House Passes Budget Resolution Cutting Billions From Medicaid Funding

The US House of Representatives passed a budget resolution (H Con Res 14, 119th Congress) that includes deep cuts to Medicaid, advancing the Republican-led plan in a 217-215 vote Tuesday evening.¹

If the resolution becomes law, states could be forced to make up for the federal funding shortfall. | Image credit: wallentine – stock.adobe.com

If advanced by the Senate, the resolution will cut about $880 billion from the House Energy and Commerce Committee—which oversees health care spending in programs such as Medicaid—over the next decade as part of a broader GOP budget framework aimed at enacting $4.5 trillion in tax cuts to put towards raising the country’s debt limit.²

With nearly 80 million Americans covered by Medicaid and CHIP, this vote would affect almost a quarter of the US population if passed into law.³

This news comes after multiple Republicans pushed back against the budget plan, with some arguing the cuts are too deep while others said they were willing to hold out for even deeper ones.⁴ President Donald J. Trump also recently endorsed the House budget after the White House reassured that Medicaid would not be impacted by a federal funding freeze that is still being blocked.^3.5

Following hours of debates, House leaders announced the proceedings were postponed, halting the vote for close to 90 minutes as representatives worked to sway stances at the last minute to secure the last 2 votes needed.¹ The delay, which stretched well beyond the customary window of time, was met with calls for "regular order" from the packed floor, highlighting the challenges in locking down support for the Medicaid-cutting measure. With fewer than 20 votes left to cast, 1 of the 2 Republican "nay" votes recorded shifted to "yea" moments later.

Potential Impacts of Medicaid Cuts

If the resolution becomes law, states could be forced to make up for the federal funding shortfall, likely leading to coverage losses, benefit reductions, or stricter eligibility requirements.³ One of the most controversial provisions allows states to impose work requirements for Medicaid beneficiaries, a move that could eliminate coverage for millions.

Hospitals, nursing homes, and community health centers—many of which rely on Medicaid reimbursements—would also feel the impact. According to the Kaiser Family Foundation, 32% of Medicaid spending in 2023 was for hospital-based care. Cutting federal support could strain health care facilities that are already underfunded, particularly in rural areas where hospital closures have outpaced new openings in recent years.

“Slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities,” a group of Republican representatives warned in a letter to House Speaker Mike Johnson before the vote.⁶

A Politico review found that 11 Republicans in swing districts collectively represent nearly 2.7 million Medicaid recipients. Some of these lawmakers—including Reps David Valadao (R, California), Mike Lawler (R, New York), and Robert Bresnahan (R, Pennsylvania)—have expressed reservations about the bill’s impact on their constituents.

Over in the Senate, there is growing opposition to major Medicaid cuts. Senator Josh Hawley (R, Missouri), representing a state where more than 21% of residents rely on Medicaid, said he did not support massive cuts to the program. He also endorsed a Democratic amendment alongside Sen Susan Collins (R, Maine) that would prevent tax cuts for the wealthy if any Medicaid funding were cut from the Senate budget resolution that is also being formed. However, the amendment was shut down by the rest of the party.

References

1. United States House of Representatives. February 25, 2025. Accessed February 25, 2025. https://live.house.gov/
2. Freking K, Mascaro L. House Republicans unveil blueprint to extend $4.5 trillion in tax cuts and lift the debt ceiling. The Associated Press. February 12, 2025. Accessed February 25, 2025. https://apnews.com/article/house-republicans-budget-blueprint-trump-tax-cuts-ff2bddf31f4e7cb0928139072392a091
3. Bonavitacola J. Trump endorses budget that would slash Medicaid funding. AJMC^®. February 20, 2025. Accessed February 25, 2025. https://www.ajmc.com/view/trump-endorses-budget-that-would-slash-medicaid-funding
4. Johnson brushes off Musk, but GOP budget holdouts stand firm. Hill ML. Politico. February 25, 2025. Accessed February 25, 2025. https://www.politico.com/live-updates/2025/02/25/congress/johnson-brushes-off-musk-but-gop-budget-holdouts-stand-firm-00205925
5. Klein HE. Trump’s federal grant freeze threatens Medicaid funding. AJMC. January 28, 2025. Accessed February 25, 2025. https://www.ajmc.com/view/trump-s-federal-grant-freeze-threatens-medicaid-funding
6. Hooper K. Republicans’ plans for Medicaid have a political problem. Politico. February 24, 2025. Accessed February 25, 2025. https://www.politico.com/news/2025/02/24/medicaid-gop-cuts-republicans-congress-00205542