What is Medicaid?
Medicaid provides health care coverage for millions of Americans, with nearly 72 million enrolled in 2024. The program is jointly funded by the federal government and states—states administer their own programs, while the federal government provides the majority of Medicaid’s funding and sets parameters that states must meet. The states are federally required to provide coverage for low-income families, qualified pregnant women and children, as well as people with certain disabilities. Every state can choose to offer Medicaid coverage to other populations beyond the federal requirements.
Why is Medicaid under threat now?
The Trump Administration’s agenda includes reducing federal spending, which is being echoed by the new Congress. The U.S. House of Representatives passed a budget resolution in February that would require the House Committee on Energy and Commerce, which oversees Medicare and Medicaid, to cut $880 billion in federal spending from its jurisdiction through 2034. Achieving that level of savings would be nearly impossible without targeting the Medicaid program. Fast forward to the beginning of April—the U.S. Senate passed a framework for budget cuts and the House narrowly adopted it on April 10, 2025. Now, both chambers can work on tax and spending legislation to advance President Trump’s agenda through budget reconciliation—which allows lawmakers to bypass the Senate’s 60-vote filibuster rule and allow bill passage with a simple majority. We will know the true extent of the threat to Medicaid once this process gets underway.
Why should nurses care about Medicaid cuts?
Nurses should care about protecting Medicaid for a number of reasons. Medicaid accounts for 19% of hospital revenues and serves as the primary payer for long term care services and supports. Therefore, these cuts would lead to job losses across the health care sector—one estimate holds that 477,000 health care workers will lose their jobs as a result of Medicaid cuts. This could potentially include nurses in both hospitals and long-term care settings. Or, if nurses’ jobs are spared from these cuts, nurses will likely face other workplace challenges from other staffing reductions.
For nurses, Medicaid cuts would likely further exacerbate workplace challenges such as higher nurse-to-patient ratios, which result in increased burnout and decreased job satisfaction. Nurses in nonprofit settings could see reduced wages as states grapple with how to meet the needs of their Medicaid beneficiaries within the constraints of statutory balanced budget requirements. States may have little choice but to decrease provider payments or eliminate coverage of optional benefits, further limiting access to care for Medicaid beneficiaries.
Finally, Medicaid cuts would impact patient access and health outcomes. Medicaid cuts will result in beneficiaries losing their coverage and access to needed care. Beneficiaries will face difficult decisions about their finances—leading to delayed care and nurses seeing sicker patients. Cuts to Medicaid could threaten health care facilities’ abilities to provide access to critical services and serve patients. Medicaid funding cuts could also lead to facility closures, especially in rural and underserved areas that are currently struggling to meet the needs of their communities. Closures would devastate communities where health care facilities are critical not only for health care services, but also for contributing to the overall economic health of a community by providing jobs.
Nurses know that protecting Medicaid protects patients, providers, and communities.
What comes next?
When it comes to Medicaid, we do not know what is coming next—how lawmakers will target reductions or reforms simply is unknown at this time. But the American Nurses Association’s Policy and Government Affairs Team is steadfast in its focus on educating policymakers on the importance of Medicaid for our nurses and their patients—and how any reductions will impact nurses across the country.
Learn More and Tell Us Your Story!
For more information on Medicaid and how it works, check out Why Medicaid Matters and Understanding Medicaid and CHIP: A Comprehensive Overview.
Help protect Medicaid by telling your legislators to protect Medicaid, as well as sharing your Medicaid story with ANA.