Johnson says 4.8 million Americans won't lose Medicaid access ‘unless they choose to do so'
Speaker Mike Johnson (R-La.) doubled down on his claim that there won't be Medicaid cuts in President Trump's 'big, beautiful bill,' despite projections that millions of low-income individuals would lose health insurance as a result of the bill.
Johnson, during an appearance on NBC's 'Meet the Press,' pushed back on independent projections that the bill would lead to 4.8 million who would lose coverage because of work requirements, saying they won't lose it 'unless they choose to do so.'
'Those 4.8 million people will not lose their Medicaid unless they choose to do so,' he told host Kristen Welker.
'You're telling me that you're going to require the able-bodied — these young men, for example, okay — to only work or volunteer in their community for 20 hours a week, and that's too cumbersome for them? I'm not buying it. The American people are not buying it.'
He added that the people who are complaining about losing their coverage are doing so 'because they can't fulfill the paperwork,' noting that the policy follows 'common sense.'
'When people work, when able-bodied young men work, it's good for them, for their dignity, their purpose, and it's good for the community,' he said. 'If you can't find a job, then volunteer in your community for 20 hours, and you will meet the requirement.'
The proposed Medicaid and health care reforms would require states to impose work requirements on childless adults aged 19-64 to be eligible for Medicaid. It also aims to shorten the open enrollment period for the Affordable Care Act, among other changes.
The reforms are key components of the bill, which the House Energy and Commerce Committee crafted after being tasked with finding more than $800 billion in savings over a decade. Those portions of the GOP proposal would save $625 billion over 10 years, according to the CBO.
Johnson said that the bill 'strengthens' Medicaid and said what they are doing is 'an important and frankly heroic thing.'
'It's intended for young, you know, single, pregnant women and the disabled and the elderly,' he said. 'But what's happening right now is you have a lot of people, for example, young men, able bodied workers, who are on Medicaid. They're not working when they can.'
His comments are just the latest assertion from Johnson that the bill won't threaten Medicaid coverage for people who need it.
However, the bill is hitting some roadblocks for Republican lawmakers, who are finding themselves enveloped in criticism at their town halls.
Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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Subscribe to The Post Most newsletter for the most important and interesting stories from The Washington Post. Specific policies could change as the bill heads to the Senate, where multiple Republicans have expressed concerns over work requirements for Medicaid. Yet the proposals reflect a shifting view among Republicans in Washington about who should receive federal benefits. In a New York Times op-ed last month, four top Trump officials overseeing housing, health and food programs wrote that welfare programs were created to help the neediest but have 'deviated from their original mission both by drift and by design.' Even able-bodied adults should look to welfare as a 'short-term hand-up, not a lifetime handout,' wrote Health and Human Services Secretary Robert F. Kennedy Jr., Centers for Medicare and Medicaid Services Administrator Mehmet Oz, Agriculture Secretary Brooke Rollins and Department of Housing and Urban Development Secretary Scott Turner. 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They say the policies risk dropping some of the most vulnerable benefits recipients - such as people who work inconsistent hours, go through bouts of unemployment, struggle with health issues that don't qualify as disabilities or do unpaid work caring for relatives. 'We have never required a 64-year-old single widow who's taking care of her grandchild to work in order to be able to receive SNAP benefits,' said Lauren Bauer, a fellow in economic studies at the Brookings Institution, referring to the food assistance program for low-income families. 'And I guess that's going to change.' Work requirements for benefits programs have been pushed at various times over decades. President Bill Clinton campaigned on a promise to 'end welfare as we know it' and in 1996 worked with the Republican-controlled Congress to overhaul benefits in a landmark law. The measure ended Aid to Families with Dependent Children - which effectively entitled the poorest Americans to federal help - and introduced Temporary Assistance for Needy Families, known more commonly as TANF. The number of people receiving federal welfare payments fell by half in four years, to 6.3 million in 2000. And the past few decades have given rise to debates over whether the changes worked, especially since measures of poverty fluctuate with recessions and other economic forces. The new policies under consideration could be even more far-reaching. Under the Affordable Care Act, adults with low incomes and no children or disabilities qualified for Medicaid for the first time, marking a significant expansion of the safety net insurance program. The new Republican plan would require beneficiaries to spend at least 80 hours a month working, training for a job, in school or volunteering to qualify for Medicaid. 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Within the Moving to Work cohort, the official said around 40 public housing agencies already have work requirements, are implementing them or plan to soon, and that such requirements often improve household incomes and employment. Opponents say an increase in work requirements would fall heavily on people who already have a harder time getting work, keeping steady housing or accessing health care. And they say the loss of benefits would be even more extensive given planned cuts to major services. For example, the White House budget proposal would significantly cut rental assistance programs for the fiscal year beginning in October, in part to shift more power to the states. It is unclear whether those cuts would be achieved through work requirements, since HUD's plans are still in flux. That could amount to millions of people losing aid whether they work or not, since many states won't be able to cover those losses. 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