President Trump signed the “One Big Beautiful Bill” (BBB) into law on the Fourth of July. One component of this reconciliation bill calls for reducing the expected increase in Medicaid spending by $344 billion over the next ten years.

This is another numbers-heavy column, but hang on until the end, because you’ll understand why the manufactured outrage over this issue is just political hype. Medicaid spending is still going up, but only half as fast. It’s not a cut.

The current federal Medicaid budget is projected to be $925 billion. That represents 15% growth in just the last two years. Ongoing annual growth of 7.5% means the budget would double every 10 years. The “Big Beautiful Bill” is estimated by the Congressional Budget Office to slow the growth of federal Medicaid spending by $34.4 billion a year for ten years. $34.4 billion is a lot of money, but it’s just 3.7% of the current year’s Medicaid spending.

Across the country, organized protesters (the same signs, slogans, and tactics just spontaneously arose thousands of miles apart on the same day?) claim these “cruel” cuts will “gut” the nation’s healthcare safety net. Do you mean to tell me that a program, currently growing at 7.5% a year, cannot tolerate less growth without sending the nation into an “unprecedented” tailspin?

Of course, cutting 3.7% from a budget that is growing by 7.5% is not a cut at all. It simply means Medicaid spending will increase at a slower rate. As for the claims of “unprecedented” reductions, this simply is not true.

During the federally declared COVID emergency, the requirement to document your ongoing eligibility for Medicaid benefits was dropped. Nearly four years later, the requirement to prove Medicaid eligibility was reinstated. A March 5, 2024 News From The States article claimed, “more than half-million (Michiganders) have been left off the rolls.”

Do you remember the protests and claims of devastation back in March 2024? Of course you don’t, because there were none. In fact, under the Biden Administration, Medicaid enrollment dropped by over 16 million nationally between the beginning of 2023 and June 2024, as a result of “redetermination” of eligibility. How is a 3.7% BBB annual reduction in Medicaid spending increases worse than a 16% reduction in Medicaid enrollment in just over one year? Well, it’s not.

The BBB creates a work requirement for able-bodied Medicaid recipients. This means adults must work, volunteer, or study 80 hours a month to continue receiving Medicaid benefits. Of course, there are exceptions to the work requirement. The House BBB applied mandatory exemptions for all parents and caretakers, the “medically frail” (blind or disabled, including physical / intellectual/ developmental disabilities), women who are pregnant or postpartum, those with a substance use disorder, those with “serious or complex” medical conditions, those meeting SNAP/TANF work requirements, and other temporary hardship exemptions. Obviously, this is not a wholesale removal of at-risk recipients from the Medicaid rolls.

There has been, and will continue to be, a lot of political rhetoric about the devastation of the BBB “cuts” (reduced annual increases) to Medicaid. Governor Whitmer has repeatedly expressed pride in the fact that over a million Michiganders – as of April 2023 – were enrolled in the Healthy Michigan program, which is expanded Medicaid. By June 2024, under “redetermination,” that number was reduced – in just 18 months – by 280,000. How is it that Healthy Michigan enrollment can drop more than 25% under Biden / Whitmer administrations, without protesters taking to the streets, but an estimated 3.7% annual reduction in growth sends protesters out nationwide?

The protests are manufactured for political purposes. They are meant to scare.

BBB requires states to condition Medicaid expansion eligibility on the new work requirements by December 31, 2026. That’s right. Healthy Michigan recipients will have to meet federal work requirements 18 months from now. Michigan survived a reduction of 280,000 Healthy Michigan recipients in an 18-month period (from January 2023 to June 2024). The new BBB work requirements, that will become effective 18 months from now, will not result in societal collapse.

State Rep. Mark Tisdel, R-Rochester Hills represents Michigan House District 55, which includes the cities of Rochester and Rochester Hills, and part of Oakland Township. You can reach him by calling 517-373-1792 or by sending an email to [email protected]