was commissioned by Senator Ron Wyden (D-Ore.) and Representative Frank Pallone (D-N.J.). The CBO is a nonpartisan congressional agency that provides independent assessments of economic and budgetary policies.
What will happen if cuts are approved?
According to the CBO, if federal Medicaid contributions shrink, states will have several options:
- Increase their own Medicaid spending
- Lower payment rates for healthcare providers
- Reduce the scope or availability of optional benefits
- Limit Medicaid enrollment
States could adopt one or more of these strategies, but none would prevent a decline in Medicaid enrollment or stop millions from losing access to health insurance.
With federal budget negotiations heating up, the battle over Medicaid spending is just beginning-and the final outcome remains uncertain.