Alliance Alert: The House Energy and Commerce Committee has advanced a budget proposal that includes sweeping changes to Medicaid, threatening the health coverage of millions. Chief among these proposals are new work requirements and more frequent eligibility checks, which would erect bureaucratic barriers rather than address fraud. These changes are not about integrity—they’re about exclusion.
If implemented, these measures are projected to strip coverage from an estimated 7.6 million Americans over the next decade. The Congressional Budget Office confirms that the Medicaid cuts—disguised as “savings”—would reduce access to health services for millions of low-income families, children, people with disabilities, and seniors.
These so-called work requirements are paperwork traps. Data shows that the vast majority of adult Medicaid recipients are already working, caregiving, in school, or unable to work due to illness or disability. But many of them will lose coverage simply because they can’t keep up with reporting requirements or miss a deadline. This is not hypothetical—it already happened.
Arkansas is a cautionary tale. When the state implemented work requirements in 2018, more than 18,000 people lost coverage in just seven months. There was no evidence the policy increased employment—it just made people sicker and poorer.
Even very conservative Republican leaders are pushing back. In a NY Times opinion piece this week, Senator Josh Hawley warned that Medicaid cuts would devastate working families, close rural hospitals, and betray voters who supported expansion through ballot initiatives. In his own words: “Our voters support social insurance programs. More than that, our voters depend on those programs.”
This moment calls for national advocacy and a clear message: Do not dismantle Medicaid to score political points!
We urge all advocates who want to save Medicaid’s essential safety net function to:
- Call your U.S. Representative, especially if they’re a House Republican, and demand they vote against Medicaid cuts.
- Share your story or the stories of people impacted by Medicaid in your community.
- Mobilize your networks—organize town halls, social media campaigns, or letter-writing efforts to build public pressure.
To help these efforts, the Alliance for Rights and Recovery has launched an action alert system to help community members across the country contact their representatives and urge them to protect Medicaid.
Send your message today:
ACT TODAY!
We need Congress to hear from the people who rely on Medicaid—not just lobbyists or political strategists. Let’s protect our health coverage, our services, and our communities.
Medicaid is a lifeline, not a loophole. It’s time to reject cruel policies that will force millions to fall through the cracks. Let’s stand up together—because health care is a right, not a privilege tied to paperwork!
Medicaid Cuts Inch Closer
By Kelly Hooper and Chelsea Cirruzzo | Politico | May 15, 2025
MARATHON MARKUP CONCLUDES — After a 26-and-a-half-hour markup, Republicans on Wednesday advanced the health care section of the GOP’s sweeping tax bill that would slash Medicaid spending by hundreds of billions of dollars, POLITICO’s Ben Leonard and Alice Miranda Ollstein report.
The House Energy and Commerce Committee, in a 30-to-24 party-line vote, advanced a draft bill that would make major changes to Medicaid while omitting many of the most controversial changes initially considered — appealing to moderate Republicans worried about triggering coverage losses that would spark political blowback in swing districts.
But hard-liners elsewhere in the GOP conference are still demanding even steeper cuts and complain the bill’s work requirements don’t kick in until 2029. Republican leaders will have to decide how to handle those disagreements before the full House votes on the legislative package — tentatively scheduled for next week.
Why it matters: The Medicaid portions of the GOP megabill would already lead to 10.3 million people losing coverage under the health safety-net program and 7.6 million people going uninsured, according to partial estimates from the CBO released by committee Republicans.
GOP leaders could also struggle to get a provision in the E&C draft bill defunding Planned Parenthood over the finish line. Several centrist Republicans not on the committee oppose targeting the organization, which provides contraception, testing for sexually transmitted infections and other health services in addition to abortion.
The daylong markup: During the marathon markup that started Tuesday evening, Republicans voted down a slew of Democratic amendments, which included stripping out or softening provisions to impose Medicaid work requirements and charging Medicaid recipients co-pays of up to $35 for health services. Meanwhile, Democrats railed against both GOP policies, arguing they punish the poor to finance tax cuts for the rich.
