25 million Americans could lose their health coverage if Republicans cut Medicaid budget by one third across the board

The budget resolution passed by House Republicans on February 25 does not include specific policies, and at this stage of the budget process, it is impossible to know how budget reconciliation legislation will be written. However, the House-passed budget requires a minimum of $1.5 trillion in federal funding cuts and requires at least $2 trillion in cuts in order to unlock proposed additional tax breaks for the wealthiest Americans. To help hit those targets, the Republican House Budget Committee laid out a menu of potential cuts, including cutting up to $2.3 trillion from Medicaid – about one third of Medicaid’s projected federal funding over that period.    

Given the size of cuts under consideration, and the potential that states would be forced to make additional cuts if federal funding for Medicaid decreases, this analysis from the Joint Economic Committee – Minority lays out what it could mean if Republicans succeed in cutting federal funding for Medicaid by up to one third and distribute those cuts evenly across all populations and geographies. These numbers are not intended to predict precisely what will happen, but rather to help demonstrate the magnitude of the cuts that congressional Republicans may make.

Rural America: Medicaid covers nearly a quarter of Americans in rural areas – more than 10 million people. If the Republican budget cuts a third of federal Medicaid funding across all geographies, 3 million people in rural areas could lose their health insurance.

Children: Medicaid insures nearly 40% of children nationwide, or around 30 million kids. If the Republican budget cuts a third of federal Medicaid funding for this population, 10 million children could lose their coverage – 1 in 8 kids nationwide.

Nursing home residents: Medicaid pays for about 60% of nursing home residents in the United States. If the Republican budget cuts a third of federal Medicaid funding for nursing homes, 1 in every 5 seniors could lose their nursing home care.

Overall: Medicaid covers more than 80 million people in the United States, nearly a quarter of all U.S. residents. If the Republican budget cuts a third of federal Medicaid funding across the board, more than 25 million Americans could lose their health coverage.

State-by-State Impact

As with the national numbers on page 1, the following state-by-state analysis lays out what it could mean if Republicans succeed in cutting one third of federal Medicaid funds, spread evenly across all populations and geographies. These numbers are not intended to predict precisely what will happen, but rather to help demonstrate the magnitude of the cuts that congressional Republicans may make.

Alabama

Medicaid covers more than 1 million people in Alabama, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Alabama could see—

• 84,000 rural residents lose their health coverage
• 170,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 330,000 people cut off from their health insurance

Alaska

Medicaid covers nearly 250,000 people in Alaska, more than 22% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Alaska could see—

• 19,000 rural residents lose their health coverage
• 21,000 children lose their health insurance
•  Nearly 1 in 4 of seniors lose their nursing home care
• In total, more than 80,000 people cut off from their health insurance

Arizona

Medicaid covers more than 2 million people in Arizona, more than 20% of the people in the state. If
the Republican budget cuts a third of federal Medicaid funding across all populations and
geographies, Arizona could see—

• 47,000 rural residents lose their health coverage
• 190,000 children lose their health insurance
• More than 1 in 6 seniors lose their nursing home care
• In total, more than 660,000 people cut off from their health insurance

Arkansas

Medicaid covers nearly 780,000 people in Arkansas, more than 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Arkansas could see—

• 100,000 rural residents lose their health coverage
• 110,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 250,000 people cut off from their health insurance

California

Medicaid covers more than 13.6 million people in California, more than 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, California could see—

• 59,000 rural residents lose their health coverage
• 1.2 million children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 4.5 million people cut off from their health insurance

Colorado

Medicaid covers nearly 1.2 million people in Colorado, more than 17% of the people in the state. If

the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Colorado could see—

• 48,000 rural residents lose their health coverage
• 140,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, nearly 400,000 people cut off from their health insurance

Connecticut

Medicaid covers more than 950,000 people in Connecticut, more than 21% of the people in the
state. If the Republican budget cuts a third of federal Medicaid funding across all populations and
geographies, Connecticut could see—

• 14,000 rural residents lose their health coverage
• 94,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 310,000 people cut off from their health insurance

District of Columbia

Medicaid covers more than 260,000 people in the District of Columbia, nearly 25% of the population. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, D.C. could see—

• 17,000 children lose their health insurance
• More than 1 in 4 seniors lose their nursing home care
• In total, more than 86,000 people cut off from their health insurance

Delaware

Medicaid covers 270,000 people in Delaware, nearly 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Delaware could see—

• 17,000 rural residents lose their health coverage
• 28,000 children lose their health insurance
• More than 1 in 6 seniors lose their nursing home care
• In total, more than 90,000 people cut off from their health insurance

Florida

Medicaid covers more than 3.9 million people in Florida, more than 17% of the people in the state.
If the Republican budget cuts a third of federal Medicaid funding across all populations and
geographies, Florida could see—

• 44,000 rural residents lose their health coverage
• 590,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 1.3 million people cut off from their health insurance

Georgia

Medicaid covers nearly 2 million people in Georgia, more than 17% of the people in the state. If the
Republican budget cuts a third of federal Medicaid funding across all populations and
geographies, Georgia could see—

