https://issuesinsights.com/2025/05/19/medicaid-end-it-dont-mend-it/
As soon as Republicans mentioned cutting spending on Medicaid as part of their “reconciliation” bill, the usual suspects started rolling out their standard talking points. They’re cutting health care for the poor to pay for tax cuts for the rich! Millions will lose coverage! The disabled will suffer! Oh, the humanity!
Well, if the GOP is going to be accused of destroying Medicaid when all they are proposing is a minor haircut, why not go all out and scrap this hopelessly flawed, fraud-riddled, budget-busting disaster of a program and start over from scratch?
First, let’s dispense with the claim of “devastating” cuts to Medicaid. The House reconciliation bill would reduce Medicaid spending by $625 billion. That might sound like a lot, but it’s stretched out over 10 years, at a time when Medicaid is on track to spend $8.6 trillion. Medicaid spending will still go up every year under the House bill, just a tiny bit more slowly.
What Republicans should really be talking about is giving Medicaid the USAID treatment. Shut it down and start over from scratch.
Let’s line up the reasons.
It was sold on a lie. The original claim made in the mid-1960s was that the federal government and the states would split the cost of Medicaid. But that happened only once: in the program’s first year. Ever since, the federal share has grown while the states’ shares have shrunk. By 2005, states were paying only 42% of Medicaid’s bills. In 2022, the state share dipped below 30%.
Over the past 60 years, states have pressured federal lawmakers to make a multitude of exceptions to the 50-50 split, which lawmakers were only too happy to provide because there is no cap on federal Medicaid spending.