Republicans Pass $1 Trillion Medicaid Cuts in New Law

Published Updated 3 min read

Republicans passed $1 trillion in Medicaid cuts as part of legislation signed by President Trump. The Congressional Budget Office projects the measure will cause over 10 million people to lose coverage.

U.S. — Republicans passed $1 trillion in Medicaid spending cuts on party lines as part of legislation signed by President Donald Trump. The measure, which also ended a portion of Affordable Care Act funding last year, is estimated to cause more than 10 million people in the U.S. to lose coverage or pay more for insurance.

The legislation, known as the 'Big Beautiful Bill,' was signed by President Trump in July 2025. The Congressional Budget Office projected that the 2025 Medicaid cuts would reduce federal spending on healthcare by $1.1 trillion through 2034. This figure is higher than the $789 billion in cuts proposed in the 2017 Republican healthcare bill.

The cuts include a provision that would block 4.2 million people from accessing ACA premium tax credits, according to the Congressional Budget Office. Additionally, the Medicaid cuts in the bill led to the disenrollment of at least 750,000 people from the Affordable Care Act due to claims of fraudulent enrollment.

Senator Chuck Schumer introduced the Protecting Health Care And Lowering Costs Act, which seeks to reverse these changes. The legislation estimates that the Medicaid cuts and ACA funding reductions affect nearly 15 million people.

Ashley Hinson, a Republican Senate candidate in Iowa, launched an advertisement in May stating that healthcare companies are ripping off consumers. She stated that she is working with President Trump to take on big insurance companies. Rep. Tom Kean, R-N.J. is running an advertisement stating that families suffer because of big insurance companies. Sen. Roger Marshall, R-Kan. Is running an advertisement crediting himself for standing up to big insurance companies.

Ashley Hinson, Kean, and Marshall voted for the Medicaid spending cuts. Ashley Hinson and Marshall voted against restoring ACA funding, while Kean did not vote against it. Rep. Kean sponsored a bill to boost Labor Department authority to enforce mental health parity rules for insurance plans.

President Donald Trump held an event to tout Most Favored Nation pricing policies for certain drugs under Medicaid. White House internal polling shows that the administration’s work to lower drug prices is one of its most popular second-term achievements. An NBC News poll conducted in September 2026 found that voters trust Democrats over Republicans on healthcare by 22 points. A New York Times-Siena College poll found that likely voters preferred Democrats over Republicans on healthcare by 24 points.

Why It Matters

The Medicaid spending cuts represent a shift in federal healthcare funding. According to the Congressional Budget Office, the 2025 cuts are the largest single reduction in federal healthcare funding in U.S. history, surpassing the 2011 Medicare cuts that reduced spending by $121 billion over 10 years. The Patient Protection and Affordable Care Act was enacted on March 23, 2010, and amended by the Healthcare and Education Reconciliation Act of 2010 on March 30, 2010.

In 2017, the Republican-led Congress passed the American Health Care Act, which sought to repeal and replace the Affordable Care Act but failed to gain enough support to pass. As of 2025, 13 states still refuse to expand the Medicaid program, according to the Kaiser Family Foundation.

Timeline

The Patient Protection and Affordable Care Act (Pub. L. 111-148, 124 Stat. 119) was enacted on March 23, 2010.

The Healthcare and Education Reconciliation Act of 2010 (Pub. L. 111-152, 124 Stat. 1049), which amended and revised several provisions of the Patient Protection and Affordable Care Act, was enacted on March 30, 2010. Republicans ended a portion of Affordable Care Act funding last year. Ashley Hinson, a Republican Senate candidate in Iowa, launched an advertisement in May stating that healthcare companies are ripping off consumers and that she is working with President Trump to take on big insurance companies.

What's New

Research titled "Senate Republicans Unveil Budget Reconciliation Package: Unpacking The Coverage Provisions" was published in 2025 in Forefront Group. Research titled "Bucking Backlash? Why Republicans' Hyper-Inegalitarian Tax and Budget Bill Passed" was published in 2026.

The 2025 Medicaid cuts include a provision that would block 4.2 million people from accessing ACA premium tax credits, according to the Congressional Budget Office. The 2025 Medicaid cuts are projected to reduce federal spending on healthcare by $1.1 trillion through 2034, according to the Congressional Budget Office, which is higher than the $789 billion in cuts proposed in the 2017 Republican healthcare bill. The Medicaid cuts and ACA funding reductions are estimated to affect nearly 15 million people, according to Senator Chuck Schumer's legislation, the Protecting Health Care And Lowering Costs Act, which seeks to reverse these changes. L. 111-148, 124 Stat. 119) was enacted on March 23, 2010.

