Those caring for relatives with severe disabilities say planned Republican cuts will be fatal for some

The bill will cut Medicaid across the US by 7.6 million to 10.3 million people, according to Congressional Budget Office estimates, with the majority of the cuts as a result of work reporting requirements, increasing barriers for enrollment and renewal of Medicaid coverage, and limiting states’ ability to raise state Medicaid funds through provider taxes.

Medicaid recipients and advocates are warning of the negative impacts of work reporting requirements, pointing to the examples of the two states to have already tried work requirements for Medicaid, Georgia and, briefly, Arkansas. In both states, there was a significant increase in individuals without health insurance and medical debt, and no boost in employment, one of the Trump administration’s key arguments for imposing the requirements.

The Medicaid work reporting requirements would begin in December 2026, with proponents of the reporting requirement for able-bodied adults to work, volunteer or attend an education program at least 80 hours a month. The change comes after the Republican House speaker, Mike Johnson, claimed Medicaid recipients were “taking advantage”, “cheating” and “defrauding” the system.