The United States Congress is using a fast-track budget process known as budget reconciliation to pass legislation that will take away millions of people's health care and food access to pay for tax cuts for corporations and wealthy Americans. 

Reconciliation is a legislative process that allows Congress to quickly pass a budget bill. Legislation can move quickly because it faces a special procedure in the Senate: the bill can only include budget-related items and only requires 51 votes instead of the usual 60. Reconciliation is most used when one political party controls the House, Senate, and the presidency, allowing them to move forward on their budget priorities. 

The House of Representatives passed its budget reconciliation bill with massive cuts to Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and other social services. Now the Senate is producing its bill, which they plan to vote on and send back to the House before sending it to the President for signature by July 4th. That gives us just weeks left to demand that our members of Congress represent everyday Americans and oppose cuts to Medicaid. 

Tell Congress to Oppose Medicaid Cuts! 

Read on to learn about what’s in the House budget bill and what you can do. 

What is Medicaid?

Medicaid is the country's single largest source of health coverage, covering 1 in 5 people. The program insures nearly 72 million people, including children, pregnant people, parents, and older adults with limited incomes, as well as people with disabilities. These members of our community rely on Medicaid for essential care, including doctors' visits, hospitalizations, long-term care, maternity care, mental health treatment, and rural clinic services. 

Medicaid’s positive impact is well-documented. Coverage for children is associated with improved health and educational outcomes in childhood and adulthood. States that have adopted the Affordable Care Act's expanded Medicaid — making adults with incomes up to 138% of the federal poverty level eligible — have dramatically reduced uninsured rates, associated with improved health and financial security. 

Medicaid is a joint federal and state program; many states cannot compensate for the shortfall of federal Medicaid cuts. Federal funding accounts for between 50 and 77% of the cost of a Medicaid enrollee’s coverage and 90% for a Medicaid expansion recipient. Medicaid is often the largest expenditure in a state’s budget. When Congress cuts Medicaid funding, it will force states to raise taxes, cut other state programs, and/or reduce the scope of Medicaid benefits or enrollments for some currently qualifying people. 

The House-Passed Bill 

On May 22, the House passed its One Big Beautiful Bill, a more than 1,000-page budget bill with permanent tax and Medicaid cuts, among other provisions. An analysis by the nonpartisan Congressional Budget Office (CBO) found that between the bill’s tax and benefits cuts, if it became law, households with the lowest incomes would suffer.

Tax Cuts 

The House bill preserves and expands tax cuts. This includes making the set-to-expire 2017 Tax Cuts and Jobs Act, which had tax cuts that disproportionately benefit wealthy Americans, permanent. According to the Institute on Taxation and Economic Policy, the highest-earning 20% of Americans will receive 69% of the bill’s tax cuts, and the highest-earning 1% of Americans will receive an average tax cut of about $70,000. 

Medicaid Cuts 

The bill also makes the largest cuts to Medicaid in the program’s history. It makes these spending cuts through policies that threaten the loss of Medicaid coverage for millions of currently eligible people, often due to things like administrative burdens or job loss penalties.  

According to the CBO's latest estimate, the bill would cut Medicaid by over $790 billion over 10 years. Earlier CBO estimates suggest that Medicaid changes will result in more than 10 million people losing their Medicaid coverage and 7.6 million people becoming uninsured by 2034.  

The bill removes rules designed to help people enroll and stay enrolled in Medicaid, which will likely result in fewer people getting the coverage they need. The bill imposes a moratorium on implementing the 2023 and 2024 Centers for Medicare & Medicaid Services (CMS) rules jointly referred to as the Eligibility and Enrollment final rule. These rules were designed to streamline the process for people to enroll and stay enrolled in Medicaid and for Medicare beneficiaries to apply for the Medicare Savings Program, which offers coverage of Medicare premiums and cost-sharing. 

The bill also imposes requirements on Medicaid enrollees that will likely cut people from the program. The bill puts “community engagement” requirements on certain enrollees, requiring them to work, volunteer, or be enrolled in an educational program for at least 80 hours a month. Research shows that the majority of Medicaid enrollees are already working or face barriers to work, most of which would exempt them from the requirement altogether. It is estimated that these requirements would not increase employment but would threaten eligible people with loss of coverage because of administrative burden or unexpected job loss. 

Medicare Cuts 

Another CBO analysis estimates that the House bill will cause a $45 billion cut to Medicare in 2026, growing to $75 billion in 2034. Medicare is a health insurance program for people 65 years-of-age or older and people with certain disabilities. These massive Medicare cuts are a result of the House bill increasing the federal deficit by $2-3 trillion by 2034, as the 2010 Pay-As-You-Go (PAYGO) Act requires that legislation that increases the deficit must be paid for by tax increases or spending cuts. 

What You Can Do 

As the Senate authors and prepares to vote on its budget bill and then the House prepares to vote to resolve bill differences, you can use the League’s action alert to urge your members of Congress (MOCs) to oppose legislation with Medicaid cuts. The page includes an: 

• Email directly to your MOCs
• Phone script to call your local congressional office, and
• One-pager that you can email or take in person to your MOCs’ local or DC offices. 

Also, check out our new blog on advocating to your members of Congress during congressional recesses.