• 120,000 rural residents lose their health coverage
• 360,000 children lose their health insurance
• Nearly 1 in 4 seniors lose their nursing home care
• In total, more than 630,000 people cut off from their health insurance

Hawaii

Medicaid covers nearly 440,000 people in Hawaii, or 20% of the people in the state. If the
Republican budget cuts a third of federal Medicaid funding across all populations and
geographies, Hawaii could see—

• 20,000 rural residents lose their health coverage
• 35,000 children lose their health insurance
• More than 1 in 6 seniors lose their nursing home care
• In total, more than 140,000 people cut off from their health insurance

Idaho

Medicaid covers more than 330,000 people in Idaho, or 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Idaho could see—

• 34,000 rural residents lose their health coverage
• 53,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 110,000 people cut off from their health insurance

Illinois

Medicaid covers more than 3.4 million people in Illinois, or 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Illinois could see—

• 85,000 rural residents lose their health coverage
• 330,000 children lose their health insurance
• Nearly 1 in 4 seniors lose their nursing home care
• In total, more than 1.1 million people cut off from their health insurance

Indiana

Medicaid covers more than 1.8 million people in Indiana, or 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Indiana could see—

• 100,000 rural residents lose their health coverage
• 190,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 600,000 people cut off from their health insurance

Iowa

Medicaid covers nearly 680,000 people in Iowa, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Iowa could see—

• 84,000 rural residents lose their health coverage
• 95,000 children lose their health insurance
• Nearly 1 in 6 seniors lose their nursing home care
• In total, more than 220,000 people cut off from their health insurance

Kansas

Medicaid covers nearly 430,000 people in Kansas, nearly 15% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Kansas could see—

• 46,000 rural residents lose their health coverage
• 72,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 140,000 people cut off from their health insurance

Kentucky

Medicaid covers nearly 1.5 million people in Kentucky, more than 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Kentucky could see—

• 170,000 rural residents lose their health coverage
• 160,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, nearly 500,000 people cut off from their health insurance

Louisiana

Medicaid covers more than 1.6 million people in Louisiana, more than 30% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Louisiana could see—

• 83,000 rural residents lose their health coverage
• 190,000 children lose their health insurance
• Nearly 1 in 4 seniors lose their nursing home care
• In total, more than 530,000 people cut off from their health insurance

Maine

Medicaid covers nearly 370,000 people in Maine, or 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Maine could see—

• 43,000 rural residents lose their health coverage
• 29,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 120,000 people cut off from their health insurance

Maryland

Medicaid covers more than 1.6 million people in Maryland, or 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Maryland could see—

• 17,000 rural residents lose their health coverage
• 150,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 530,000 people cut off from their health insurance

Massachusetts

Medicaid covers more than 1.6 million people in Massachusetts, nearly 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Massachusetts could see—

• 8,400 rural residents lose their health coverage
• 160,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 530,000 people cut off from their health insurance

Michigan

Medicaid covers more than 2.5 million people in Michigan, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Michigan could see—

• 120,000 rural residents lose their health coverage
• 280,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 830,000 people cut off from their health insurance

Minnesota

Medicaid covers nearly 1.2 million people in Minnesota, more than 15% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Minnesota could see—

• 89,000 rural residents lose their health coverage
• 130,000 children lose their health insurance
• More than 1 in 6 seniors lose their nursing home care
• In total, nearly 400,000 people cut off from their health insurance

Mississippi

Medicaid covers more than 640,000 people in Mississippi, or nearly 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Mississippi could see—

• 120,000 rural residents lose their health coverage
• 110,000 children lose their health insurance
• Nearly 1 in 4 seniors lose their nursing home care
• In total, more than 200,000 people cut off from their health insurance

Missouri

Medicaid covers more than 1.3 million people in Missouri, more than 15% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Missouri could see—

• 99,000 rural residents lose their health coverage
• 160,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 430,000 people cut off from their health insurance

Montana

Medicaid covers more than 230,000 people in Montana, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Montana could see—

• 40,000 rural residents lose their health coverage
• 32,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 76,000 people cut off from their health insurance

Nebraska

Medicaid covers more than 350,000 people in Nebraska, more than 15% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Nebraska could see—

• 38,000 rural residents lose their health coverage
• 53,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 110,000 people cut off from their health insurance

Nevada

Medicaid covers more than 810,000 people in Nevada, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Nevada could see—

• 12,000 rural residents lose their health coverage
• 91,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 270,000 people cut off from their health insurance

New Hampshire

Medicaid covers more than 180,000 people in New Hampshire, or 13% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, the Granite State could see—

• 24,000 rural residents lose their health coverage
• Nearly 30,000 children lose their health insurance¹
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 60,000 people cut off from their health insurance

New Jersey

Medicaid covers more than 1.9 million people in New Jersey, or 18% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, New Jersey could see—

• 230,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 630,000 people cut off from their health insurance

¹This estimate for the number of children is based on more recent data available in New Hampshire from the NH Department of Health and Human Services, February 2025 report “New Hampshire Medicaid Demographic Trends and Geography”, and therefore differs from the source of child enrollee estimates for other states in this report.

