In a pre-dawn vote Thursday, House Republicans passed a sweeping economic package aligned with President Donald Trump’s agenda—one that offers tax cuts to corporations and the wealthy, but raises alarm bells over the future of Medicaid, Medicare, and Social Security.
Over 7 Million at Risk of Losing Medicaid
At the heart of the legislation is a controversial move that could strip Medicaid benefits from more than 7 million Americans.
The bill introduces strict work requirements for Medicaid recipients—despite decades of research showing such mandates often lead to large-scale coverage losses, especially among people with chronic conditions or part-time caregivers who struggle to meet bureaucratic reporting demands.
According to the nonpartisan Congressional Budget Office, the policy would disproportionately affect low-income adults without children, many of whom already work in unstable or seasonal jobs. If finalized, it would be the single largest rollback of Medicaid access in over a decade.
Tax Cuts Now—Entitlement Cuts Later?
While the bill’s headline feature is a new round of tax cuts modeled after Trump’s 2017 legislation, the long-term fiscal implications are raising red flags for entitlement programs.
Experts warn that the steep cost—projected at over $4 trillion over 10 years—could add intense pressure to reduce federal spending elsewhere, particularly on so-called “mandatory” programs like Medicare and Social Security.
Trump and his Republican allies insist they will “protect” these programs, but the budget math tells a different story.
Marc Goldwein of the Committee for a Responsible Federal Budget described it bluntly: “You can’t lower taxes, raise defense spending, and keep your promises on Medicare and Social Security without going massively into debt—or cutting those very programs.”
What It Means for Medicare and Social Security
While Medicare and Social Security weren’t directly cut in this bill, the legislation paves the way for future reductions.
Key Republican leaders have floated plans to “restructure” Medicare into a premium support system—effectively a voucher program that could shift more costs onto seniors.
Meanwhile, proposals to raise the Social Security retirement age or limit cost-of-living adjustments are quietly gaining traction.
“This bill sets the stage for entitlement reform under the banner of fiscal responsibility,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget. “And that almost always means Medicare and Social Security are next.”
Political Fallout: A 2026 Midterm Flashpoint
The bill now heads to the Senate, where it faces slim margins and unified Democratic opposition.
Still, the House passage marks a critical win for Trump, who is looking to secure major legislative victories in his second term.
But it could come at a political cost: Democrats have already vowed to make the cuts—and the threat to popular programs—a central issue in the 2026 midterms.
“They’re giving tax breaks to billionaires while putting health care and retirement security at risk for millions,” said Rep. Hakeem Jeffries (D-NY). “That’s the real story here.”
MORE COVERAGE: Trump Administration | Congress | Medicaid | Social Security
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