Here’s what could happen next.
WASHINGTON — A major Medicaid funding shift may be on the horizon as House Republicans consider reforms aimed at restoring fiscal discipline while keeping vital healthcare services intact. In a recent interview on Fox Business’ Mornings With Maria, Rep. Austin Scott (R-GA) detailed a proposal that could dramatically reshape how Medicaid expansion is funded—putting more control back into the hands of the states and less in Washington’s bloated bureaucracy.
Currently, over 80 million Americans rely on Medicaid—a taxpayer-funded program intended to help low-income individuals access medical care. While President Donald Trump has promised to protect essential programs like Medicaid, some members of Congress are reviewing how federal dollars are being spent, especially under expansion terms set by the Obama-era Affordable Care Act (ACA).
Under the ACA, states that expanded Medicaid receive a 90% federal match—meaning the federal government foots nearly the entire bill. Rep. Scott explained that Republicans are considering lowering that match to somewhere between 50% and 80%, the traditional range prior to the ACA, to encourage greater fiscal responsibility and state-level accountability.
“When Democrats expanded Medicaid under the Affordable Care Act, they locked in a 90-10 funding ratio,” Scott told Fox Business. “What we’re discussing is restoring that to more sustainable levels—where states carry a fairer share.”
Scott made it clear: no one would be removed from Medicaid, so long as governors continue to support the program at the state level. “This isn’t about cutting people off,” he said. “It’s about restoring balance, responsibility, and fairness to how we manage public funds.”
A Battle Brewing in Washington?
While this move is being praised by many conservatives as a long-overdue step toward smarter government, not everyone in the GOP is on board. A dozen centrist Republicans have already signaled their opposition, sending a letter to House leadership warning they won’t support any bill that reduces Medicaid coverage for vulnerable populations.
As expected, Democrats are lashing out. Far-left Senator Ruben Gallego (D-AZ) took to X (formerly Twitter), claiming that if federal funding drops below 90%, “hundreds of thousands” of working-class families in Arizona could lose coverage. Meanwhile, Georgia Democrat and physician Michelle Au accused Republicans of shifting the blame to governors while forcing through federal cuts.
What’s Next?
At this stage, House leadership has not officially introduced any legislation changing Medicaid’s funding formula. However, this proposal may become part of President Trump’s broader legislative package, which is expected to include extensions of the Trump tax cuts, renewed border security measures, and targeted spending reductions to get inflation under control and protect Social Security and Medicare.
🔍 What This Means for You
✅ No one is getting kicked off Medicaid—states would just take on a slightly bigger share
✅ More control for your state government—less interference from Washington bureaucrats
✅ Common-sense reforms—ensuring taxpayer money is spent wisely
✅ A key part of Trump’s America First agenda—protecting seniors, veterans, and working families
Bottom Line: House Republicans are taking steps to protect the integrity of Medicaid without putting vulnerable citizens at risk. This is about smart spending, state empowerment, and preserving healthcare—not reckless cuts. As President Trump leads the charge to drain the swamp and restore prosperity, this reform could be another major win for American taxpayers.