House Republicans have released the main cost-cutting part of President Donald Trump’s “big, beautiful bill,” proposing at least $880 billion in reductions, mostly from Medicaid — to help fund $4.5 trillion in tax cuts.
The lengthy legislation, made public late Sunday, is sparking the most intense health care fight since Republicans tried to repeal and replace the Affordable Care Act (Obamacare) during Trump’s first term in 2017.
Republicans claim the savings will come from eliminating “waste, fraud, and abuse” by adding new work and eligibility requirements. However, Democrats argue that these changes will lead to millions losing health insurance. According to the nonpartisan Congressional Budget Office (CBO), the proposals could result in 8.6 million fewer people having coverage over the next ten years.
“Savings like these allow us to use this bill to renew the Trump tax cuts and keep Republicans’ promise to hardworking middle-class families,” said Rep. Brett Guthrie of Kentucky, the Republican chair of the Energy and Commerce Committee, which oversees health care funding.
Democrats strongly opposed the plan, calling it a hidden effort to dismantle Obamacare. “In no uncertain terms, millions of Americans will lose their health care coverage,” said Rep. Frank Pallone of New Jersey, the top Democrat on the committee. He warned of hospital closures, reduced care for seniors, and higher premiums if the bill passes.
With House Speaker Mike Johnson aiming to pass the bill by Memorial Day, Republicans plan a busy week of public hearings on different parts of the legislation before combining them into one large package.
House Republicans propose Medicaid cuts as Democrats warn millions could lose coverageThe political outcome is uncertain. Over a dozen House Republicans have told party leaders they won’t support cuts to health care programs that their constituents rely on. Trump himself has pledged not to repeat efforts from his first term and says Medicaid will not be cut.
In total, 11 House committees are assembling parts of the plan as Republicans aim to save at least $1.5 trillion to help extend the 2017 tax cuts, which expire at the end of the year. The Energy and Commerce Committee, tasked with finding $880 billion in savings, hit its goal mainly by cutting health care funding and repealing some Biden-era clean energy programs. The CBO’s early review estimated the proposals would lower the deficit by $912 billion over ten years, with about $715 billion from health-related changes.
A major focus is on Medicaid, which provides nearly free health coverage to over 70 million Americans. The proposed changes would require able-bodied adults without dependents to meet “community engagement” conditions, like working, studying, or volunteering for at least 80 hours a month. These adults would also need to prove they still qualify twice a year instead of once, which could lead to people losing coverage due to paperwork or access issues.
Though many states expanded Medicaid with federal incentives, the bill would cut a 5% funding boost introduced during the COVID-19 emergency. It would also stop federal funds from going to states for immigrants who haven’t proven their citizenship.
Another proposed change is a freeze on the provider tax used by some states to boost Medicaid funding. Critics say it results in higher federal payouts and misuses the system.
The sections related to energy are shorter but would roll back parts of President Biden’s climate agenda from the Inflation Reduction Act. These changes include canceling funds for energy loans and investment programs and speeding up approval processes for natural gas and oil projects.
