Guy Ciarrocchi: They did not cut Medicaid (for better or worse)

Medicaid spending is set to increase in 2026 by 6.8 percent. It will grow by the same amount in 2027, too. 

Those are facts. The “big, beautiful bill” doesn’t reduce spending in 2026 or 2027. Many of the reforms don’t even take effect until January 2027. And, the cost restructuring — placing more burdens on states to design their own plans — doesn’t begin until 2031.

All of the yelling, theatrics, and warnings of death are built on misinformation, lies, or cynical politicians trying to gain political power. They do not care that innocent people — seniors, families with children, or the disabled — might become frightened. It’s just a cost of doing business for the Left and their quest for an insatiable, ever-growing, ever more powerful federal government. 

But, what about the “cuts?” The fact is there is no direct cut to Medicaid spending. And under this law, not one citizen who is supposed to be helped loses one dollar: not one senior citizen, no child, no truly disabled person. There will likely be even more money per person available once the reforms kick in.

Only politicians, leftwing activists and their allies in the legacy media would call increased spending “cuts.” Why do they scream about “cuts?” Because they always want a lot more spending. So, when they only get “some” more spending, they scream and wail like a child who “only” got one scoop of her favorite ice cream.

As has been detailed, when the Left expects 10 percent annual increases in funding, and a new budget provides “only” 6.8 percent; they scream about “cuts.” 

The sad political reality is that the Left talks about death and despair as a rhetorical tool. To grab attention. To instill fear. To try to pull voters away from Trump and the GOP.

Plus, many on the Left are screaming about “cuts” to avoid what they’re really defending, but won’t say out loud.

What they are really angry about are the reforms in the “big, beautiful bill.” The Left hates any limits being placed on the scope of the budgets of their pet projects. There are reforms in the bill that slow the growth, ensure that the money spent goes only to those truly deserving and in need, and that money is not wasted. (By the way, when the economy grows, and more poor people get jobs and don’t need Medicaid — and, therefore, less money is needed for Medicaid — that’s a good thing for everyone.)

The federal government will stop paying for Medicaid for illegal immigrants. It’s not surprising that the Party that let them in, gave them housing and cell phones, and even allows them to vote in local elections is angry that taxpayers won’t also pay for their unlimited medical coverage.

Additionally, able-bodied, single citizens will be required to work or volunteer 20 hours per week to get Medicaid. This is the same principle applied to welfare assistance — that had required 40 hours per week. This is a fairness principle that President Clinton signed into law, and those Democrats even campaigned on. And while President Obama loosened the Clinton reforms, no Democrat-controlled Congress ever repealed those work requirements for welfare.

Yet, we hear that Democrats in 2025 are outraged that even a 20-hour volunteer requirement is being put in place. Again: for single, able-bodied adults. Not one child. Not one senior citizen. Not moms with kids. Not anyone who is disabled and cannot work. Plus…even if a citizen is a single, able-bodied adult, you may get a waiver to get Medicaid coverage if you are caring for someone who is gravely ill or elderly.

A third reform that protects taxpayers and slows Medicaid’s rate of growth — another battle line for the Left: “Covid emergency” coverage is ending. In 2026 — six years after Covid was discovered, four-and-a-half years after the vaccine, four years after every school was finally re-opened and everyone went back to work, the “big, beautiful bill” finally ends the flow of taxpayers dollars on another Covid “emergency” provision.

Lastly, there is a heightened focus on waste, fraud and abuse — coming out of the work of DOGE and Congressional oversight. Democrats mock this approach citing studies that “only” five to eight percent of Medicaid spending is obtained fraudulently. Sadly, to Democrats in Congress, targeting five to eight percent of spending is not worth addressing, yet slowing the rate of growth of a pet program will allegedly cause death and destruction.

Democrats are angry that illegal immigrants will no longer get Medicaid. Democrats are angry that anyone getting taxpayer-funded benefits should have to contribute to society — or, heaven forbid, strive to get off benefits. They’re angry that another Covid chapter is closing. And they’re angry that any program should come under the microscope for waste, fraud and abuse. 

Most of all, they’re just angry.

Medicaid isn’t being cut. The reforms will lead to even more money being available for those truly in need and deserving.

No taxpayer money for illegal immigrants, no more extra “Covid” money, and if you want Medicaid and are an able-bodied, single adult, you have to work or volunteer. That will cause people to contribute and give back — and some people to find work. These are good things.

For better or worse, Medicaid is not being cut. It’s being reformed. This isn’t a problem. Those screaming are the problem.

Guy Ciarrocchi is a Senior Fellow with the Commonwealth Foundation. He writes for Broad+Liberty and RealClear Pennsylvania. Follow Guy at @PaSuburbsGuy