Here’s How the GOP Cuts Medicaid

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🗓️ 20 May 2025

⏱️ 28 minutes

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Summary

In a return to a classic party policy goal, Republicans want to add “work requirements” to Medicaid to offset costs in Trump’s “one big beautiful bill.” Work requirements for health insurance have been tried before, on the state level, and the end result is a lot of people—including working people—losing their health insurance. Guest: Leo Cuello, research professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families and former Health Policy Director of the National Health Law Program. Want more What Next? Subscribe to Slate Plus to access ad-free listening to the whole What Next family and across all your favorite Slate podcasts. Subscribe today on Apple Podcasts by clicking “Try Free” at the top of our show page. Sign up now at slate.com/whatnextplus to get access wherever you listen. Podcast production by Ethan Oberman, Elena Schwartz, Paige Osburn, Anna Phillips, Madeline Ducharme, Isabel Angell, and Rob Gunther. Learn more about your ad choices. Visit megaphone.fm/adchoices

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0:00.0	Last week, the New York Times published an op-ed with a remarkably star-studded byline.
0:13.2	Its authors were the Secretary of Health and Human Services, R of K, the head of the Centers for Medicare and Medicaid.
0:20.2	That's Dr. Oz.
0:22.0	The HUD Secretary, the Secretary of Agriculture.
0:25.9	These four were all united behind a single headline.
0:29.8	If you want welfare and can work, you must.
0:37.4	I sort of wonder if that title was engineered in a lab to make you cringe.
0:43.9	Yeah, I mean, it's problematic in a lot of ways.
0:50.6	Leo Cueo is a lawyer who works in public policy, mostly health care.
0:56.2	What drove him nuts about this op-ed is that it makes the case for work requirements, for Medicaid recipients,
1:03.1	by leaning on a history that he says is just plain wrong.
1:08.4	Leo gets why the GOP might be leading on faulty data.
1:12.6	Republicans want to cut $880 billion from the budget,
1:16.6	with the big, beautiful reconciliation bill they're steering through Congress.
1:20.6	But they just can't do that without cuts to Medicaid.
1:24.6	And in the end, that is what a work requirement for health care is.
1:30.3	The work requirement is the biggest cut in their current reconciliation bill.
1:34.4	It gets them just over $300 billion, right?
1:38.7	So this is about money.
1:43.2	Before I go much further, allow me to explain what I meant by faulty data.
1:49.4	The heart of the Republican argument in favor of work requirements for Medicaid goes like this.
1:55.5	We have tried it before, and it worked.
	...

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