Speaker Mike Johnson Gives Update on Plans for Medicaid

Speaker of the House Mike Johnson gave an update to Axios on Tuesday regarding plans for Medicaid.

“There’s some talk about work requirements and various aspects, but we haven’t determined the final parameters of it yet. That’ll be a bicameral discussion,” Speaker Mike Johnson told Axios earlier this week.

Republican lawmakers have been toying with the idea of using Medicaid offsets to free up spending for other priorities, such as Trump’s proposed tax cuts.

Why It Matters

Medicaid provides healthcare coverage to roughly 80 million low-income individuals across the United States. It’s also the third most costly federal spending program, behind Social Security and Medicare.

What To Know

Following the November 2024 election, Republicans in Congress once more raised the idea of overhauling Medicaid as a component of a reconciliation bill.

In other words, members are looking to potentially restructure aspects of the Medicaid program to reduce government spending and redirect it toward other initiatives. Reconciliation, in particular, helps to circumvent a potential filibuster in the Senate.

One potential Medicaid restructuring is the implementation of work requirements, as highlighted in Speaker Johnson’s statement—though Axios reported Senate Finance Chair Mike Crapo “hasn’t heard about the discussion of Medicaid work requirements from the House GOP side.”

Imposing work requirements would potentially reduce costs by limiting the number of Americans eligible for the program. Currently, Georgia is the only state actively imposing work requirements for Medicaid eligibility.

What People Are Saying

Alex Beene, financial literacy instructor for the University of Tennessee at Martin, told Newsweek: “It’s unclear what the exact changes [to Medicaid] could be, but if aspects of Medicaid were tied to a work requirement, it could instantly become more difficult for some recipients to qualify for benefits if the demand isn’t possible given their condition. Again, this is all based on comments and speculation, so we can’t say for sure what the future holds. However, possible cuts could definitely provide problems for the wallets of many beneficiaries whose wallets are already strained with other expenses.”

Kevin Thompson, founder and CEO of 9i Capital Group, told Newsweek: “Work requirements would be devastating for many low-income families that have very little coverage outside of the home. Although there may be programs such as the CCDF, one concern for some is making too much money and being kicked from certain programs, which leaves you with a net loss in regard to money to the household.”

Brett Guthrie, House Energy and Commerce Chair, told Axios: “We have to have savings…I’m sure Medicaid reform is going to be a part of it.”

What Happens Next

“I think support will be fairly strong for any package that reduces taxes, but there could definitely be some hesitation from some legislators on expansive cuts to Medicaid,” said Beene.

Beene notes that the broadening of Medicaid services and access in recent years has been popular among voters and that any Medicaid cuts could receive pushback that shapes future elections.

“…I see many legislators taking a considerate approach in the cuts made and the explanations as to why they’re being made,” he said.