As Republicans on Capitol Hill take their first steps to advance President Donald Trump’s agenda, New York Democrats and health care advocates are warning about the potential impact back home. 

Medicaid is one of the programs Republicans are targeting for savings to pay for Trump’s plan, which calls for sweeping tax and spending cuts. 

The House GOP introduced legislation this week to cut Medicaid by hundreds of billions of dollars over a decade, in part by imposing new work requirements for benefits. The Congressional Budget Office says it could leave more than 7 million people nationwide uninsured. 

What You Need To Know

  • The House GOP introduced legislation this week to cut Medicaid by hundreds of billions of dollars over a decade, in part by imposing new work requirements for benefits

  • Republicans largely defend the work requirements and other reforms, arguing they would curb waste and fraud in the program, while Democrats, such as Rep. Gregory Meeks of Queens, accuse Republicans of playing politics with people’s lives 

  • The bill would also, Democrats warn, rein in federal Medicaid funding for states like New York that use state dollars to provide health care coverage for undocumented immigrants
  • Advocates also warn the Medicaid funding cuts could also put rural hospitals at risk, potentially forcing some to close down

In New York, approximately 7 million people are currently enrolled in Medicaid, according to the State Department of Health. Of that, roughly 4 million reside in the five boroughs.

Republicans largely defend the work requirements and other reforms, arguing they would curb waste and fraud in the program.

However, Democrats, such as Rep. Gregory Meeks of Queens, accuse Republicans of playing politics with people’s lives. 

“You're trying to figure out how you get that money out of Medicaid … to continue the tax cuts for the billionaires like Elon Musk,” Meeks said.

The House GOP bill would also, Democrats warn, rein in federal Medicaid funding for states like New York that use state dollars to provide health care coverage for undocumented immigrants. 

Congressman Joseph Morelle of Rochester, a former leader in the state Assembly, said, “New York is clearly going to struggle financially because of this.” 

“Federal government is now saying: If you do that, we're going to cut federal reimbursement, even though we don't reimburse you for those services,” he said. 

Advocates also warn the Medicaid funding cuts could also put rural hospitals at risk, potentially forcing some to close down.

Stephanie Teachman of Silver Creek, N.Y., who serves as the local president of CSEA 607, is among those worried about the future of those hospitals. She was on Capitol Hill Wednesday, urging lawmakers to shield Medicaid from cuts. 

In an interview, she argued it is vital those hospitals remain open, invoking an experience where she feared her young son might have a concussion.

“If I didn't have the hospital that I have currently, which is 20 minutes [away], I would have had to drive an hour, probably, to have him checked out in the middle of the night,” she said. 

While Republicans broadly defend steps to reform Medicaid as fiscally responsible, some have also expressed concern about the potential impact certain spending reductions could have.

Asked about rural hospitals, in an interview, Rep. Nick LaLota of Suffolk County, said, “I do have significant concerns[about] how this affects our hospital system.”

Earlier this year, LaLota joined a handful of Republicans in writing to House Republican Leadership, warning, "We cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations."

In an interview Wednesday, LaLota said he will be closely monitoring the bill as it moves through the Congress, saying, “I'm confident that, in time — either through our process here in the House, the manager’s amendment here in the House, or in the Senate, through guys like [Sen.] Josh Hawley — they're going to hold the line to ensure this bill is compassionate and does not hurt people who deserve their Medicaid.”

Hawley, a Republican from Missouri, has repeatedly warned his party against cutting Medicaid. 

The Republicans plan to push this agenda through without the votes of any Democrats, but it is not expected to be easy. 

Factions of the GOP are at odds over different provisions, especially the cap on the federal deduction for state and local tax payment, known as SALT.

A handful of New York Republicans say they will vote no unless that cap is significantly raised.