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'People Will Suffer, People Will Die': GOP Nears Final Passage of Largest Medicaid Cuts in US History
"The top 1% are salivating over getting an extra $300,000 a year because of this dangerous bill," said one House Democrat. "Billionaires win."
Jul 03, 2025
House Republicans are on the verge of passing legislation that is projected to strip health coverage and food aid from millions of people across the United States, all to pay for tax breaks that will flow disproportionately to a small sliver of rich Americans.
The final vote on the sprawling budget reconciliation package, which narrowly passed the Senate on Tuesday, is expected Thursday after hours of jockeying among Republican leaders and holdovers in the GOP's ranks overnight. Republicans finally cleared a procedural hurdle to begin debate on the measure after 3 am ET on Thursday.
"If Republicans are so proud of their Big Bad Betrayal Bill... why did they begin debate at 3:28 am?" asked Rep. Pramila Jayapal (D-Wash.). "Why are they hiding from the American people?"
House Minority Leader Hakeem Jeffries (D-N.Y.) delayed the final vote on the bill with an hours-long—and, as of this writing, still ongoing—speech that featured stories from constituents who are horrified that they will soon lose health coverage or food aid.
"This isn't abstract, taking away healthcare from the American people," said Jeffries. "It's concrete, it's real, it has devastating implications."
Watch Jeffries' remarks live:
The unpopular legislation that set to clear the House Thursday is substantially more expensive than the version the chamber's Republicans approved in May, and it includes roughly $300 billion more in cuts to Medicaid. The bill now heads to the desk of U.S. President Donald Trump, who has repeatedly pledged not to cut Medicaid.
Analysts estimate that over the next 10 years, roughly 17 million Americans will lose health coverage under the GOP package, both due to the measure's Medicaid cuts and its failure to extend Affordable Care Act subsidies set to expire at the end of the year.
The bill's assault on Medicaid—including its restriction on states' use of provider taxes to fund their programs—is expected to ravage rural hospitals, notwithstanding Republicans' last-ditch attempt to put a Band-Aid on the massive wound they're set to create.
The legislation would also trigger more than $500 billion in automatic cuts to Medicare due to its multitrillion-dollar addition to the deficit.
One recent study estimated that the bill's healthcare cuts would result in more than 51,000 additional, preventable deaths across the U.S. each year.
"The decision we have been entrusted by the American people to make will have ramifications for millions of our fellow Americans, and indeed for our country, for decades to come," Rep. Brendan Boyle (D-Pa.), the top Democrat on the House Budget Committee, said in floor remarks early Thursday.
"In just a few short hours, some of them on Medicaid will be waking up and turning on the news to find out if what we did here tonight means they're about to lose it," said Boyle. "Some of the people who get their healthcare from the ACA exchanges will be turning on their TV to find out what we've done in these next few minutes, and if they will still be able to have healthcare... The kids who rely on SNAP, the nutrition assistance program, they may not quite understand it, but make no mistake about it—what we are about to do in the next few minutes here will have a profound effect on their lives."
As Ranking Member @HouseBudgetDems, I'm on the House floor right now to lead the fight against Trump's Big Bill for Billionaires.
This bill is an attack on my neighbors — and I'm not going to let Republicans kick 17 million Americans off their health care without a fight. pic.twitter.com/MeBkYKd8f2
— Rep. Brendan Boyle (@CongBoyle) July 3, 2025
The GOP bill proposes $186 billion in Supplemental Nutrition Assistance Program cuts over the next decade, which analysts say will imperil benefits for millions—including many children. The Center on Budget and Policy Priorities estimates that around 1 million children "would see food assistance to their families cut substantially or terminated" due to the legislation's SNAP cuts, including its expanded work requirements.
The measure's unprecedented cuts to the safety net, as well as clean energy programs, will only partially offset its trillions of dollars in tax cuts. According to the Institute on Taxation and Economic Policy (ITEP), more than 70% of the legislation's net tax breaks "would go to the richest fifth of Americans in 2026, only 10% would go to the middle fifth of Americans, and less than 1% would go to the poorest fifth."
