The GOP released their compromise budget proposal, which is aimed at enriching billionaires and killing off millions of poor Americans.
Overall Scope and Goals
- The GOP budget proposal aims to reduce federal spending by about $912 billion over the next decade, with $880 billion in cuts specifically targeted by the House Energy and Commerce Committee.
- The cuts are largely intended to offset the cost of renewing and expanding Trump-era tax cuts and to fund increased military and domestic spending.
Medicaid Cuts and Changes
Magnitude and Impact
- The proposal would result in approximately 8.6 million people losing their health insurance coverage over ten years, according to Congressional Budget Office estimates.
- The majority of the savings — about $715 billion — would come from changes to Medicaid and the Affordable Care Act.
Key Medicaid Provisions
| Provision | Details | Expected Impact |
|---|---|---|
| Work Requirements | Able-bodied adults must meet new work obligations to remain eligible. | Many could lose coverage due to non-compliance. |
| More Frequent Eligibility Checks | Recipients would need to re-enroll every six months instead of annually. | Increased administrative burden, likely coverage loss |
| Cost-Sharing Requirements | Some beneficiaries would have to pay up to 5% of their income for care. | Higher out-of-pocket costs for low-income patients |
| Freeze on Provider Taxes | States would be prohibited from raising provider taxes to fund Medicaid. | States may need to cut benefits or eligibility |
| Funding Restrictions | Cuts federal funding for Planned Parenthood and bans Medicaid dollars for gender-affirming care for youth. | Reduces access to certain services |
| Undocumented Coverage | Reduces funding for states that use their own money to cover undocumented immigrants. | States may drop this coverage |
State-Level Effects
- States would be forced to overhaul Medicaid financing or cut benefits due to new federal mandates and the freeze on provider taxes.
- The proposal avoids the most extreme structural changes (like per-capita caps), but still places significant pressure on state budgets.
Political Context
- The plan is a compromise between GOP moderates (concerned about backlash from major cuts) and hardliners (seeking deeper reductions).
- Democrats and healthcare industry groups, especially hospitals, strongly oppose the plan, warning of hospital closures and higher premiums.
Medicare Cuts
- The current proposals and reporting do not highlight direct, explicit cuts to Medicare itself. The focus is overwhelmingly on Medicaid and ACA-related reductions.
- Some broader budget documents may propose slower growth or indirect savings in Medicare, but the main legislative text under debate centers on Medicaid.
Additional Context
- The proposal is part of a larger legislative package that includes $4.5 trillion in tax breaks, border security investments, and energy policy changes.
- The bill is still subject to revision as it moves through committee, with a key markup scheduled for this week.
Summary Table: Medicaid-Related Cuts
| Area | Description | Projected Savings/Impact |
|---|---|---|
| Medicaid/ACA Cuts | Work requirements, eligibility checks, cost-sharing, provider tax freeze, funding restrictions | $715B+ over 10 years |
| Coverage Loss | Estimated number of people losing coverage | 8.6 million |
Notable Omissions
- The proposal does not include the most radical Medicaid restructuring (e.g., per-capita caps), which hardliners wanted but moderates opposed.
- No direct, significant Medicare cuts are outlined in the current legislative text.
Bottom Line
The 2025 GOP budget proposal centers on deep Medicaid cuts through stricter eligibility, work requirements, cost-sharing, and new state funding restrictions, with the intent of financing large-scale tax cuts and other priorities. While not as draconian as some earlier right-wing proposals, it would still lead to millions losing coverage and force states to make difficult choices on benefits and eligibility. No major new Medicare cuts are highlighted in the current version.