Inside the $880 Billion Republican Plan for Medicaid Overhaul
A key House committee has drafted a far-reaching proposal that would restructure Medicaid eligibility, restrict health care funding for transgender procedures, and dismantle several Biden-era climate initiatives, according to a document obtained by The Daily Signal.
The plan is a critical piece of the House reconciliation bill that will become the mega-bill to pass President Donald Trump’s MAGA agenda.
Last month’s budget resolution tasked the House Energy and Commerce Committee with slashing $880 billion in spending. Since then, swirling rumors—especially about Medicaid cuts—have stirred chaos on Capitol Hill. Now, with Tuesday’s markup looming, the committee’s plan could make or break the House’s sweeping budget reconciliation package.
According to the document, the Energy and Commerce Committee is looking to require states to add community engagement requirements for able-bodied adults without dependents to receive federal Medicaid assistance. These individuals would be required to work or perform community service for at least 80 hours per month. This community engagement requirement would not apply to individuals under 19 or over 64, pregnant women, among other exempt categories.
One section of the forthcoming legislation blocks federal Medicaid and CHIP funding from going to gender transition procedures for minors. Another, the document outlines, would prevent Medicaid dollars from going to nonprofit organizations that focus on family planning or reproductive services, provide for abortions beyond Hyde Amendment exceptions, and received over $1 million in Medicaid payments last year.
The bill takes particular aim at Medicaid benefits directed toward illegal immigrants. One provision of the forthcoming bill aims to ensure proof of citizenship or requisite immigration status is provided before the state doles out Medicaid care benefits, rather than enrolling such applicants immediately and then waiting for proof of citizenship later. Another provision reduces the Federal Medical Assistance Percentage (FMAP) for Medicaid expansion states that provide health care coverage for illegal immigrants under state-run health programs.
The committee is also taking aim at energy subsidies included in former President Joe Biden’s Inflation Reduction Act. While crucial portions of the IRA’s energy subsidies fall under the jurisdiction of the House Ways and Means Committee, Energy and Commerce is looking to repeal these grants and rescind unobligated funds in these programs, such as grants for clean heavy-duty vehicles, diesel fuel emissions reductions, and the Greenhouse Gas Reduction Fund.
The Energy and Commerce Committee is one of three House panels still working to advance its reconciliation bill. Its markup session on Tuesday will be a key factor in determining whether House Speaker Mike Johnson brings the full reconciliation package to the floor before the Memorial Day recess.
