From Capitol Hill, Medicaid is tracking to be under scrutiny for significant cuts

• Despite some of the political rhetoric in recent years, Mississippi’s Medicaid program has operated on responsible footing compared to other states, writes columnist Sid Salter.

On March 7, the Democratic Minority of the bipartisan and congressionally created Joint Economic Committee—one of two economic advisory committees established in 1946—released a report detailing their concerns about where the Republican Majority has signaled they might go to accomplish theiroverall  tax cut goals.

The U.S. House passed a budget resolution in late February that would require between $1.5 trillion and $2 trillion in federal spending cuts to lay the groundwork for the Trump Administration and the House Majority to extend the 2017 tax cuts with proposed additional tax breaks for affluent taxpayers.

The report carefully notes that the budget resolution “does not include specific policies” and that it is too early to “know how the budget reconciliation legislation will be written,” but makes the case that the Medicaid program is “on a menu of potential cuts” laid out by the House Budget Committee.

Specifically, House Democrats believe that a Medicaid cut of $2.3 trillion or about a third of projected Medicaid spending. Medicaid is a joint federal-state program that covers medical costs for the poor, the blind, people with disabilities, the elderly and children.

Overall, the JEC-Minority report argues that the GOP plan could see 25 million Americans lose their health care coverage, including 10 million children and as many as 1-in-5 senior citizens in nursing homes. The report is an attempt to illustrate what a one-third cut to Medicaid would look like.

The JEC report claims Mississippi covers more than 640,000 Mississippians or over 25% of the state’s total population. A congressional cut of one-third of federal Medicaid funding across all segments could result in 120,000 rural residents and 110,000 children losing their health coverage as part of a total of over 200,000 people who would be left without Medicaid coverage. As many as 1-in-4 senior citizens could lose their nursing home care.

For context in Mississippi’s contiguous states, Alabama’s Medicaid program covers more than 1 million people or over 20 % of the state’s total population. A one-third Medicaid cut would generate more than 330,000 Alabamians cut off from their health care coverage and 1-in-5 would lose nursing home coverage. Arkansas’s program covers 780,000 people or over 25% of the state’s population with 1-in-5 losing their nursing home coverage.

Louisiana’s program covers over 1.6 million people or over 30% of the state’s population. A one-third Medicaid cut would generate over 530,000 cuts from the Medicaid rolls and nearly 1-in-4 seniors would lose their nursing home care. Tennessee’s Medicaid program covers almost 1.5 million people or about 20% of the state’s population. Nearly 1-in-5 seniors would lose their nursing home coverage.

Despite some of the political rhetoric in recent years, Mississippi’s Medicaid program has operated on responsible footing compared to other states – which is one reason President Trump chose Mississippian Drew Snyder to manage the program at the national level.

Before the 2024 election, there was hope that Medicaid expansion might finally be considered in Mississippi, as it was in neighboring Arkansas and Louisiana.

In 2010, the Patient Protection and Affordable Care Act or “Obamacare” was enacted by Congress – then the biggest public policy overhaul and coverage expansion of public healthcare since the 1965 enactment of the Medicare and Medicaid programs. Today, Mississippi remains one of 10 states that has not adopted some form of Medicaid expansion to draw down additional federal funds to pay for health care for the working poor.

The 10 states include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming. The failed 2024 Mississippi Medicaid expansion effort would have expanded Medicaid coverage to about 200,000 people who earned up to 138% of the federal poverty level, or $20,120 annually for one person.

But in 2025, Mississippi lawmakers have not felt they had sufficient guidance from Washington on the future of the existing Medicaid program and little enthusiasm for helping facilitate expansion of the program.

To the contrary, the prevailing political winds have made maintaining Mississippi’s existing Medicaid program against cuts look like a more reasonable goal.