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How Republicans will cut Medicaid without "cutting benefits" [1]
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Date: 2025-04-28
I just read another post where a Republican Congressman said that he would not cut Medicaid benefits. Yet everyone believes that Medicaid will need to be cut if Republicans are to meet the budget framework that will allow them to give more tax cuts to billionaires. So how can this happen if Republicans say they won’t cut benefits?
The answer is in how Medicaid is funded. While Medicaid is a federal program, it is jointly funded by the states and the federal government . Generally, states are reimbursed for their Medicaid expenditures using a sliding scale in which poorer states have a higher percentage of their expenditures paid for by the federal government, with wealthier states having a lower percentage. For the part of Medicaid that was expanded under the Affordable Care Act the federal matching rate is 90 percent.
So a major way in which Medicaid expenditures is to change either of these rates with the effect that more of the Medicaid cost will be shifted to states. This will reduce federal expenditures without a single Medicaid benefit being cut (although many states then will probably cut benefits, eligibility, etc. because they won’t have the resources to compensate for the reduced federal spending.)
This means that every time anyone has an opportunity to question their representative, they should not ask about “cutting Medicaid.” Instead, they need to ask if they will oppose any change to the existing federal-state funding formula. Otherwise, Republicans will continue to engage in these misleading word games.
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