The Democrats' warnings that the Republican-led "One, Big, Beautiful Bill" will bring the fall of Medicaid – government-provided health insurance funded at both the federal and state levels for low-income Americans – do not check out.
The bill proposes significant changes to Medicaid, including at least $715 billion in cuts over the next 10 years. That could result in almost 14 million people losing health coverage, according to the American Association of People with Disabilities (AAPD).
But are those people even eligible for Medicaid in the first place?
The bill includes provisions aimed at reducing waste, fraud, and abuse by removing individuals who are illegal, duplicate enrollees, or otherwise ineligible.
There are also work requirements for the able-bodied; they do not have to be paid jobs but can be community service instead.
The bill also includes cost sharing for able-bodied adults who are eligible for Medicaid expansion that would come in the form of copayments, coinsurance, and deductibles.
Cost sharing would not apply to individuals with incomes below 100% of the federally recognized poverty level. Children, pregnant women, and individuals with disabilities or chronic conditions would also be exempt, and there would be flexibility for states to design their own cost sharing strategies.
What's she talking about?
As of December 2024, 78.5 million Americans were enrolled in Medicaid or its sister program, Children's Health Insurance Program (CHIP).
Senator Elizabeth Warren (D-Massachusetts) angrily described the bill's Medicaid goals in recent comments in her home state.
"This bill would cut Medicaid, gut the Affordable Care Act, and slash food assistance," she said. "If it passes the Senate, this bill will rip healthcare away from 14 million people – over a quarter of a million right here in Massachusetts – all to pay for handouts to billionaires."
"This Republican bill will raise costs for working families from groceries to healthcare to utility bills while making the richest Americans even richer," Warren added.
Mark Tapscott, senior congressional analyst with The Washington Stand, the Family the Research Council's outlet for news and commentary from a biblical worldview, told "Washington Watch" Thursday that he has listened to that clip multiple times and has "yet to figure out anything that she says that has a factual basis to it."
He noted new analysis from The Foundation for Government Accountability, a Florida-based group, that shows one out of every five dollars spent on Medicaid is an improper payment.
"It's going to somebody who should not be getting it," he summarized. "If you eliminate all of those improper payments, you're not reducing coverage for anybody; in fact, you might be making it possible to improve the coverage."
Republicans have consistently defended their reform efforts, emphasizing that changes are designed to protect benefits for the most vulnerable and to ensure the programs' sustainability. They contend reforms are needed to prevent misuse of taxpayer funds.
"If you eliminate fraud, waste, and abuse in Medicaid, you've got a huge amount of money that you can spend on real priorities for the country," House Speaker Mike Johnson has said.
Ohio Republicans agree. The legislature there is considering new requirements for Medicaid.
Critics say their proposal would end coverage for more than 60,000 Ohioans, but Suzanne Bowdey, The Washington Stand's editorial director and senior writer, told Perkins legislators have found that 30% of Ohio enrollees were actually ineligible for the program.
This news comes as Ohio Democrats are pushing for Medicaid expansion.
"They found a number of people who were millionaires who had Medicaid, a number of people who had assets worth $10,000-$999,000 who are receiving Medicaid," Bowdey relayed. "It's just a shocking abuse of taxpayer waste."
Ohio currently has almost 2.9 million citizens enrolled in Medicaid and CHIP.
Not hard to find Medicaid fraud
Bowdey suggested the fraud uncovered in Ohio, a red state, makes one wonder what might be hiding in the weeds elsewhere.
"Multiply that by 49 other states, then look at the blue states where governors have been able to really abuse this system and put people on who are work-capable or able-bodied," she figured. "You have, in many cases, illegal immigrants; as we've seen Mike Johnson say, there are over 1.4 million illegal immigrants. This doesn't even account for that."
Tapscott said that Medicaid reforms in the House bill are on the right track. What changes the Senate might make remain to be seen.
"I'm always hesitant to make a value judgment about legislation before we see the final version," he noted. "Who knows what the Senate's going to do to it?"
But if the goal is to make government more efficient, he said the Big, Beautiful Bill is "certainly a significant step forward."
According to the latest data, California dwarfs all other states in Medicaid with 13.9 million combined enrollees. By comparison, there are 6.6 million in New York, 4.1 million in Texas, 3.7 million in Florida, 3.2 million in Illinois, and 3.1 million in Pennsylvania.