"The effects of President Trump's tariff policies alone offset most of the tax cuts for the bottom 80% of Americans," ITEP found. "For the bottom 40% of Americans, the tariffs impose a cost that is greater than the tax cuts they would receive under this legislation."
Rep. Gabe Amo (D-R.I.) said in a floor speech early Thursday that "budgets are statements of values," and Republicans "are showing they have none."
"People will suffer, people will die, and it will be the hands of Republicans who vote yes," said Amo. "The top 1% are salivating over getting an extra $300,000 a year because of this dangerous bill. Billionaires win."
Back speaking on the House floor at 3:45am because budgets are a statement of values — with this big, ugly bill Republicans have none.
Americans will suffer. Americans will die. And it will be at the hands of the Republicans who vote yes.
This budget is shameful. I’m a hell no! pic.twitter.com/K5Ri5lGzzs
— Congressman Gabe Amo (@RepGabeAmo) July 3, 2025
Ahead of the bill's final passage, state leaders warned that the cuts pushed by Republican lawmakers could be deeply destructive to their residents and economies.
"Voices across North Carolina are sounding the alarm—our hospitals, healthcare providers, county leaders, state leaders, business leaders, workers, nonprofits, and, most importantly, the people who rely on these essential services and industries every day," North Carolina Gov. Josh Stein wrote in a letter to his state's congressional delegation on Wednesday. "Many North Carolinians are worried about feeding their families, being able to continue seeing their doctor, or keeping their jobs. We are united in our concern that this reconciliation bill would undo decades of bipartisan progress and harm the health, well-being, and economic security of our individuals, families, and communities."
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Work Requirements for Medicaid Imply a Federal Duty To Hire
If Congress actually imposes a work requirement for Medicaid recipients, it should also enact a governmental program to employ anybody who is unable to find work elsewhere.
Jun 12, 2025
Republicans in Congress are planning to slash funding for Medicaid in order to help pay for major tax reductions for wealthy Americans and corporations. But they don't want to cut Medicaid openly, because it will gravely injure many people who voted for them.
One way to cut Medicaid expenditures without overtly reducing benefits is to increase required paperwork. Additional bureaucratic hassle will discourage people from applying for what they are eligible for. The "big beautiful bill" currently discussed in Congress incorporates this strategy.
The major provision aimed at saving money requires Medicaid recipients to work at least 80 hours a month.
Until American conservatives wise up and emulate the conservatives in Taiwan, who introduced universal medical insurance there, we will have to live with a lot of unnecessary complexity and inflated administrative expense.
The work requirement requires frequent verification that a recipient is employed—more hassle. It will deny coverage to individuals who—for one reason or another—can't find work.
Given likely job loss due to artificial intelligence, mass corporate layoffs, and huge reductions in government payrolls, the number of people without insurance because they can't find work will likely be large.
This policy will be rather hard on people who through no fault of their own are unable to find work. And inability to get medical treatment may leave some people in such poor health that it makes it even harder to find and hold a job.
The work requirement, though, appears to be popular when people are polled. But many of the polled people may underestimate the danger that they themselves will lose their jobs, their job-related insurance, and their eligibility for Medicaid.
Fortunately, the bad consequences of the requirement could be completely eliminated by one simple additional government policy: that it will hire anybody who is otherwise unable to find work.
There is, of course, no end to the useful work that people employed by the government could do: elderly people who need help in their daily lives, children who could use tutoring, parks that need to be cleaned up, hiking trails that need maintenance, etc.
But guaranteeing jobs would cost the government (which is to say taxpayers) money, which would conflict with the desire to save money prompting Congress to restrict Medicaid eligibility in the first place.
And a guaranteed jobs policy, morally necessary in order to make federal medical policy less unjust, would also make public policy even more complicated than it already is.
A better solution to this problem would be to completely decouple medical insurance from employment. The United States is the only developed country that does not guarantee medical insurance for everyone, employed or unemployed, rich or poor, young or old.
Instead, we have a tremendously complicated system with different government programs for the old, for children, for Native Americans, for veterans, for the poor. As people's situations change, they can "churn" from one program to another, all too often falling into the gaps between programs, which leave them totally uncovered.
