The fight against cuts to Medicaid is far from over. Here’s an update on where we’re at, what happens next, and how we will continue to advocate for Medicaid over the coming months.
Budget Bill Passes the House
The U.S. House of Representatives passed the budget reconciliation bill known as the “One Big Beautiful Bill Act” last week with a 215-214 vote. The bill includes the following impacts to Medicaid:
Work Requirements and Redeterminations
- Mandatory work requirements for certain Medicaid enrollees, potentially impacting eligibility.
- Requires eligibility redetermination for some adults more frequently, such as every six months.
State Funding Limitations
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- Limits the use of state-directed payments and other state funding mechanisms, including provider taxes.
- Reduces the federal matching rate (FMAP) for Medicaid expansion in states that voluntarily choose to expand.
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- Requires states to impose cost-sharing on people with incomes above the poverty level who are enrolled in Medicaid expansion.
- There are also provisions that could potentially penalize states that cover certain immigrant groups, particularly those who are not “qualified aliens” or “children or pregnant women who are lawfully residing in the United States”.
Impact on Medicaid Expansion
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- The bill’s changes could significantly impact Medicaid expansion states, particularly those that have taken steps to expand coverage for immigrant groups.
- Some analyses suggest that the bill could lead to a reduction in Medicaid enrollment and potentially increase the number of uninsured individuals.
What Comes Next?
Now that the House has passed the bill, it goes to the Senate, where Senators will debate and amend the bill. Many Senators, including Arizona’s Ruben Gallego and Mark Kelly have expressed concerns about cuts to Medicaid and have indicated they intend to change or oppose these cuts. If the Senate requires any changes be made to pass the bill, the House and Senate will meet to come to an agreement on any differences. Then the House will have to vote again on final passage before the bill goes to the President to be signed into law.
This process gives us the opportunity to continue our advocacy efforts with U.S. Representatives from Arizona as there’s a good chance the bill may end up back in the House for another vote. As a result, we will continue to encourage our staff, patients, and community members to reach out to Congress through our Medicaid Matters postcards, videos, and individual efforts.
