Medicaid Cuts Currently Being Considered by Congress: What Health Advocates Should Know

June 27, 2025

The Trump administration is currently attempting to achieve major program spending cuts through the 2025 budget reconciliation bill, also known as the “One Big Beautiful Bill Act.”[i] This bill has been the subject of grave concern across the country due to the historic cuts it calls for across vital health, housing, and human services agencies.

The US House of Representatives passed their controversial budget reconciliation package on May 22^nd. The final bill advanced to the Senate for review includes roughly $700 billion from Medicaid and $300 billion from the Supplemental Nutrition Assistance Program (SNAP) to finance generous tax cuts for the wealthy.[ii]

What Medicaid Covers Today

Nationally, Medicaid provides physical and behavioral health (mental health and substance use disorder) coverage for 83 million people, including 31 million children.[iii] Medicaid is the largest single payer of both adult and pediatric behavioral health services and covers more than a quarter of national behavioral health costs.[iv]’[v] Of all Medicaid enrolled adults ages 19-64, 35% have a diagnosed behavioral health condition and rely on Medicaid for access to treatment and community living supports.[vi] 

Impacts of House Proposals if Adopted by Senate

• Nearly 11 million Americans currently enrolled in Medicaid are estimated to lose health coverage.[vii]
•  New Jersey as a state is estimated to lose up to $3.6 billion annually in federal funding. [viii]
•  Roughly 350,000 individuals currently enrolled in NJ FamilyCare (the state’s Medicaid program) are expected to lose coverage.[ix]
• One analysis by Harvard Medical School and Hunter College estimates that if enacted, the provisions in this bill would cause between 8,241 to 24,604 medically preventable deaths annually.[x]

Together these policy changes will culminate in a more burdensome, restrictive, and unpredictable experience for all Americans relying on Medicaid for health services. The inefficient expansion of red tape and broad slashes to state mechanisms intended to improve quality of care throughout our healthcare system will have dire consequences. If enacted, communities across the US will face unnecessary suffering, delays in accessing care, overwhelmed and underfunded emergency departments, and preventable tragedies like suicide, overdose, and deaths that could have been avoided with proper and timely care.

Key Concerns

All House provisions regarding Medicaid cuts are outlined here in clear detail by the Kaiser Family Foundation. Specific provisions of concern include changes to the following:

Eligibility Rules – Effective no later than December 31, 2026

• Mandated work requirements for non-exempt adults; at least 80 hours a month



Medicaid Expansion (Affordable Care Act)

• Increased frequency eligibility checks; at least once every 6 months – Effective December 31, 2026
• Reduction in the federal reimbursement rate for select states based on coverage policies for immigrants – Effective Oct 1, 2027
• Requires cost-sharing for select services of up to $35 per service – Effective Oct 1, 2028

Financing & Long-Term Care – All Effective Upon Enactment

• Ban on new and prohibition of increases to existing provider taxes; modifications to waiver for state approval limiting state health financing options
• Cap on state-directed payments for inpatient, outpatient hospital, nursing facility, and qualified practitioner services

Carolyn Beauchamp, MHANJ President & CEO:



“Senate adoption and final passage of the House proposed Medicaid cuts would be nothing short of catastrophe. Our health systems would destabilize, leaving millions of people living with physical health or behavioral health conditions without access to care. MHANJ is unequivocally opposed to these provisions and the cruelty their enactment would require.”

Where We Are in the Process

The Senate must now finalize their own reconciliation bill; they can choose to allocate spending or deductions differently than the House of Representatives. The first bill draft released from the Senate shows not only an adoption of these cuts, but expansions to some provisions enabling more restrictive policies for Medicaid members and state health financing mechanisms.[xi]

As of June 27^th, the Senate is still in the drafting process of their budget bill. Once the Senate reconciliation bill is finalized and passed within that chamber, both chambers of Congress will have to negotiate differences and combine their reconciliation bills into one so they can vote on final identical budget bills. After being passed by both chambers, the budget bill will go to the President’s desk to be signed into law for enactment. The timeframe for this process is constantly evolving, but currently the federal administration is striving to sign the final budget bill into law by July 4^th.[xii]

Take Action!

