GOP's Medicaid Reforms are Reasonable

Victor Joecks on May 27, 2025

Republicans need to explain the Medicaid reforms in President Donald Trump's big, beautiful bill, not run away from them.

Early Thursday morning, House Republicans passed their version of Trump's big, beautiful bill. It contains tax cuts, money for immigration enforcement and a partial rollback of handouts for green energy projects. It also includes nearly $800 billion in Medicaid spending reductions over the next decade.

Democrats are already attacking Republicans on that issue.

"Because of this House Republican bill, if it were to pass and become law, people will die," House Minority Leader Hakeem Jeffries, D-N.Y., said days before it passed.

Former President Barack Obama's chief of staff and failed Chicago mayor, Rahm Emanuel, argued Democrats should make this their chief campaign issue. He claimed, "Trump and the GOP Congress want to cut taxes on well-connected billionaires by slashing health care for working families."

"House Republicans passed the largest cuts to Medicaid in history," Nevada Rep. Susie Lee wrote on X. As a result, "thousands of Nevadans and millions of Americans will lose healthcare."

Sounds scary. And it will be unless Republicans tell the public the full story. Trump's bill doesn't kick poor kids off the program. It reduces future Medicaid expenditures by imposing a work requirement on healthy adults. To stay eligible, they would need to work or volunteer for 80 hours a month. Alternatively, they could devote 40 hours a month to their education.

It would penalize states that enroll illegal immigrants. It would implement enhanced address verification. It would end payment for genital mutilation surgeries.

Look at that list again. It's laughable to suggest that requiring people to work or volunteer 20 hours a week will cause them to die. Emanuel's claim that Republicans will slash health care for working families doesn't add up, unless he's referring to illegal immigrants. Some people will lose their subsidized health care. However, if someone isn't willing to engage in part-time work to keep it, Medicaid must not be too valuable to them.

Republicans need to articulate why assistance programs like Medicaid should be a safety net, not a hammock. The obvious reason is that the country can't afford it. People keeping more of their own money didn't cause the country's $36+ trillion national debt. It's the spending, stupid.

Another reason is that work is a good thing -- for individuals and society. The Democrats' vision is a country where people depend on the government from birth to death. Republicans' vision is a country where people get off their backsides and improve their lot in life by working hard.

The appeal of the former is that it's easy. Individuals can remain in an electronic or drug-induced stupor when Uncle Sam is handing out "free" housing, food and health care.

The appeal of the latter is that it's meaningful and a path to a better life. Work isn't just something to pass the time. It creates value for yourself and your community. It gives purpose. It's a way to provide for your family and offspring. It's something you can be proud of. It builds your skills so you can do something in five or ten years that you couldn't do today.

The public understands this. Polling shows that work requirements are popular with the public.

Republicans also need to sell the contrast. Tell voters that Democrats want to protect Medicaid for illegals. Instead, the GOP wants to ensure Medicaid is there for truly needy Americans, while working American families receive an expanded child tax credit.

Even with the propaganda press running interference for Democrats, those are winning arguments. But Republicans must make them.

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Victor Joecks is a columnist for the Las Vegas Review-Journal. Email him at vjoecks@reviewjournal.com or follow @victorjoecks on X. To find out more about Victor Joecks and read features by other Creators Syndicate writers and cartoonists, visit the

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