Pew Research: New Rules Threaten Health Care for Millions

A Lifeline for Millions

Medicaid, the joint federal-state health insurance program, currently covers about 1 in 5 Americans. Designed to serve low-income individuals, children, pregnant women, the elderly, and people with disabilities, Medicaid is a cornerstone of the U.S. healthcare system. As of January 2025, 71.4 million people were enrolled in Medicaid, with another 7.3 million in CHIP (Children's Health Insurance Program).

• Medicaid paid for 41% of all births in the United States in 2023.

How It Works

Though federally overseen, each state runs its own version of Medicaid—resulting in 56 distinct programs. States have flexibility to expand eligibility and offer additional services, leading to wide variation in coverage and enrollment.

Who It Covers

Children make up 36% of enrollees, while 26% are adults covered by the ACA expansion. The rest include elderly individuals, the disabled, and other low-income adults. Over half of U.S. children receive health insurance through Medicaid or CHIP.

• 83% of Americans—including 74% of Republicans—have a favorable view of Medicaid.

Medicaid’s Pandemic Surge

COVID-era “continuous coverage” policies triggered a record enrollment spike, peaking at 87.4 million in April 2023. Enrollment has declined since the rule expired in December 2023.

The Big Beautiful Bill: What Just Changed

Recently, Congress passed the Big Beautiful Bill, ushering in sweeping Medicaid changes:

• $285 billion in cuts over 10 years

• Work requirements for many adult enrollees

• Millions expected to lose coverage, per CBO

Who Pays for It

Medicaid’s $894 billion annual cost is split about 70/30 between federal and state governments. Poorer states receive more federal support—up to 85% in some cases.

Working But Still in Need

Despite the focus on work requirements, the facts show:

• 44% of enrollees aged 19–64 work full-time

• 20% work part-time

• Most non-working adults are caregivers, students, or disabled

What’s at Stake

Medicaid funds a third of nursing home care, 41% of U.S. births, and significant mental health and long-term care services. Cuts impact the most vulnerable—children, seniors, and the disabled.

Nearly half of Medicaid enrollees have household incomes under $50,000.

The Road Ahead

As Medicaid faces unprecedented changes, millions risk losing critical health coverage. Understanding what’s at stake—and who’s affected—has never been more important.

Stay Informed. Stay Engaged.