Medicaid Cuts Are Already Here

😤 Everyone said the Medicaid cuts would hurt adults. They lied.
The kids were in the crossfire the whole time.

📰 According to First Focus on Children, one year ago President Trump signed into law the biggest cuts to Medicaid in U.S. history in H.R. 1, the One Big Beautiful Bill Act. Congress insisted the cuts targeted only the childless adult population. New data published this week, on the law’s one-year anniversary, says otherwise. Medicaid and CHIP together cover approximately 36 million babies, toddlers, school-aged kids, teens, and young people transitioning into adulthood. These youth comprise nearly half of all Medicaid and CHIP beneficiaries. Congress did not protect them. It miscalculated, or it lied.

🔥 Here is my take. The framing that this bill was about fiscal discipline was always a political cover story. When you cut nearly $1 trillion from Medicaid and CHIP, you do not get to control who bleeds. You just get to pick the story you tell about it afterward.

📊 The numbers are not projections anymore. A RAND report cited by First Focus on Children found the cuts will reduce state Medicaid funds by $679 billion by 2034, with state general funds declining by $82 billion in total. Twenty-six states face losses of 5% or more of their Medicaid funds by 2034. Arizona, Iowa, and Nevada can expect Medicaid program reductions of more than 15%. And North Carolina has already enacted a Medicaid funding bill that eliminated coverage for 27,000 lawfully present children and pregnant women, a population it had covered for more than a decade. The law is not even fully implemented yet.

🤔 Here is the counterpoint people will raise. States have flexibility. They can protect kids if they choose. And some legislators in North Carolina did call that cut unintentional. I hear it. But here is the answer. You cannot hand states a $679 billion hole and then act surprised when children fall through it. Flexibility without funding is just blame transfer. The damage is done regardless of intent.

💡 This is the part that keeps me up at night as someone building in healthcare access. The system we are trying to build early detection and preventive care on top of is being gutted from underneath, and the first people to fall are the ones who had the least leverage to begin with. Kids do not vote. Kids do not lobby. Kids just lose their coverage quietly while everyone argues about work requirements.

🎯 Calling something a budget fix does not make it one when 27,000 children lose coverage in a single state before the main provisions even kick in.

❓ To every health plan executive still treating Medicaid as a stable channel for pediatric growth: what is your real plan for the 26 states facing cuts of 5% or more by 2034, and have you said that plan out loud to your board yet?

👉 Follow Jonathan Govette, CEO of Oatmeal Health, for daily healthcare insights on LinkedIn. Deeper dives in The Oatmeal Bite on Substack: https://news.oatmealhealth.com