this post was submitted on 12 Mar 2025
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CHANG: Now, the budget bill does not specifically mention Medicaid, but that's because the budget just gives instructions to lawmakers on the committee that oversees Medicaid to find $880 billion in cuts over the next decade. The legislation doesn't explain exactly where lawmakers should make those cuts, so I started by asking Park very simply, can Congress find $880 billion in federal savings without cutting spending for Medicaid?

PARK: It cannot, unless you're cutting Medicare, and both Speaker Johnson, other House Republican leaders and President Trump have said that they do not want to cut Medicare. So if you take Medicare off the table, Medicaid constitutes 93% of all mandatory spending that remains under the jurisdiction of the Energy and Commerce Committee.


CHANG: Speaker Johnson has talked about how there is about $50 billion worth of fraud in Medicaid each year. Is that an accurate estimate? I'm just curious.

PARK: It is not. What he's trying to do is equate a measure that's used in the federal government to assess improper payments. But he's trying to equate these improper payments as fraud, and the vast majority of improper payments are not because the payments shouldn't have been made, but there were some errors in terms of the documentation related to that payment or errors in terms of some of the procedural steps that were taken in making those payments. But there's no finding that that was actually fraud or even payments that should not have been made.


PARK:...So states are essentially left holding the bag. They're going to have to make the painful choices in terms of cutting eligibility, cutting benefits, cutting payments to providers like hospitals and nursing homes that serve Medicaid beneficiaries. And in fact, that's one of the reasons it's politically attractive to some federal policymakers, is because they're not explicitly cutting Medicaid benefits. They're making states, legislatures, governors have to make the politically difficult choices, the politically painful choices that they'll have no choice but to make in light of these massive cost shifts that they could face.

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[–] tal 1 points 2 weeks ago* (last edited 2 weeks ago)

The above has a NPR summary addressing what I think the major points of misinformation are surrounding the Medicaid issue. This is where a lot of the cuts are happening.

  • Cuts are not just "waste, fraud, and abuse", which is a hand-wavy justification for how cuts can occur without impacting services, and where the claimed numbers are coming from there.

  • Congress is going to cut Medicaid (or Medicare, but this is considered unlikely). They cannot meet their budget numbers otherwise.

  • The reason that "Medicaid" does not show up in the budget is not because, as Speaker Johnson has asserted, there are no cuts to Medicaid. It is because the budget, if passed, will force states to perform the cuts. Federal legislators will not be required to perform the politically-damaging action of directly cutting Medicaid themselves.