Illegal immigrants, ‘able-bodied’ non-workers: 7.6 million in US may lose Medicaid, but Trump admin says they ‘didn't deserve it’

The White House is preparing to take on criticism from Senate Republicans over planned Medicaid cuts by arguing that the changes will only impact those who, in their view, should not have been on the programme in the first place.

A group of Republican senators has raised concerns about the proposed cuts to Medicaid in the major tax and spending package passed by the House last month. However, senior officials close to President Donald Trump told POLITICO the reductions are designed to exclude undocumented immigrants and able-bodied individuals who are not working.

“This bill will preserve and protect the programs, the social safety net, but it will make it much more common sense,” said Russ Vought, Director of the Office of Management and Budget, on Sunday. “That’s what this bill does. No one will lose coverage as a result,” he added.

Work rules and immigration status key to new eligibility

The legislation would introduce new work requirements for Medicaid and block undocumented immigrants from accessing the programme. Supporters of the bill argue these measures will result in hundreds of billions in savings over the next ten years.

According to official projections, around 7.6 million low-income people could lose coverage as a result of the proposed changes. While the White House claims the focus is on narrowing eligibility to those who “deserve” assistance, health experts warn that the effects may extend well beyond undocumented immigrants and unemployed adults.

Additional paperwork and tougher requirements could make it more difficult for eligible Americans to stay enrolled, leading to many losing coverage even if they meet the criteria.

Trump officials stress support for elderly and disabled

The administration has continued to publicly stress that the plan will not affect elderly or disabled Americans who rely on Medicaid.

“Medicaid does not belong to people who are here illegally, and it does not belong to capable and able-bodied men who refuse to work,” said one White House official.

White House spokesperson Kush Desai said Trump would “protect and preserve Medicaid” by “kicking illegal immigrants off of the program and implementing commonsense work requirements,” adding that the public had voted for such policies.

Lessons from past backlash

The proposed changes come despite Republicans facing major setbacks in 2017 over attempts to roll back health care coverage. Efforts to repeal Obamacare that year were met with strong public opposition and were seen as a factor in the GOP’s poor performance in the following midterm elections.

But Trump officials believe the current strategy could prove more popular, especially if the cuts are seen as targeted efforts to protect the system for those who need it most.

The messaging is also in line with Trump’s policy, framing policies as simple choices between those who belong and those who do not. Just as he has done with immigration and trade, Trump is presenting Medicaid reform as a way to protect American resources from those he sees as taking unfair advantage.