Medicaid is one of the Big Four that along with interest on the national debt take up 70% of the federal budget. Medicare and Social Security are spent on old farts, who generally voted GOP. So that isn't going to get touched. Medicaid goes to both parties...that won't get touched. And Defense is getting ramped up.
By the way, if you're excited about DOGE...good luck.
Medicaid Insures Millions of Americans. How the Health Program Works, in Charts.
The program is a political flashpoint because of its vital role in the lives of adults and children across the country
By Anna Wilde Mathews and Paul Overberg, WSJ
March 24, 2025 5:30 am ET
As Congress gears up to pass President Trump’s massive legislative package, one of the biggest fights is over the future of Medicaid. To make their targeted budget numbers, Republicans will likely need to carve hundreds of billions of dollars in spending out of the health program that serves lower-income people. But Medicaid is a political flashpoint because of the core role it plays in the lives of millions of Americans—many of whom vote for Republicans—as well as state budgets and the healthcare economy.
Here’s why the stakes are so high as lawmakers debate its future.
Medicaid is the biggest government health insurance program in the U.S., covering around 72 million people as of October 2024, or about 79 million when the affiliated Children’s Health Insurance Program, or CHIP, is included—more than Medicare.
Begun in 1965 as a program for needy Americans, including low-income children with caretakers, as well as elderly, blind and disabled people, Medicaid has grown over the years. It cost $872 billion in 2023, most of it state and federal government spending, or about 18% of what the nation paid for healthcare. Enrollment rose during the pandemic, when periodic eligibility reviews were suspended, but since then, millions have been removed from the rolls as reviews resumed.
Today Medicaid, along with CHIP, for low-income children, covers a far larger array of people. Current enrollees include poor adults without children, people with a broad range of disabilities and patients needing long-term care, either at home or nursing facilities.
Medicaid covers a range of medical care including hospital stays, medicines, mental-health appointments, outpatient services and nursing homes—as well as certain ancillary services such as transportation to appointments in some states. Depending on the state, anywhere from 18% to 63% of births are covered by Medicaid.
Medicaid’s big role has made it politically difficult to attack, with both Republican- and Democratic-leaning states relying heavily on the program. Medicaid is also sensitive because of its unique financing, which is a combination of federal and state money. Some states rely more heavily than others on federal funding and might be at more risk from federal cuts, which could require reductions in benefits or enrollment.
A KFF poll completed in February found that about half of American adults, and 45% of those who voted for President Trump, said they or a family member had gotten help from Medicaid at some point. Only 17% of the respondents—and 35% of Trump voters—wanted to see Medicaid funding cut.
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