Historic Medicaid cuts loom. Why are Republican governors silent this time? Unpacking the political shifts and consequences. #MedicaidCuts #HealthcareDebate #GOPShift
00:00A significant legislative battle is unfolding in Washington, with President Trump and a Republican-controlled Congress poised to enact historic enacted cuts of approximately $1 trillion over 10 years.
00:13Unlike 2017, when GOP governors were a vocal force against similar measures, many are now notably silent, even as their states face multibillion-dollar budget holes.
00:25Medicaid, a joint federal-state program, covers over 70 million low-income and disabled individuals, including nearly half of the nation's children, and necessary reform so that Medicaid is being used for temporary assistance and not a permanent entitlement.
00:43Pennsylvania Governor Josh Shapiro criticized Trump and congressional Republicans for allegedly misleading Americans, stating on X.
00:51They re-rushing to kick hundreds of thousands of Pennsylvanians off their health care, and lying about it.
00:58Policy experts suggest fewer moderate Republican governors are in office.
01:03And several expansion states adopted Medicaid through ballot initiatives, often against gubernatorial opposition.
01:10Many Republican governors now back Medicaid work requirements, even if it means less federal money and fewer people covered.
01:18Though approved by state lawmakers and federal agencies for decades, some Republicans criticize it as money laundering.
01:26The Senate bill would limit the funds states could raise, leading to billions in cuts for states and their hospitals.
01:33States with Republican governors that expanded Medicaid include Alaska, Arkansas, Idaho, Indiana, Iowa, Louisiana, Missouri, Montana, Nebraska, New Hampshire, Nevada, North Dakota, Ohio, Oklahoma, South Dakota, Vermont, Virginia, West Virginia, and Utah.
01:53Senator Jim Justice of West Virginia, a former Democrat who opposed Medicaid cuts in 2017, voted for Trump's bill as a Republican, stating it strikes a good balance between protecting the most vulnerable and those who rely on the program while rooting out waste, fraud, and abuse.
02:13Arkansas and Ohio, for instance, have already passed state laws for work requirements.
02:17New York Governor Kathy Falkal warned that the legislation could devastate hospitals and lead to over 34,000 job cuts in her state, potentially forcing hospitals to curtail critical services or even close.
02:31In 2017, Republican governors in Ohio, Nevada, and Massachusetts spoke out, contributing to the narrow failure of Trump's bill to repeal the Affordable Care Act.
02:42South Dakota Governor Larry Roden Spokesperson, Josie Harms, added,
02:47Governor Roden supports workforce participation as a requirement of Medicaid expansion eligibility,
02:54trusting their federal delegation to fight for state priorities and Trump's promises.
02:59In a notable shift from 2017, no governors addressed another significant cut to provider taxes.
03:06The broader scope of the current bill, which includes tax cuts and increased spending for border security and defense,
03:15rather than solely health care reform, presents a complex dilemma for Republican governors.
03:20Larry Jacobs of the University of Minnesota suggested some governors might be privately expressing concerns,
03:27but are publicly silent to avoid Trump's scrath, citing the Liz Cheney effect.
03:31Senator Tom Tillis, a Republican from North Carolina, recently announced he would not seek re-election
03:38after expressing concerns about the bill and facing threats from the president.
03:43Tillis was one of three GOP senators to vote against the bill, which still narrowly passed.
03:49These are state levies on health care institutions that help states pay their share of Medicaid and gain additional federal funds.
03:57This change is projected to cost states billions.
04:00Republicans argue the program expanded too much under previous and swayed Democratic administrations
04:06by including non-disabled adults and have long sought to scale it back.
04:12Key cuts in Trump S-1, big, beautiful bill, stem from new policies aimed at reducing enrollment
04:18through increased paperwork demands, including a work requirement.
04:23These policies primarily affect states that expanded.
04:26Medicaid under the Affordable Care Act, 19 of these states are led by Republican governors.
04:33Their silence provides political cover for GOP lawmakers from their states,
04:38who are moving to cut Medicaid coverage for millions who gained it in the last decade.
04:44KFF Health News contacted all 19 governors.
04:47Only six responded, mostly supporting work requirements for able-bodied adults.
04:53Drew Galang, a spokesperson for West Virginia Governor Patrick Morrissey, stated,
04:59Implementing work requirements for able-bodied adults is a good in stark contrast.
05:05Democratic governors have actively campaigned against the bill.
05:08Larry Leavitt of KFF noted the surprising silence from red state governors,
05:14particularly in expansion states, given their powerful role in blocking similar efforts in 2017.
05:21Charles Chip Kahn of the Federation of American Hospitals indicated that while governors are less vocal publicly,
05:28federal lawmakers are hearing from state legislators.
05:30Beyond work requirements, the largest Medicaid cuts stem from restrictions on provider taxes.
05:37A practice used by all states, except Alaska.