Chair Brett Guthrie (R-Ky.) and committee Republicans defended the provisions as fiscally responsible and politically popular and argued they have learned from states’ rocky implementation of work requirements when crafting the legislation.
Democrats grilled their GOP counterparts and the committee’s Republican counsel on how the provisions would function in practice — asking how soon patients would be subject to work requirements after being hospitalized for a mental health crisis and what counts as disability that qualifies someone for an exception.
“Everyone will suffer,” Ohio Democratic Rep. Greg Landsman said. “The result will be millions and millions of people who won’t get health insurance, and most of them are probably eligible.”
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Democrats Take Aim at GOP’s Medicaid Work Requirements
By Ben Leonard | Politico | May 14, 2025
Democrats aggressively oppose all elements of a Republican proposal to overhaul Medicaid as a way to cut spending — but they are now zeroing in on the specific proposal to make work requirements a condition of qualifying for the program.
The messaging tactic was crystallizing in the early morning hours of Wednesday, as the House Energy and Commerce Committee continued its marathon markup of its portion of the GOP’s larger party-line package of tax cuts and extensions, border security investments, energy policy and more.
“What I believe you’re doing, not intentionally, is figuring out every way possible for them not to qualify, either because they can’t fill out the paperwork [or] they don’t know how to do it,” said committee ranking member Frank Pallone (D-N.J.) to Republicans of the effect of their policies on Medicaid recipients.
The work requirement proposal being considered would produce the biggest savings of any other policy in the House Energy and Commerce Committee’s draft bill, accounting for nearly $301 billion over a decade, according to a Congressional Budget Office estimate released by panel Republicans. That level of savings is even higher than many people had anticipated, indicating there would be significant uninsured rates as a result of the policy: The CBO estimated that the Medicaid portions would lead to 7.6 million people losing Medicaid benefits.
Other Democrats also made the case that the work requirements amounted to paperwork requirements. Health subcommittee ranking member Diana DeGette (D-Colo.) pointed to KFF data showing that among adults on Medicaid not getting Social Security or Medicare, 92 percent worked full or part-time. She argued it would lead to major coverage losses, including among patients who are eligible for exemptions due to those very same paperwork burdens.
“You can’t just cut $715 billion in Medicaid without slashing benefits for people,” DeGette said, referring to the preliminary CBO estimate of the savings expected to be achieved through the health policy portions of the GOP megabill.
Energy and Commerce chair Brett Guthrie (R-Ky.) said Republicans have learned lessons from previously-attempted work requirements in Arkansas, including the advantages of avoiding “overly cumbersome” monthly checks.
“We don’t want to repeat the Arkansas model,” Guthrie said, detailing a laundry list of exemptions.
Rep. Alexandria Ocasio-Cortez (D-N.Y.) shot back that Republicans have also looked to Georgia’s Medicaid work requirements in the program to help inform the bill, noting the state has “the third most catastrophic uninsured American number in the country.”
“They are modeling and completely retrofitting the United States’ Medicaid system to model it after [Georgia] in the dead of night, at 2:38 in the morning, when everyone is asleep, when we’ve asked for the opportunity to do this in the light of day, so people can call their representatives’ offices in order to stop this disaster,” she continued.
Amid the debate, Rep. August Pfluger (R-Texas), said the work requirements would merely prevent able-bodied adults who don’t want to work from getting coverage. He asked Rep. Raul Ruiz (D-Calif.) if he thought there should be any sort of work requirement to get Medicaid benefits.
“No. That’s an easy one,” Ruiz said.
After hours of debate, Republicans in unison voted down an amendment that would have required the Health and Human Services Secretary to certify that the GOP bill would not reduce any Medicaid benefits offered by states, pointing to President Donald Trump’s repeated pledges to protect the program.
“We will not touch essential health care services for vulnerable populations,” said health subcommittee chair Buddy Carter, a Georgia Republican who recently launched a bid for Senate in 2026.