House Republicans have unveiled a sweeping $880 billion budget proposal that imposes Medicaid work requirements, bans gender-affirming care for minors, and rolls back climate initiatives, igniting fierce backlash over projected coverage losses and political motives.
At a Glance
- House GOP proposes $880 billion in federal spending cuts, primarily targeting Medicaid
- Bill includes work requirements and biannual eligibility checks for Medicaid recipients
- Federal funds for gender-affirming care for minors and certain abortion providers would be banned
- Congressional Budget Office estimates 8.6 million Americans could lose health coverage
- Legislation also seeks to repeal Biden-era climate policies
Sweeping Medicaid Reforms Unveiled
House Republicans, led by House Energy and Commerce Committee Chair Rep. Brett Guthrie, have introduced a budget reconciliation bill that would slash $880 billion in federal spending, with Medicaid facing the most significant cuts. The bill would require able-bodied adults without dependents to work at least 80 hours per month to retain Medicaid eligibility and mandates that states conduct eligibility checks every six months.
The legislation would also prohibit the use of federal Medicaid and Children’s Health Insurance Program (CHIP) funds for gender-affirming care for minors and cut off Medicaid support to organizations that perform abortions, except under exceptions allowed by the Hyde Amendment. As reported by The Daily Signal, these changes reflect the GOP’s broader push to reshape public health funding.
Watch a report: House GOP unveils Medicaid work requirements in Trump’s ‘big, beautiful bill’ (Fox News).
CBO Forecast: Millions Could Lose Coverage
According to a new analysis by the Congressional Budget Office, the proposed Medicaid changes would leave an estimated 8.6 million Americans uninsured over the next decade. Critics warn that the added administrative burdens and work requirements could disproportionately affect low-income individuals and families.
Rep. Frank Pallone Jr. called the bill a “nighttime ambush,” arguing that “hospitals will close, seniors will not be able to access care, and premiums will rise for millions” if it passes. Health policy analyst Larry Levitt told Common Dreams that while the technical details may be complex, the resulting harm is clear and severe.
Climate Rollbacks and MAGA Priorities
Beyond healthcare, the bill also targets multiple climate provisions implemented by the Biden administration. These include the repeal of clean energy tax credits, grants for local decarbonization efforts, and electric vehicle subsidies. As Axios notes, this rollback aligns with Republican efforts to redirect funding toward extensions of the 2017 Trump-era tax cuts.
Critics, including some within the GOP, worry the legislation tilts too far toward ideological goals at the expense of essential services. Sen. Josh Hawley expressed concern to The Guardian that prioritizing corporate tax cuts over working-class healthcare may erode Republican support.
GOP Faces Internal Fractures
Although the bill attempts to consolidate Republican priorities, it has opened rifts within the party. Moderate lawmakers like Rep. Don Bacon have voiced opposition, warning via the Wall Street Journal that the cuts could backfire politically and damage the party’s reputation with swing voters.
As the bill heads into markup in the House Energy and Commerce Committee, its fate remains uncertain—caught between a divided GOP, a unified Democratic opposition, and mounting public scrutiny.