We'd all be better off, and would probably save money, if Congress wiped out all of today's complicated government insurance programs—including Obamacare, Medicare, and Medicaid—replacing them with a single program insuring everybody no matter their age or work status.
Unfortunately, American conservatives have been trained to reject a single-payer program like Medicare For All as "socialistic," without inquiring into the benefits such a program would produce. And enacting a major program like this would require bipartisan support.
Until American conservatives wise up and emulate the conservatives in Taiwan, who introduced universal medical insurance there, we will have to live with a lot of unnecessary complexity and inflated administrative expense.
Given this unpleasant fact, if Congress actually imposes a work requirement for Medicaid recipients, it should also enact a governmental program to employ anybody who is unable to find work elsewhere.
Since it is unlikely that Congress will do this, the best outcome we can realistically hope for is that the work requirement for Medicaid recipients will be stripped out of the bill in the Senate.
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'What Don't They Want You to Know?' GOP Sets 1 AM Hearing to Advance Disastrous Medicaid Cuts
"They have such contempt for the American people," said Democratic Rep. Jim McGovern.
May 20, 2025
House Republicans are set to take the next step toward passage of their sprawling reconciliation bill at a Wednesday hearing scheduled to begin while most Americans are fast asleep.
The GOP-controlled House Rules Committee will convene at 1 am ET Wednesday morning to consider the legislation and recent changes pushed by Republican hardliners, who are demanding even more aggressive cuts to Medicaid and green energy programs.
Specifically, a faction of far-right Republicans led by Rep. Chip Roy of Texas wants the bill's proposed work requirements for Medicaid recipients to take effect earlier than the originally proposed 2029 start date. House Majority Leader Steve Scalise (R-La.) said Tuesday that Republicans had settled on "early 2027" as a new start date.
While the House Rules Committee has not responded to reporters' questions about the timing of Wednesday's hearing, critics said it appears to be an attempt to avoid the kinds of protests and public scrutiny that daytime meetings have attracted.
Rep. Jim McGovern (D-Mass.), the ranking member of the rules panel, blasted his Republican colleagues over the dead-of-night hearing time, writing on social media that "they have such contempt for the American people."
"If Donald Trump's big beautiful tax break for billionaires is so great... why not pass it in primetime?" McGovern asked. "Why jam it through in the middle of the night? What don't they want you to know?"
Rep. Debbie Dingell (D-Mich.) added that "if you think you are doing what is right for the American people, you don't consider it in the dead of night."
"This bill doesn't just cut Medicaid, it guts Medicaid, and it will cause millions of eligible people in House districts across the country to lose access to the Medicaid benefits they need."
The GOP reconciliation package, a centerpiece of President Donald Trump's legislative agenda, would slash Medicaid and federal nutrition assistance by more than a trillion dollars combined over the next decade—cuts that would help offset the cost of massive tax breaks for rich Americans.
The spending cuts, which would be achieved in part through draconian and ineffective work requirements, would strip healthcare coverage and food aid from millions of Americans and potentially devastate rural hospitals, farmers, and local economies.
"Instead of listening to the millions of Americans clogging their phone lines and showing up at townhalls, or even those in their own party warning against severe cuts to Medicaid, House Republicans are making bigger cuts and terminating people's healthcare coverage even faster," said Anthony Wright, executive director of Families USA.
"This bill doesn't just cut Medicaid, it guts Medicaid, and it will cause millions of eligible people in House districts across the country to lose access to the Medicaid benefits they need," Wright said. "When will we hear from those members?"
Later Wednesday morning, Medicaid recipients from across the country—including districts represented by House Republicans—are set to gather on Capitol Hill to protest the GOP legislation.
"Upon arrival on May 21, they will hold a press conference, demand face-to-face meetings, deliver petitions signed by thousands of constituents urging GOP decisionmakers to change course, and take direct action in order to be heard," the People's Action Institute and Popular Democracy said Tuesday.
"The plan to eviscerate Medicaid and other programs in order to siphon public dollars into the pockets of billionaires who already pay less in taxes than working families is universally unpopular," they added.
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