June 15, 2025

How the GOP Can Win The Medicaid Argument

Republicans in Congress have a big opportunity to fix Medicaid, a health insurance program for low-income Americans. Democrats and the media are already attacking them, claiming they want to take healthcare away from millions. But Republicans shouldn’t back down. They can make a strong case for reforming Medicaid to better serve those who truly need it.

Medicaid has grown far beyond its original purpose. It was meant to help vulnerable people like low-income pregnant women, children, people with disabilities, and the elderly. Now, it covers many able-bodied adults, including single men, which strains the program’s budget. The federal government pays states more to cover these adults—90% of their costs—compared to 50-77% for the most vulnerable groups. This setup pulls resources away from those who need them most.

A 2022 study found that states expanding Medicaid shifted money away from low-income children to cover more adults. Most voters don’t think the government should prioritize healthy adults over poor children or pregnant women. Republicans can argue that fixing this imbalance strengthens Medicaid for those it was meant to serve.

House Republicans are working on a plan to save $880 billion over 10 years by reforming Medicaid. One idea is to make the funding system fairer, so states don’t get extra money for covering able-bodied adults. Another is to add work requirements for healthy adults, which 62% of Americans support, according to a poll. This would ensure Medicaid focuses on the truly needy, not those who could work but don’t.

Republicans also want to stop illegal immigrants from getting Medicaid, which some states allow. They estimate 1.4 million illegal immigrants are enrolled, costing taxpayers billions. By ending this and cracking down on fraud—$543 billion in improper payments over the last decade—Republicans can save money without hurting vulnerable Americans.

Democrats will fight these changes, saying they’re cruel. But Republicans shouldn’t stay quiet. They need to explain that their reforms protect Medicaid for the elderly, disabled, and poor children while cutting waste. If they make this case clearly, they can win over voters and avoid political trouble in future elections.

The lesson from past failures, like the attempt to repeal Obamacare, is that Democrats will attack no matter what. Republicans must go on the offensive, showing how their plan fixes a broken system. If they do, they can reform Medicaid, reduce debt, and keep the program strong for those who need it most.

Based on information from the Wall Street Journal, May 5, 2025

[](https://budget.house.gov/press-release/wall-street-journal-editorial-board-the-gops-medicaid-moment-of-truth)