Experts in health-care policy are speaking out against further Medicaid cuts once Congress returns from its spring recess to work on a second budget reconciliation package.
The legislation will fund the Iran war and the Department of Homeland Security. Last summer, Republicans cut $1 trillion from Medicaid in their reconciliation bill known as the “One Big Beautiful Bill Act.”
Joan Alker, co-founder and executive director of the Center for Children and Families at Georgetown University, said she’s concerned that the administration may use allegations of Medi-Cal fraud to justify further cuts.
“The House Budget chair, Arrington, has been very explicit that he’d like to see more Medicaid cuts,” she said. “We’re hearing a lot of rumors about this, so that is extremely concerning, and we will certainly be paying very close attention to that.”
Alker said she fears that the Trump administration’s focus on fraud is really an attempt to attack the president’s political enemies in blue states, to distract voters from past Medicaid cuts, and to lay the groundwork for additional cuts.
In January, the Centers for Medicaid Services sent a letter to Gov. Gavin Newsom questioning Medi-Cal spending, noting that the In-Home Supportive Services program grew almost 350% over the past decade. The state responded that the program has grown as the state successfully moved more older Californians into cost-effective home-based care, limiting spending on institutional care such as nursing homes.
Andy Schneider, a research professor at Georgetown University’s McCourt School of Public Policy, said in-home services allow more people to age in place.
“The fact that IHSS spending has gone up, in the state’s view, is testament to a successful rebalancing,” he said, “one that in the past, the federal government has encouraged.”
Blue states have also been targeted in letters from the House Energy and Commerce Committee. Three weeks ago, Trump established a government-wide anti-fraud task force, led by Vice President J.D. Vance and White House advisor Stephen Miller.
