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Congressional Democrats are already plotting how to reverse Republicans’ just-passed Medicaid cuts if they take the House or Senate majorities in 2026.
And they’re notably confident that they’ll get the GOP votes they need to do it.
That’s in part because of the legislative cliffs that Republicans set up in the mammoth tax-and-spending bill that President Donald Trump signed earlier this month. The law tees up new work requirements for Medicaid for 2027 and restrictions on states’ federal money for Medicaid for 2028.
Those looming cuts are already hitting some hospitals: One Nebraska medical center recently announced plans to close, in part because of Trump’s new law. Enter Democrats, who see Trump’s Medicaid slashing as their ticket to success in the midterms.
If they can return to power, they see Republicans as willing to work with them on undoing the cuts. After all, past Congresses have retroactively delayed unpopular provisions like the “Cadillac tax” on high-cost health care accounts, including by passing the “doc fix” which prevented cuts to providers’ Medicare reimbursements.
“There’s a very realistic prospect that the votes to cut Medicaid will prove to be some of the least popular votes in congressional history, and that it might be actually quite easy to effectuate the repeal, once people see and understand what these crazy people did,” Sen. Sheldon Whitehouse, D-R.I. told Semafor, adding in a joking faux-Republican voice: “‘Get me out of here! Get me out of here!‘”
Several Senate Democrats agreed with Whitehouse in interviews this week. They have an even more recent example of Republican unraveling to point to: In Trump’s new law, his party undid huge portions of the 2022 Inflation Reduction Act’s clean energy subsidies.
Importantly, Democrats will need to win back at least one chamber of Congress next year to have a chance at avoiding the Medicaid cuts, after warning for months about the negative impacts. Republicans are unlikely to ever endorse rolling back work requirements, but cuts to the provider tax and state directed payments — both used to finance Medicaid treatment — could then be in play.
In an interview Thursday, Senate Minority Leader Chuck Schumer told Semafor that “if God willing we get back in power and we get back the House, we’re going to undo the damage” from Republicans’ bill.
Some Republicans are already indicating they’re open to an intervention. Sen. Josh Hawley, R-Mo., has said repeatedly he hopes to ensure “there are no Medicaid cuts that take effect.”
In the interim, he said, his state should be spared from cuts over the next five years by a rural hospital fund and delays to other cuts.
Other GOP lawmakers said they could be open to at least postponing them if states found their situations untenable.
“There will probably be a legitimate effort to get them delayed,” said Sen. Jim Justice, R-W.Va., who added that he still preferred the less aggressive Medicaid cuts that House Republicans initially sought. “I say we wait and see what the economy does.”
“If we don’t really kick in [economically] and go crazy … the states will look at that and say, ‘Boy, that’s going to be a big load,’” Justice said.
Still, “it’s way too early to tell” how the GOP approaches the cuts in the future, said Sen. Shelley Moore Capito, R-W.Va. She doubted Republicans would pare back what they voted for, at least in the short term.
“If the hole’s too big or if the changes are too drastic, I could see us elongating the timelines,” she said.
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It will be months, and in some cases, years before the legislation’s effects on the health care system are fully known. Lawmakers weren’t even sure what was in the bill until a few days before they voted — making it difficult for Democrats to lay any real groundwork for their future legislative plans.
“We’d have the will,” Sen. Peter Welch, D-Vt., said. “We’d have to find the way.”
Reversing the work requirements will be particularly difficult, since it takes states years to implement federally directed changes. Democrats said they were also concerned about the simultaneous lapse of enhanced Affordable Care Act subsidies later this year; those could hike some premium payments by over 75%.
The higher premiums “will hit in September; insurance companies have to set their rates,” Sen. Mark Warner, D-Va., said.
“In my state, the bills go out at the end of October; beginning of November,” he added. “We’re going to get those bills and I imagine — since we’ve got a gubernatorial race and all the statehouse up — it’ll be a chance to remind people.”
Some on the left pushed back on the idea that Democrats won’t be able to combat the cuts until they control Congress. Sen. Jeff Merkley, the top Democrat on the House Budget Committee, said he hoped to find opportunities to bolster health insurance before the election.
“It’s a disaster that will unfold over the next three years, and we should use every opportunity to reverse a horrific decision,” Merkley said.
Room for Disagreement
Many Republicans say their party won’t undo the Medicaid cuts, which they say are necessary to protect the program against fraud.
They point to extra money in the bill for rural hospitals, which Republicans added to bolster the facilities ahead of likely losses in federal Medicaid revenue.
“I think we kind of addressed this issue, so I think there ought to be a cap,” Sen. Eric Schmitt, R-Mo., said. “That’s a lot of money to address any concerns.”
Eleanor and Burgess’ View
Even if Democrats can win enough Republicans’ backing to reverse the cuts, it’ll be a long road back to where the US health care system was a week ago.
Any social safety net that runs through the states takes a lot of time and coordination to reshape — just look at Covid-era changes to unemployment insurance.
Still, that doesn’t mean a future Democratic majority, which remains very hypothetical, would be without options if enough GOP lawmakers won’t join them.
Democrats could conceivably undo the Medicaid cuts using the same kind of party-line spending package that enacted them.
But they’d need to also win the White House and both chambers of Congress in 2028 for it to become law.