NEJM February 26, 2025
A top priority for Congress and President Donald Trump is extending and expanding tax cuts expiring at the end of 2025. To enact these cuts, congressional Republicans plan to use budget reconciliation, an expedited procedure that bypasses the Senate filibuster. Republican leaders in the House intend to make at least $880 billion in Medicaid cuts over 10 years to offset some of the tax cuts’ $4.5 trillion cost. Although members of the House and Senate disagree on timing and various components of a budget resolution and a budget-reconciliation bill, Medicaid is clearly on the chopping block.
Medicaid, however, is more essential than it has ever been. It provides affordable, comprehensive health coverage to more than 72 million low-income Americans.1...