The truth about Medicaid changes in the House-passed One Big Beautiful Bill

June 23, 2025
Newsletters
Updates From Congresswoman Julie Fedorchak v2

 

Dear Friend,

My office has heard from North Dakotans with questions and concerns about the Medicaid reforms in the House-passed version of the One Big Beautiful Bill. Given the misinformation circulating, I want to make sure you have the facts. 


QUESTION: Did Republicans cut $880 billion from Medicaid? 

ANSWER: No. Here’s the truth in terms of spending on Medicaid:  

Taking all the Medicaid program reforms into consideration, Medicaid spending under the House plan will still increase 25 percent over the next 10 years. Only in Washington is that considered a cut. House leadership tasked the Energy & Commerce Committee, of which I am a member, to find $880 billion in savings. We actually found more than $1 trillion savings. Included in that was $344 billion in savings from increasing eligibility checks, eliminating Medicaid benefits to illegal immigrants, and adding work requirements.  


QUESTION: Did the reconciliation bill cut Medicaid for mothers, children, seniors, and people with disabilities? 

ANSWER: Absolutely not. These reforms strengthen the program by focusing resources on those it was intended to serve. 

The Medicaid provisions in the One Big Beautiful Bill target waste, fraud, and abuse. That includes removing individuals who aren’t legally eligible—like the estimated 1.4M illegal immigrants currently enrolled—and making sure that only those who truly qualify receive benefits through twice a year eligibility checks. We also require able-bodied adults ages 19-64 to work, volunteer, or attend school 20 hours a week to remain eligible.


QUESTION: Will tens of millions of Americans lose Medicaid coverage?  

ANSWER: No. That claim is not supported by the facts and has been debunked by sources including the New York Times. 

Under this bill, the only individuals who stand to lose Medicaid coverage over the next 10 years are the estimated 1.4 million illegal immigrants enrolled in the program, 1.2 million individuals that do not qualify for Medicaid to begin with, and 4.8 million able-bodied individuals who choose not to meet community engagement requirements. 


QUESTION: Will thousands of North Dakotans lose Medicaid coverage? 

ANSWER: North Dakota manages Medicaid efficiently and is well-positioned under these reforms. Roughly 13% of North Dakota residents are enrolled in Medicaid. More than half of those are seniors in long-term care—who are not affected by the community engagement requirements established in the One Big Beautiful Bill. 

According to KFF data, 72% of Medicaid-covered adults in North Dakota already work full or part-time. Only around 10% fall into the category of able-bodied adults aged 19–64 who may need to meet the new community engagement requirements. 

If you’d like to read more, North Dakota reporter Michael Standaert recently wrote a helpful piece titled, “North Dakota well-positioned to deal with proposed Medicaid changes.”


QUESTION: Are the One Big Beautiful bill’s work requirements too burdensome?  

ANSWER: No. The community engagement requirement is 20 hours per week of work, school, or volunteering—reasonable expectations for able-bodied adults receiving taxpayer-funded Medicaid coverage. Below is a list of populations exempt from work requirements:

 

  • Individuals under 19 or over 64  

  • Pregnant women  

  • Foster youth and former foster youth under the age of 26  

  • Members of Tribes   

  • Medically frail individuals (including those with disabilities, chronic illnesses, or substance use disorders) 

  • Individuals already meeting work requirements through the Temporary Assistance for Needy Families (TANF) program or Supplemental Nutrition Assistance Program (SNAP) 

  • Parents and caregivers 

  • Individuals who are incarcerated or recently released from incarceration within the past 90 days 



QUESTION: Does this bill impact Medicare or Social Security? 

ANSWER: No, this bill does not touch Medicare and Social Security benefits. Importantly, it reduces taxes on Social Security for low and middle-income seniors by allowing a new $4,000 deduction for seniors earning under $75,000 individually or $150,000 for married couples. This deduction allows eligible seniors to offset the taxes they would otherwise pay on their Social Security benefits.   


These reforms are about making Medicaid work better—protecting it for the vulnerable and ensuring it remains financially sustainable for the future.

As always, I’m committed to making government more efficient, more accountable, and more focused on the people it’s meant to serve. If you’d like more frequent updates, be sure to sign up for my press releases, and subscribe here for my monthly newsletter. If you have any additional questions or concerns, please call my D.C. office at (202) 225-2611. Your voice and values are what guide my work in Congress. It is an honor to serve you in the People’s House.   

Sincerely,
JF Signature

Julie Fedorchak
Member of Congress