Between now and the moment this bill reaches President Trump’s desk, you can take action to help prevent these bills and their Medicaid cuts from becoming law. Contact your legislators in both the House of Representatives and the Senate throughout the final weeks of this process.

• Use this resource to find your Senators and ways to contact them. -- New Jersey residents may contact Senator Cory Booker here and Senator Andy Kim here.

• Use this resource to find your Representative and ways to contact them

There are 3 NJ Representatives who voted in favor of the House budget bill with Medicaid cuts. Voters in these districts have a unique role in swaying these Representatives and advocating for Medicaid. Please see their names, districts, and ways to contact them below.



• Representative Jeff Van Drew (NJ-02), Contact here
• Representative Chris Smith (NJ-04), Contact here
• Representative Tom Kean Jr. (NJ-07), Contact here

Additional methods in advocating for Medicaid include connecting with people around you, attending or creating community events that discuss these pending changes, and empowering individuals to speak out against them. Sharing your Medicaid story with elected officials, friends, family, and at events like protests or rallies is crucial in illustrating how important Medicaid services are. Now is the time to make your voice heard. 

[i] Committee for a Responsible Federal Budget.“Breaking Down the One Big Beautiful Bill”

[ii] Lorie Konish; CNBC. “What historic Medicaid and SNAP cuts in the House Republican bill would mean for benefits”

[iii] Kaiser Family Foundation. “Medicaid in the United States”

[iv] Children’s Rights. Medicaid & CHIP Fact Sheet March 2025

[v] Centers for Medicare & Medicaid Services. “Medicaid and CHIP Access: Coverage and Behavioral Health Data Spotlight”

[vi] Kaiser Family Foundation. “5 Key Facts About Medicaid Coverage for Adults with Mental Illness”

[vii]Nathaniel Weixel; The Hill. “CBO: Nearly 11 million people will be uninsured if GOP megabill becomes law”

[viii] NJ Department of Human Services. “New Jersey Human Services has modeled how the specific House-approved proposals will impact Medicaid here in New Jersey”

[ix] “”

[x] Adam Gaffney, David Himmelstein, and Steffie Woolhandler; Annals of Internal Medicine. “Projected Effects of Proposed Cuts in Federal Expenditures on Medicaid Enrollment, Uninsurance, Health Care, and Health”  

[xi] Barbara Sprunt; NPR. “Senate Republicans’ changes to ‘big beautiful bill’ tee up clash with House”

[xii] Deirdre Walsh, Claudia Grisales; NPR. “Medicaid changes don’t meet Senate rules in ‘big, beautiful bill’ says parliamentarian”

MHANJ recognizes current news coverage, pending changes to health insurance programs, and political landscape can be overwhelming. If you are struggling with feelings of hopelessness, anxiety, substance use, or thoughts of suicide, there is support available.

All US residents can call or text 988 or chat 988lifeline.org for emotional and crisis support

New Jersey residents are encouraged to utilize the following MHANJ call lines during business hours:

• New Jersey MentalHealthCares – (866)202-HELP (4375)
• The Peer Recovery Warm Line – (877)292-5588
• NJ Connect for Recovery Call Line – (855)652-3737
• The New Jersey Self-Help Clearing House – (800)367-6247

For any questions or concerns, please reach out to the MHANJ Government Affairs Team:

Carolyn Beauchamp, President & CEO, cbeauchamp@mhanj.org

Barb Johnston, Director, Policy & Advocacy, bjohnston@mhanj.org

Abigail Lewis, Policy & Advocacy Manager, alewis@mhanj.org

Tonia Ahern, Community Advocate, tahern@mhanj.org

The MHANJ is a statewide non-profit organization that strives for children and adults to achieve victory over mental health and substance use disorders.