HOUSTON – The House of Representatives narrowly passed a sweeping budget reconciliation bill Thursday that includes the largest cuts to Medicaid in the program’s history.
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The healthcare section of President Donald Trump’s so-called “Big Beautiful Bill” introduces stringent new requirements that would fundamentally reshape how Medicaid operates, including:
• Work requirements for adults aged 19-64
• Stricter eligibility verification processes
• Enhanced citizenship checks
• Tougher provider screening requirements
• Cuts to states covering undocumented residents
• Cost-sharing up to $35 per service
For patients like Adjei-Sarpong, a 25-year-old sickle cell patient who depends on Medicaid to help cover her life-saving treatments, these changes could be devastating.
“It’s a ticking time bomb,” she said. “This is a life-threatening disease. It could kill people if you don’t take care of it.”
This, she says, is on the heels of her already struggling with medical debt.
“About 90k in medical debt because there’s a lot of insurance gaps,” she explains. “I was in a hospital for once two to three months. The hospital’s like, ‘hey, we’ll cover this, but you have the rest.’ They didn’t even cover half of my hospital bill.”
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House Republican leadership pushed the bill through despite opposition from both moderate Republicans concerned about coverage losses and hard-line conservatives who argued the cuts didn’t go far enough.
Texas Republican Chip Roy, who initially voted against the bill in committee, ultimately supported the final version after securing additional provisions.
The bill now heads to the Senate, where it faces an uncertain future. Moderate Republicans in the upper chamber have expressed concerns about the depth of the cuts and their impact on vulnerable populations.
“Medicaid is a lifeline for me specifically,” says Adjei-Sarpong, who needs regular medications that cost $400 per month without coverage. “Sickle cell is unpredictable; I could go to the hospital anytime. I may need medication at any time. And Medicaid helped me and my family pay for these things that insurance won’t cover.”
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The Congressional Budget Office estimates that by 2034, the changes would result in at least 8.6 million Americans losing their health insurance coverage. Healthcare advocates warn this number could be even higher as states struggle to maintain coverage with reduced federal support.
The Senate is expected to take up the measure in the coming weeks, setting up a crucial vote that could determine the future of healthcare access for millions of Americans.
