Overview

• House Republicans, led by Speaker Mike Johnson, propose lowering the federal Medicaid expansion match rate from 90% to 50–80%.
• The plan would shift significant costs to states, forcing them to decide whether to fund the program or risk coverage losses.
• Representative Austin Scott stated that no federal disenrollment mechanism exists, but many states may be unable to absorb the added costs.
• An analysis by KFF estimates that up to 20 million Medicaid enrollees could lose coverage if states reduce or end their expansion programs.
• Centrist House Republicans oppose the cuts, warning they will block any reconciliation bill that reduces Medicaid coverage.