By Sid Salter
Columnist
Since the U.S. House of Representatives passed a budget resolution that calls for a
$2.3 trillion cut to mandatory spending over the next decade. Republican lawmakers are
working to make $880 billion of those cuts in the Medicaid program.
The Congressional Budget Office has established that cuts of that size would
necessitate Medicaid program cuts, despite repeated promises from President Trump
that he and his cabinet would not cut the program. Trump did say he intends to cut
“fraud” and waste from the program.
House Democrats believe that a Medicaid cut of $2.3 trillion, or about a third of
projected Medicaid spending. Medicaid is a joint federal-state program that covers
medical costs for the poor, the blind, people with disabilities, the elderly, and children.
House Republicans say their counterparts across the aisle are engaging in fear-
mongering and political grandstanding as the word “Medicaid” is not mentioned in the
budget resolution.
Democrats claim Medicaid in Mississippi covers more than 640,000 Mississippians, or
over 25% of the state’s total population.
Further, they claim a congressional cut of one-third of federal Medicaid funding across
all segments could result in 120,000 rural residents and 110,000 children losing their
health coverage, as part of a total of over 200,000 people who would be left without
Medicaid coverage. As many as 1-in-4 senior citizens could lose their nursing home
care.
Mississippi remains one of 10 states that have not adopted some form of Medicaid
expansion or so-called “Obamacare” to draw down additional federal funds to pay for
health care for the working poor.
The decision not to expand Medicaid has left an estimated 166,600 uninsured non-
elderly adults in the state ineligible for Medicaid coverage under the Affordable Care Act
standard.

Like the two major parties in Congress, advocacy groups are likewise split on the issue
depending on their political or policy leanings. The liberal Brookings Institution holds
that Medicaid cuts are dictated by the GOP-backed proposal.
“Two types of potential cuts—lowering the federal matching rate for the Affordable Care
Act Medicaid Expansion and implementing work requirements—would be especially
harmful to 50–64-year-olds, who are less likely to be able to work and more likely to
have existing or emerging health issues. Work requirements would significantly reduce
insurance enrollment without boosting employment, and these impacts are likely to be
larger for this population,” Brookings concluded.
The conservative Heritage Foundation saw it from a different perspective: “During the
COVID-19 pandemic, Medicaid had a significant surge in enrollment. Due to restrictions
on the states preventing them from verifying eligibility during the pandemic, total
enrollment jumped from 70 million in February 2020 to a high of 94 million in April 2023.
“Allow work requirements as a condition of receiving benefits. Like in other welfare
programs, certain able-bodied Medicaid enrollees should be required to work or look for
work as a condition of receiving benefits. The first Trump Administration approved
several state proposals to put in place a work requirement. The Biden Administration
rescinded those agreements.”
While disagreements between the state House and Senate are present, it’s unlikely the
Mississippi Legislature will make any significant changes to the existing Medicaid
program until President Trump brings more clarity to his stance on Medicaid and until
Congress acts on the legislation.
In a relatively poor state like Mississippi, Medicaid remains too volatile a program for
missteps by state leaders.
Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com.