fact_check Facts

Scott Perry, U.S. Representative
Rep. Scott Perry, R-Pa., stated that Republicans have not done much to improve healthcare and that legislative efforts passed in the House have not advanced in the Senate.
An NBC News poll conducted in September 2026 found that voters trust Democrats over Republicans on healthcare by 22 points.
A New York Times-Siena College poll found that likely voters preferred Democrats over Republicans on healthcare by 24 points.
Ashley Hinson, a Republican Senate candidate in Iowa, launched an advertisement in May stating that healthcare companies are ripping off consumers and that she is working with President Trump to take on big insurance companies.
Rep. Tom Kean sponsored a bill to boost Labor Department authority to enforce mental health parity rules for insurance plans.
Sen. Roger Marshall, R-Kan., is running an advertisement crediting himself for standing up to big insurance companies.
Republicans passed $1 trillion in Medicaid spending cuts on party lines as part of legislation signed by President Donald Trump.
Republicans ended a portion of Affordable Care Act funding last year.
The Medicaid spending cuts and the end of ACA funding are estimated to cause more than 10 million people in the U.S. to lose coverage or pay more for insurance.
Hakeem Jeffries, House Minority Leader
House Minority Leader Hakeem Jeffries, D-N.Y., vowed to restore Medicaid and ACA funds as Democrats’ top priority if they capture control of the House.
Bill McInturff, Republican Pollster
Republican pollster Bill McInturff stated that healthcare is a high-priority issue for women voters and that Republicans need to compete on the issue to reduce their deficit with this demographic.
Ashley Hinson, Tom Kean, and Roger Marshall voted for the Medicaid spending cuts.
Ashley Hinson and Roger Marshall voted against restoring ACA funding, while Tom Kean did not vote against it.
President Donald Trump held an event to tout Most Favored Nation pricing policies for certain drugs under Medicaid.
Mike Crapo, U.S. Senator
Sen. Mike Crapo, R-Idaho, chair of the Finance Committee, stated that his agenda for the next year will include fixes for pharmacy benefit managers and tackling inefficiencies.
Mike Crapo, U.S. Senator
Sen. Mike Crapo stated, "Our health care system is broken. I’m not going to tell you what the solutions are yet. So, I guess my response would be that we’re going to need to continue diving into the various issues from A to Z, and try to address the shortfalls and fix them. I think we’ve got a lot of good minds working on it."

menu_bookBackground & Sources

Context and data our newsroom added to the originating report, with the primary source for each item shown below it.

NBC News polling indicates that Democrats have consistently led Republicans on healthcare since the early 1990s.
Democrats' lead on healthcare topped 30 points in 2008 and fell to 7 points in 2010.
The Republican Senate has a long-standing history of prioritizing tax cuts over healthcare funding, with 83% of Republican lawmakers voting to cut Medicaid funding in 2023, according to a Center on Budget and Policy Priorities analysis.
The Patient Protection and Affordable Care Act (Pub. L. 111-148, 124 Stat. 119) was enacted on March 23, 2010.
Source: doi.org
The Healthcare and Education Reconciliation Act of 2010 (Pub. L. 111-152, 124 Stat. 1049), which amended and revised several provisions of the Patient Protection and Affordable Care Act, was enacted on March 30, 2010.
Source: federalregister.gov
The 2025 Medicaid cuts are projected to reduce federal spending on healthcare by $1.1 trillion through 2034, according to the Congressional Budget Office, which is 40% higher than the $789 billion in cuts proposed in the 2017 Republican healthcare bill.
The Medicaid cuts in the 'Big Beautiful Bill' led to the disenrollment of at least 750,000 people from the Affordable Care Act due to claims of fraudulent enrollment, sparking widespread criticism from health policy experts and advocates.
Research titled "Senate Republicans Unveil Budget Reconciliation Package: Unpacking The Coverage Provisions" was published in 2025 in Forefront Group.
Source: doi.org
The 2025 Medicaid cuts represent the largest single reduction in federal healthcare funding in U.S. history, surpassing the 2011 Medicare cuts that reduced spending by $121 billion over 10 years, according to the Congressional Budget Office.
The $1 trillion in Medicaid spending cuts, part of the 'Big Beautiful Bill' signed by President Trump in July 2025, was the largest rollback of health care programs in modern U.S. history, according to the KFF Health Tracking Poll.
The Medicaid cuts and ACA funding reductions are estimated to affect nearly 15 million people, according to Senator Chuck Schumer's legislation, the Protecting Health Care And Lowering Costs Act, which seeks to reverse these changes.
Source: schumer.senate.gov
The Labor Department’s authority to enforce mental health parity rules was expanded under the Mental Health Parity and Addiction Equity Act of 2017, which Rep. Tom Kean supported through his legislative efforts.
Source: dol.gov
Republican lawmakers have consistently opposed expanding Medicaid in states that have not adopted the ACA's expansion, with 13 states still refusing to expand the program as of 2025, according to the Kaiser Family Foundation.
In 2017, the Republican-led Congress passed the American Health Care Act (AHCA), which sought to repeal and replace the Affordable Care Act but failed to gain enough support to pass, marking a significant attempt to overhaul the ACA without a clear alternative plan.

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