Nearly one in five American citizens (nearly 80 million people) rely on Medicaid for their basic health care.[1] This includes low-income individuals and families, children, pregnant women, elderly adults, care givers, and people with disabilities.
The Heritage Foundation’s Republican policy manifesto, Project 2025, calls on the Centers for Medicare and Medicaid Services to impose targeted time limits or lifetime caps on Medicaid benefits.[2]
Kansas has proposed a 36-month lifetime cap.[3] Individuals would lose eligibility for coverage regardless of their financial situation.
But those that will be most affected largely come from poor red states. The percentage of the population in those states that receive Medicaid benefits range from approximately 20% to 35%.[4]
Roughly 20% of current enrollees, approximately 16 million people, qualify for income-based Medicaid (i.e., the poor and care givers) would be at immediate risk to lose their benefits.
Thirty-four mostly Republican and mostly poor states set eligibility standards for income-based Medicaid coverage below the federal poverty level.[5] Sometimes far below.
Texas is a particularly striking example. Medicaid household income eligibility limits for adult parents/caregivers is 12% of the federal poverty level.5,[6],[7]
The maximum household income eligibility limit ranges from $1,800/year for an individual to $3,744/year for a family of four in Texas.
Many in lower economic brackets are already excluded from Medicaid because household incomes exceed state eligibility limits or because there is at least one worker in the household. They make up a significant portion of the more than 26 million uninsured Americans.
A Republican administration will terminate Medicaid benefits to tens of millions. When they again cut taxes on the morbidly rich, tens of millions more Americans will lose access to health care.
Project 2025 also lays out the Republican plan to gut Medicare.[8] But that’s for a blog on another day.
[1] https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html
[3] https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ks/ks-kancare-pa3.pdf
[5] https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels/index.html
[8] https://static.project2025.org/2025_MandateForLeadership_FULL.pdf beginning at p.462
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