To pay for Donald Trump’s tax cuts for the wealthiest Americans and big corporations, the GOP has outlined a sweeping $5 trillion in cuts from Medicare, Medicaid, and the Affordable Care Act.
These government-funded health care programs support 70 million elderly, poor, and disabled Americans. If the plan goes forward—which it is likely to in the GOP-led House and Senate—it could have devastating impacts on U.S. health care.
In their 50-page memo, Republicans outline how they would use a 10 percent tariff on all imports to save the government money—at the cost of American consumers.
If implemented, the GOP’s plan would strip undocumented immigrants’ eligibility for health care, cut Affordable Care Act expansion, implement requirements for Medicare that experts say would remove 600,000 recipients, and create “site neutrality” that would force doctors to perform procedures in their offices instead of outpatient hospital settings.
Site neutrality is the idea that patients should pay the same price for the same service, regardless of where it’s performed. The goal is to reduce health care costs and promote the viability of independent practices—at the expense of potentially making a patient less safe due to not being in a hospital setting when they receive intensive care.
Trump recently signed an executive order repealing President Joe Biden’s prescription price caps for people on Medicare and Medicaid, calling them “deeply unpopular” and “radical.” He also issued a directive Tuesday to prohibit any public communication from the Department of Health and Human Services until it is reviewed and approved by a presidential appointee.
The Republican plan would reduce the federal government’s Medicare cost burden, leaving states to pick up the slack.
Health care has long been a target for Republicans, primarily because it’s one of the largest items in the federal budget, accounting for nearly a quarter of all federal spending—an estimated $1.7 trillion in 2024 alone. Cutting these programs is part of a broader strategy to reduce federal spending, but it’s also one that could disproportionately harm the most vulnerable Americans.
In response to the anticipated slashes, Democrats like Sen. Elizabeth Warren of Massachusetts voiced their opposition in a letter to HHS nominee Robert F. Kennedy Jr. earlier this month.
“I am concerned about Republican proposals to cut Medicaid in order to pay for proposed tax cuts to ultra-wealthy individuals and large corporations,” Warren wrote.
“The House Republican Contract Against America will end Medicaid as we know it, destroy the Affordable Care Act, and eliminate the mortgage interest deduction, which will raise costs on tens of millions of working-class and middle-class Americans,” House Minority Leader Hakeem Jeffries said in a press conference Thursday, adding that Democrats vow to push back on the agenda “with every fiber in our body.”
The GOP’s proposed cuts would upend the lives of millions of people, all for the benefit of the wealthiest Americans and corporations. Will that stop them, though? Not likely.
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