NBC NEWS – President Donald Trump’s sprawling domestic policy bill includes nearly $1 trillion in cuts to Medicaid, the government health insurance program for low-income and disabled Americans.
Dubbed the “big, beautiful bill,” the new legislation will extend Trump’s 2017 tax cuts and make up for them in part by slashing federal Medicaid funding, introducing copays for some services and — for the first time — implementing nationwide Medicaid work requirements.
The final version of the bill didn’t include an estimate of coverage losses; an earlier Congressional Budget Office report projected that about 11 million people could lose their health coverage and become uninsured by 2034 because of the program cuts.
Medicaid is jointly funded by the federal government and the states, which usually mandate that applicants meet certain criteria, such as low income, disability or caregiving status.
Only two states have implemented Medicaid work requirements: Arkansas in 2018 and Georgia in 2023. Georgia’s program, called Pathways to Coverage, remains in effect.
Over the 10 months Arkansas’ work requirement was in place, more than 18,000 people in the state lost Medicaid coverage.
Georgia hasn’t done a good job keeping track of how many have lost coverage, but enrollment remains low, said Leighton Ku, director of the Center for Health Policy Research at the Milken Institute School of Public Health at George Washington University.
When people lose Medicaid coverage, they view it as “sort of a slap in the face,” Ku said.
“When your income is down, when you’re unemployed, that’s when you lose everything,” he said. “When you’re most in need. That’s when you lose your food assistance, that’s when you lose your health insurance coverage” …
