Significant cuts to Medicaid could be on the table next Congress as President-elect Trump and Republicans look for ways to offset tax cuts and streamline government spending. Republicans on Capitol Hill don’t seem thrilled with the idea, but aren’t rejecting it outright.

Sen. Chuck Grassley (R-Iowa) said it was too soon to be sure whether Medicaid cuts were coming. “But with this effort to … reform everything, programs, I think it’s something that you can expect. I wouldn't be surprised if we were going to be looking,” he said of the program.

According to the Department of Health and Human Services (HHS), more than 88 million people, including almost 40 million children, were enrolled in Medicaid as of September 2023. It remains the largest source of federal funding for states.

President-elect Trump has vowed to not to touch entitlement programs like Medicare and Social Security, but has made no such promise when it comes to Medicaid, making it a more likely target for budgetary trims.

“Trump has said Medicare, Social Security and Defense cuts are off the table. With Republicans looking for spending reductions to help pay for tax cuts, the math is inescapable. The Medicaid and ACA cuts will then be on the table,” Larry Levitt, KFF executive vice president for health policy, said in a briefing days after Trump was declared the president-elect.

And Trump seemed to send similar signals in his announcement of surgeon, television celebrity and former Senate candidate Mehmet Oz as his nominee to head the Centers for Medicare and Medicaid (CMS).

Trump said Oz would “cut waste and fraud within our Country’s most expensive Government Agency.”

Where Republicans stand

Medicaid cuts would require an act of Congress, and with Trump set to........

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