Congressional Republicans are considering a budget reconciliation package that would make significant changes to Medicaid and the Affordable Care Act (ACA). For example, the Energy and Commerce Committee released legislative text that includes work and reporting requirements for certain Medicaid enrollees and codifying changes in a recent Trump Administration proposed rule on the ACA Marketplaces, among other policy changes.

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The House and Senate are working on legislation to meet the requirements in the budget resolution, which targets cuts to Medicaid of up to $880 billion or more over 10 years. Although it is unclear what specific policies will be included in the final reconciliation bill, significant reductions in Medicaid spending would likely impact hospitals given that the program accounted for about one fifth (19%) of all spending on hospital care in 2023.

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The recently passed budget resolution targets cuts to Medicaid of up to $880 billion or more over a decade to help pay for tax cuts. Major cuts to Medicaid may impact coverage for the almost 1 in 5 Medicare beneficiaries (11.9 million) who are also enrolled in Medicaid.

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