New Mexico

Medicaid covers more than 780,000 people in New Mexico, or 33% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, New Mexico could see—

• 83,000 rural residents lose their health coverage
• 95,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 260,000 people cut off from their health insurance

New York

Medicaid covers nearly 7 million people in New York, or 29% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, New York could see—

• 150,000 rural residents lose their health coverage
• 590,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 2.2 million people cut off from their health insurance

North Carolina

Medicaid covers more than 2.6 million people in North Carolina, nearly 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, North Carolina could see—

• 160,000 rural residents lose their health coverage
• 330,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 860,000 people cut off from their health insurance

North Dakota

Medicaid covers more than 100,000 people in North Dakota, or 12% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, North Dakota could see—

• 14,000 rural residents lose their health coverage
• 14,000 children lose their health insurance
• More than 1 in 6 seniors lose their nursing home care
• In total, more than 33,000 people cut off from their health insurance

Ohio

Medicaid covers more than 2.9 million people in Ohio, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Ohio could see—

• 130,000 rural residents lose their health coverage
• 330,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than 960,000 people cut off from their health insurance

Oklahoma

Medicaid covers more than 970,000 people in Oklahoma, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Oklahoma could see—

• 100,000 rural residents lose their health coverage
• 150,000 children lose their health insurance
• Nearly 1 in 4 seniors lose their nursing home care
• In total, more than 320,000 people cut off from their health insurance

Oregon

Medicaid covers more than 1.4 million people in Oregon, or nearly 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Oregon could see—

• 57,000 rural residents lose their health coverage
• 110,000 children lose their health insurance
• Nearly 1 in 5 of seniors lose their nursing home care
• In total, more than 460,000 people cut off from their health insurance

Pennsylvania

Medicaid covers more than 3.2 million people in Pennsylvania, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Pennsylvania could see—

• 120,000 rural residents lose their health coverage
• 350,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, more than a million people cut off from their health insurance

Rhode Island

Medicaid covers nearly 330,000 people in Rhode Island, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Rhode Island could see—

• 25,000 children lose their health insurance
• More than 1 in 5 seniors lose their nursing home care
• In total, nearly 110,000 people cut off from their health insurance

South Carolina

Medicaid covers more than 1.1 million people in South Carolina, or 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, South Carolina could see—

• 59,000 rural residents lose their health coverage
• 170,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 360,000 people cut off from their health insurance

South Dakota

Medicaid covers nearly 130,000 people in South Dakota, or 13% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, South Dakota could see—

• 25,000 rural residents lose their health coverage
• 22,000 children lose their health insurance
• Nearly 1 in 6 seniors lose their nursing home care
• In total, more than 40,000 people cut off from their health insurance

Tennessee

Medicaid covers nearly 1.5 million people in Tennessee, nearly 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Tennessee could see—

• 110,000 rural residents lose their health coverage
• 220,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 460,000 people cut off from their health insurance

Texas

Medicaid covers nearly 4.3 million people in Texas, or 17% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Texas could see—

• 190,000 rural residents lose their health coverage
• 940,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 1.4 million people cut off from their health insurance

Utah

Medicaid covers more than 330,000 people in Utah, more than 10% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Utah could see—

• 18,000 rural residents lose their health coverage
• 57,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 110,000 people cut off from their health insurance

Vermont

Medicaid covers more than 160,000 people in Vermont, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Vermont could see—

• 32,000 rural residents lose their health coverage
• 15,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 53,000 people cut off from their health insurance

Virginia

Medicaid covers nearly 1.9 million people in Virginia, more than 15% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Virginia could see—

• 72,000 rural residents lose their health coverage
• 200,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 600,000 people cut off from their health insurance

Washington

Medicaid covers nearly 1.9 million people in Washington, more than 20% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Washington could see—

• 61,000 rural residents lose their health coverage
• 210,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 600,000 people cut off from their health insurance

West Virginia

Medicaid covers nearly 520,000 people in West Virginia, more than 25% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, West Virginia could see—

• 63,000 rural residents lose their health coverage
• 54,000 children lose their health insurance
• 1 in 4 seniors lose their nursing home care
• In total, more than 170,000 people cut off from their health insurance

Wisconsin

Medicaid covers more than 1.2 million people in Wisconsin, more than 15% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Wisconsin could see—

• 87,000 rural residents lose their health coverage
• 140,000 children lose their health insurance
• Nearly 1 in 5 seniors lose their nursing home care
• In total, more than 400,000 people cut off from their health insurance

Wyoming

Medicaid covers more than 66,000 people in Wyoming, more than 10% of the people in the state. If the Republican budget cuts a third of federal Medicaid funding across all populations and geographies, Wyoming could see—

• 19,000 rural residents lose their health coverage
• 15,000 children lose their health insurance
• 1 in 5 seniors lose their nursing home care
• In total, more than 22,000 people cut off from their health insurance