Introduction

Republicans in Congress are moving ahead rapidly with efforts to cut nearly $880 billion from Medicaid. Confusingly, however, Republicans have also promised to protect Medicaid for those who really need it. House Speaker Mike Johnson has committed to protecting Medicaid “for people who are legally beneficiaries of those programs… young single mothers down on their fortunes at the moment, the people with the real disabilities, the elderly.” Thirteen House Republicans, including New York representatives Mike Lawler, Nicole Malliotakis, Nick LaLota and Andrew Garbarino, wrote a letter to Republican Congressional leadership last week committing to a similar line: Medicaid must be protected for “those who [sic] the program was intended to help.” These statements appear to imply that large-scale Medicaid cuts are off the table.

Yet all of these representatives voted for a budget package involving $880 billion in targeted Medicaid cuts. Indeed, Mike Lawler recently published an article endorsing Medicaid work requirements and onerous eligibility checks and suggesting that 3 million of New York’s 7 million Medicaid beneficiaries shouldn’t be on the program. What explains the gap between Congressional Republicans’ rhetoric on protecting the vulnerable and their votes?

Republicans have argued that they can cut Medicaid without cutting services to vulnerable populations by cutting “waste, fraud and abuse”; by targeting people who are not, or in their view should not be, eligible for the program; and by reforming complex state financing mechanisms like provider taxes. Given the complexity of the Medicaid program, it can be hard to evaluate these claims. Below, we offer five principles to help policymakers cut through the noise and understand how changes to Medicaid at the federal level may impact New Yorkers.

[1] https://thehill.com/homenews/house/5247051-house-speaker-johnson-medicaid-cuts/

[2] https://lawler.house.gov/news/documentsingle.aspx?DocumentID=4100