12 States That Will Be Hit the Hardest by Medicaid Cuts

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One of the most significant pieces of legislation of President Donald Trump’s second administration is the passing of the One Big Beautiful Bill Act (OBBBA), a massive budget reconciliation bill basically designed as a continuation to prolong many of the major facets of Trump’s Tax Cuts and Jobs Act from 2017, from his first term.

There are many ways in which the OBBBA will impact ordinary Americans through its Medicaid cuts — a fact that originally stalled the bill in the Senate after passing in the House. Now that it’s passed, a dozen states are poised to suffer the most from the Medicaid cuts. 

Quick Take: OBBBA vs. Medicaid

There are many provisions of the OBBBA designed to implement stricter Medicaid eligibility requirements. Here are a few key takeaways:

• OBBBA slashes $1 trillion in Medicaid funding over a decade, impacting states’ ability to maintain current coverage levels.
• There will be new verification requirements to receive Medicaid, which will be limiting to many current users. 
• It is now mandating more frequent redeterminations, which increases the number of eligibility checks, making it harder for some to maintain coverage, particularly those experiencing short-term job loss.
• There is a prohibition of Medicaid for gender-affirming care.
• It allows for narrower eligibility criteria for non-citizens, excluding certain categories like refugees and asylees. 
• Medicaid will not fund any nonprofits that assist in abortion procedures or care 
• Medicaid recipients who live above the poverty line are now forced to pay more for their coverage.

States Being Hit the Hardest by Medicaid Cuts

Currently, 12 states in America are likely most vulnerable to Medicaid cuts as featured in the OBBBA. Those states have what are known as “trigger laws” — policies in place in which Medicaid expansion would either be scaled back, end entirely if federal funding for Medicaid is cut or cause reviews that could result in cut benefits or the elimination of expansions, per HealthInsurance.org. Those states are:

• Arizona
• Arkansas
• Idaho
• Illinois
• Indiana
• Iowa
• Montana
• New Hampshire
• New Mexico
• North Carolina
• Utah
• Virginia

Final Take To GO

The bottom line is that OBBBA is aiming to truly gut Medicaid and its coverage for millions of Americans. It significantly impacts Medicaid through cuts to funding, stricter eligibility requirements and increased cost-sharing for recipients. These changes are projected to reduce Medicaid spending by $1 trillion over ten years, and this healthcare bill passing raises the question as to what and who the Trump administration is really saving.

T. Woods contributed to the reporting for this article.

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