In a recent interview on CNN, House Speaker Mike Johnson made it clear: the goal isn’t to gut Medicaid—it’s to fix it.
.@SpeakerJohnson: We are NOT cutting Medicaid. There are 1.4 million illegals on Medicaid — and there are 4.8 million able-bodied individuals on Medicaid who choose not to work. That is called FRAUD, and that is what we are eliminating. pic.twitter.com/zL3ZqBDpS4
— Rapid Response 47 (@RapidResponse47) May 25, 2025
After weeks of political noise and partisan spin, Johnson addressed the controversy head-on, saying the reforms passed by the House are about protecting Medicaid by rooting out fraud, waste, and abuse—not slashing benefits for those who need them.
Specifically, he pointed to two groups his plan targets: 1.4 million non-U.S. citizens receiving state-funded health coverage, and 4.8 million able-bodied adults who aren’t working or volunteering.
Reform or Reduction? The Real Story Behind the Numbers
Let’s clear something up: the Congressional Budget Office (CBO) did report that 1.4 million people would lose “other coverage” under the House’s plan.
But these individuals are not losing Medicaid. They were never eligible for full Medicaid benefits in the first place.
That 1.4 million figure refers to people, mostly illegal immigrants, who currently get coverage through state-only programs—programs funded by state taxpayers, not the federal government.
The new bill would penalize states for offering that kind of coverage, encouraging them to redirect those funds toward citizens and lawfully present immigrants who qualify under federal rules.
As Johnson put it: “We’re not kicking anyone off Medicaid—they were never on it to begin with.”
Work Requirements: Accountability or Burden?
Another major provision? Requiring work or volunteer activity for able-bodied adults receiving Medicaid who aren’t elderly, disabled, or primary caregivers.
That’s stirred a lot of pushback, especially from progressive groups.
Critics argue that work requirements won’t help anyone—and might hurt people who are already struggling.
They point to data from groups like the Kaiser Family Foundation (KFF), which says 64% of Medicaid recipients are already working.
The other 36%? Many are in school, caring for children, or have health issues.
But supporters argue it’s about fairness and responsibility.
Lessons from Arkansas—and the Fine Print
Opponents often bring up Arkansas. Back in 2018, the state implemented Medicaid work requirements.
Within months, over 18,000 people lost coverage—not because they were refusing to work, but because of paperwork problems, missed deadlines, or confusion over the rules.
It’s a fair concern. Administrative red tape can be just as damaging as bad policy.
Who Really Loses—and Who Stands to Benefit
At the center of Johnson’s argument is a simple idea: Medicaid should serve the truly vulnerable—not people breaking immigration laws or choosing not to work when they’re able.
He pointed to groups like pregnant women, single mothers, seniors, and the disabled, saying these reforms will ensure more funding reaches them.
That message resonates with many Americans who believe safety-net programs are necessary—but should come with guardrails.
Critics Push Back
Not everyone’s buying it.
Groups like the Center on Budget and Policy Priorities (CBPP) warn that work requirements don’t boost employment—but do lead to people losing health coverage.
They argue that the real fix isn’t punishment, but better outreach and support services to help people find work and stay insured.
Others say this is less about fraud and more about politics—cutting costs at the expense of the poor.
Still, Johnson insists the reforms are both moral and practical.
Speaker Johnson’s Medicaid plan might not be perfect—but it’s not a slash-and-burn cut, either.
It’s a targeted effort to clean up a bloated system and ensure that the most vulnerable Americans don’t get pushed to the back of the line.
The question now is whether Congress—and the public—will view it as a path to integrity, or another political battle over who deserves help, and who doesn’t.
This article was written with the assistance of AI. Please verify information and consult additional sources as needed.
