Democrats are warning of the possibility of devastating cuts to Medicaid, as House Republicans in Washington move ahead with legislation to enact President Donald Trump’s agenda.

On a nearly party-line vote Tuesday, House Republicans advanced a budget blueprint, setting the framework for the eventual spending package. As part of the final bill, Trump is seeking massive tax and spending cuts alongside new funding for immigration enforcement. 

What You Need To Know

  • On a nearly party line vote Tuesday, House Republicans advanced a budget blueprint, establishing their framework for an eventual bill to enact President Donald Trump's agenda.

  • House Democratic Leader Hakeem Jeffries, who rallied alongside fellow Democrats on the House steps ahead of the Tuesday vote, argued the GOP blueprint would “set in motion the largest Medicaid cut in American history.” Democrats argue it is just a framework and no cuts are so far specified.

  • As of 2023 in New York, some of the highest concentrations of Medicaid beneficiaries are found in the Democrat-represented congressional districts of the Bronx, northern Manhattan, and parts of Brooklyn, though the program touches every corner of the state - both red and blue.
  • Experts warn that major federal Medicaid cuts would have ripple effects in Albany, potentially undercutting unrelated state programs. 

In New York, approximately 7 million people are currently enrolled in Medicaid, according to the State Department of Health. Of that, more than 4 million reside in the five boroughs.

House Democratic Leader Hakeem Jeffries, who rallied alongside fellow Democrats on the House steps ahead of the Tuesday vote, argued the GOP blueprint would “set in motion the largest Medicaid cut in American history.”

“Families will be devastated. People with disabilities will be devastated,” he said.

Rep. Adriano Espaillat, in an interview with Spectrum News, likened the GOP plan to “a tax break for the very rich at the expense of people's health and people's lives.”

As of 2023 in New York, some of the highest concentrations of Medicaid beneficiaries are found in the Democrat-represented congressional districts of the Bronx, northern Manhattan and parts of Brooklyn, according to data compiled by the Georgetown University Center for Children and Families. In some cases, upwards of three in ten residents participate in Medicaid.

That said, Medicaid touches every corner of the state, both red and blue. 

According to Elisabeth Benjamin, vice president of health initiatives with the Community Service Society of New York, “Five in eight nursing home residents in New York rely upon Medicaid. Two in seven people that have Medicare also have Medicaid. And four in nine people with disabilities. And one out of every four very low-wage workers also all rely upon Medicaid,” she said.

Data shows Staten Island Congresswoman Nicole Malliotakis represents the Republican-held New York district with the largest share of participants, with more than 20% enrolled. A report by NBC News ranked her district among the top 10 Republican-held districts in the country.

In the days leading up to the floor vote on the budget blueprint, Malliotakis leaned on House Republican leadership for assurances, telling Spectrum News on Monday, “I have a lot of seniors, I have a lot of children with disabilities, and I want to make sure that they're protected.”

On Tuesday, she voted to advance the blueprint, as did every New York Republican in the U.S. House. All Democrats voted against. 

The plan calls for a cut of $880 billion over the next decade from spending within the House Energy and Commerce Committee’s jurisdiction, though it does not specify what the cuts would be. Those cuts will be outlined later in the process.

“The Democrats will try to make it about all sorts of things, but show me where in the budget resolution it talks about specific cuts. It doesn't,” Hudson Valley Republican Rep. Michael Lawler told reporters.

Some Republicans have argued they will look to root out fraud and waste while protecting Medicaid beneficiaries, but Democrats say the math simply does not add up.

“There is zero chance that they can make that significant of a cut and not touch Medicaid,” said Rep. John Mannion, a Democrat representing the Syracuse region.

In addition to potential shortcomings for patients, experts warn that major federal Medicaid cuts would have ripple effects in state capitals nationally, including Albany, potentially undercutting unrelated state programs. 

“Fifty-nine percent of the federal funding that comes into the state of New York comes as part of these Medicaid dollars,” said Leo Cuello, a research professor at the Georgetown University Center for Children and Families. “So, if you slash that funding, the New York state budget also falls apart, and that impacts other priorities, like education.” 

This is just the early stages of the negotiations on the contours of the Republican plan. Once a blueprint is approved by the Senate and the House, lawmakers will work on the specifics of policymaking, including outlining the cuts.