It has been nearly eight years since Sen. John McCain’s middle-of-the-night thumbs-down vote torpedoed Republican efforts to repeal the Affordable Care Act and make drastic cuts to Medicaid.
With Donald Trump back in the White House and the GOP back in control of Congress, Republicans again have their eyes on Medicaid, the government health program for those with low incomes or disabilities. A GOP proposal unveiled this week would require many enrollees to prove they are working, volunteering, or studying, and to shoulder more of the costs of their care. It would also curtail taxes levied on providers that help states draw down billions in additional federal money.
Changes are needed, conservative lawmakers say, because the program is broken and costs too much. Medicaid’s annual price tag has soared from about $590 billion in 2017 to nearly $900 billion today.
If this script sounds familiar, it’s because Republicans made the same proposals and arguments in 2017, when they last had narrow control of Congress and Trump in the White House.
But while the 2025 Medicaid debate on Capitol Hill feels like a 2017 replay, the GOP’s latest effort toward a massive transformation could be more of a long shot, several health policy experts say. In the past eight years, Medicaid enrollment has surged to a record high, with the covid-19 pandemic driving numbers up and nine more states expanding the program to cover more low-income Americans, including six controlled by Republicans.
More enrollees, particularly in red states, means more constituents who rely on Medicaid to cover their health costs — making it harder for lawmakers to approve cut …