Proposed Medicaid Cuts: Who Gets Affected and By How Much

Medicaid is the joint federal-state program that provides health coverage to low-income Americans. As of 2026, it covers approximately 72 million people — making it the single largest source of health coverage in the United States by enrollment.

Proposed legislative changes under consideration in Congress include the introduction of work requirements for able-bodied adults, more frequent eligibility re-verification, and reductions in the federal matching rate paid to states. Each of these changes, if enacted, would reduce the number of people covered.

Children represent the largest share of Medicaid enrollees, followed by adults in low-income working families. Contrary to a common misconception, the majority of adult Medicaid enrollees who are able to work are already employed — often in jobs that do not provide employer-sponsored health insurance.

Rural hospitals are particularly vulnerable to Medicaid cuts. In many rural communities, Medicaid reimbursements represent 30–50% of a hospital's total revenue. Reductions in Medicaid funding have historically been linked to rural hospital closures.

The League of Women Voters has identified Medicaid cuts as one of the five most consequential legislative issues of 2025–2026, noting that the downstream effects on public health, hospital systems, and state budgets would be substantial and long-lasting.