Republicans missed a shot at serious Medicaid reform

Every decade since the 1970s, Congress has tried and failed to reform Medicaid, the health entitlement for the poor. Republican lawmakers' latest effort — as part of the One Big Beautiful Bill Act — appears to be no different. Instead of addressing the program's core deficiencies, the party instead fixated on shrinking it. The likely result? Needless disruption and little in the way of serious savings or reform.

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All told, the bill seeks to cut about $I trillion from federal Medicaid spending over a decade. This savings largely would be achieved through a series of technical changes that nonetheless would be costly and difficult to implement, and thus may not fully materialise, according to the Tribune News Service.

The most substantial amount in theory would come from adding “work requirements” for beneficiaries. Starting next December, Medicaid recipients under age 65 will need to work, seek employment, go to school or volunteer 80 hours a month, with exemptions for pregnant women, parents with children under 14, the “medically frail” and others. The goal is to save money by shrinking the pool of enrollees — without cutting benefits for those still eligible or dramatically increasing the uninsured rate.