CBO Confirms: GOP Medicaid Cuts Would Strip Coverage from Millions
A recent report from the nonpartisan Congressional Budget Office (CBO) reveals the devastating impact of Republican-backed Medicaid cuts. Over the next decade, these cuts, which total $880 billion, would cause millions of Americans—especially low-income families, seniors, children, and people with disabilities—to lose access to essential health care.
U.S. Senators Ron Wyden and Frank Pallone emphasized in a formal letter to CBO Director Phillip Swagel that GOP proposals, including per capita caps and reductions in FMAP (federal medical assistance percentage), would force states into brutal choices which includes cutting services, reducing payments to providers, or dropping people from coverage altogether.
“Medicaid is a lifeline for families, seniors, children, people with disabilities, people who are working and walking an economic tightrope.”
— Sen. Ron Wyden & Rep. Frank Pallone Letter to CBO Director Phillip Swagel (2025)
These proposals align directly with legislation known as “THE ONE, BIG, BEAUTIFUL BILL”, which aims to hand out over $5 trillion in tax cuts. The problem? These tax breaks would be paid for by gutting Medicaid and other essential programs.
Work Requirements and Eligibility Restrictions Threaten Vulnerable Populations
Republicans continue to push for work requirements even though evidence from the CBO shows these policies strip coverage without helping people find jobs. Enforcing such requirements would result in 8.6 million fewer enrollees by 2034. Many of these individuals would lose coverage not because they’re ineligible, but because they couldn’t meet burdensome and complex reporting mandates.
“Any cuts to federal Medicaid spending would leave states with tough choices about who to strip of their health coverage, what benefits to cut and for whom, and what providers’ payments to slash.”
— Sen. Ron Wyden & Rep. Frank Pallone (Congressional Budget Office)
House Speaker Mike Johnson and President Trump have publicly insisted that no one who qualifies for Medicaid would lose coverage. Johnson said, “We’re going to be very careful not to cut a benefit for anyone who is eligible to receive it,” while Trump claimed, “We aren’t going to touch [Medicaid]. Now, we are going to look for fraud.” However, according to the Senators’ letter to the CBO and the documents we’ve seen in House committees reviewing the so-called “big, beautiful bill,” none of the current proposals are under consideration to reduce spending by targeting fraud.
States Brace for Fallout Amid Budget Pressures
States that rely on federal Medicaid dollars —up to 77% of all federal funding in some cases — now face serious consequences. In Michigan, Governor Gretchen Whitmer warned that over 700,000 residents could lose coverage, a crisis that would force the state to either raise taxes or slash essential services like education and public safety.
The Senators’ letter stresses that states “will not be able to wholly offset the loss of federal funds with new taxes or reductions in other state spending.” As a result of less funding, states are likely to reduce provider payments, eliminate optional benefits, or even shrink eligibility- leaving families vulnerable.
Rollbacks on Eligibility Rules Could Exclude Millions
The threat doesn’t stop with budget cuts. Republicans also want to reverse the “Eligibility and Enrollment” rule finalized in 2024, which made it easier for children, seniors, and people with disabilities to enroll in Medicaid. The rule eliminated CHIP waiting periods and removed in-person interview requirements for older adults.
Senators Wyden and Pallone asked the CBO to estimate how many people would lose Medicaid coverage if Congress overturned the rule. They believe the change would exclude thousands, possibly millions—of eligible people. The CBO plans to report how much this would reduce federal spending and how many people would suffer as a result.
Conclusion
These Medicaid proposals, whether through caps, eligibility restrictions, work requirements, or rule repeals, would trigger a nationwide health care crisis. As the CBO confirms, millions of people would lose access to care, and states would be left scrambling to pick up the pieces.
This isn’t just a budget issue, it’s a moral one.
“At a time when states... are struggling to balance their budgets, cuts to federal Medicaid funding would be devastating.”
— Sen. Ron Wyden & Rep. Frank Pallone (Congressional Budget Office)
Sources:
Wyden, R., & Pallone, F. (2025). Letter to CBO Director Phillip Swagel. Congressional Budget Office. https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf
Wall Street Journal: GOP’s “THE ONE, BIG, BEAUTIFUL BILL” Explained
Kaiser Family Foundation (2025). Tracking the Medicaid Provisions in the 2025 Reconciliation Bill
Michigan’s Thumb (2025). Whitmer: Medicaid Cuts Could Impact 700k
CBS News (2025). Speaker Johnson Eyes Medicaid Cuts; Trump Vows "No Touch"