With a new administration 60 days from taking office and the same party to be controlling the White House, Senate, and House of Representatives, Medicaid changes are a common topic of conversation in Washington policy circles these days.

One of the objectives of those conversations:  reducing federal spending on Medicaid, which in federal fiscal year 2023 amounted to $860 billion.

Among the means of reducing those expenditures that can be expected to be the subject of policy deliberations in the coming months are:

• Instituting Medicaid work requirements.
• Ending the supplemental federal Medicaid funding states receive for Medicaid enrollees covered under the Affordable Care Act’s eligibility expansion.
• The introduction of Medicaid block grants.
• Reducing the scope of benefits and the spending limits on those benefits.
• Increasing the use of Medicaid premiums.
• Checking the eligibility of enrollees more than once a year.

Any changes that reduce either overall Medicaid enrollment or Medicaid payments to providers could have serious implications for community safety-net hospitals because those hospitals care for especially large numbers and high proportions of Medicaid patients.

Learn more about the Medicaid policy deliberations expected in the coming months from the Forbes article  “Trump’s Spending Cuts:  Project 2025 And DOGE Signal Leaner Times Ahead” and the Washington Post articles “Trump allies eye overhauling Medicaid, food stamps in tax legislation” and “Trump’s return means Medicaid battles might resume, too.”