July 8, 2025
The big, beautiful truth about Medicaid reform
By Wendi Strauch Mahoney
Critics of the “One Big Beautiful Bill Act“ (OBBB, H.R. 1) have sounded the alarm, claiming that millions of Americans will lose health insurance, particularly under Medicaid. Many have highlighted Congressional Budget Office projections estimating that 7 to 10 million individuals could lose coverage over the next decade. But those numbers—though perhaps technically accurate—deserve closer scrutiny. The truth is more complicated and far less catastrophic than headlines suggest.
Rather than gutting Medicaid, Congress sought to rein in the program’s unsustainable growth, restore its original purpose, and protect it in the long term for the truly vulnerable. The debate over Medicaid reform deserves clarity, not fear. Far from gutting the program, the Big Beautiful Bill may be the first serious effort in decades to preserve it. Here’s what the legislation actually does—and why the dire warnings are misleading.
The Current Trajectory Was Not SustainableDuring the COVID-19 public health emergency, Medicaid enrollment surged due to a federal requirement that states keep recipients continuously enrolled. From 2020 to 2023, Medicaid/CHIP enrollment grew by 23.3 million, reaching nearly 95 million, primarily due to the continuous enrollment provision. However, many of those same Americans saw their incomes recover or exceed eligibility limits post-pandemic, which means they should no longer be eligible for the programs.
As a result, Medicaid now covers nearly 1 in 4 Americans and is projected to consume more than a third of many state budgets within a decade. The OBBB reduces federal spending by roughly $930 billion over ten years by curbing provider taxes, trimming supplemental payments, and tightening eligibility enforcement. These are better characterized as structural corrections than indiscriminate cuts.
more
https://www.americanthinker.com/blog/2025/07/the_big_beautiful_truth_about_medicaid_reform.html
