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yesterday

House Republicans Narrow Medicaid Cuts, Focus on Fraud and Work Requirements

GOP leadership rules out per-capita caps and enhanced federal match rate reductions, shifting attention to anti-fraud measures and eligibility reforms.

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U.S. President Donald Trump reacts to a question during a Cabinet meeting at the White House on April 30, 2025 in Washington, DC.
“It’s going to take a lot more of these kinds of conversations, ultimately, to get to an understanding that 99 percent of the House Republican Conference can agree with,” Rep. Nick LaLota, R-N.Y., shown in February, said Tuesday.

Overview

  • Speaker Mike Johnson confirmed that per-capita caps and Federal Medical Assistance Percentage (FMAP) reductions for Medicaid expansion states are excluded from the GOP budget plan.
  • The focus has shifted to less controversial measures, including work requirements, more frequent eligibility checks, and eliminating noncitizen participation in Medicaid.
  • House Republicans aim to achieve $880 billion in savings over ten years, with Medicaid reforms as a central component of their budget resolution.
  • Moderate Republicans, including Reps. Mike Lawler and Don Bacon, have successfully pushed back against steeper cuts that could risk coverage loss for millions.
  • The Government Accountability Office is expected to release a report this fall analyzing the costs of Medicaid work requirements, which could shape future policy decisions.