Medicaid cuts will hurt families and cost GOP politically, says Kentucky governor

The country’s Democratic governors are sounding the alarm over a Republican plan that they say would leave millions of people without access to health care.

A bill drafted by House Republicans calls for hundreds of billions of dollars in cuts and steps to make it harder to enroll in or stay in Medicaid, the program that provides health coverage for low- and middle-income households. Among the changes are tougher eligibility requirements and work requirements, the Associated Press reports.

The nonpartisan Congressional Budget Office estimates that at least 8.6 million people would lose health insurance coverage by 2034 with the proposed cuts and changes to Medicaid. Republicans also proposed cuts to the Supplemental Nutrition Assistance Program (SNAP).

All 23 Democratic governors signed a statement saying that “Republicans’ proposed cuts would be disastrous – ripping away quality, affordable health care from families, forcing rural hospitals to close their doors, and causing fiscal chaos across the country.” The statement also says that the notion that states will be able to backfill the cuts with state resources is “simply inaccurate and impossible.”

Kentucky Gov. Andy Beshear speaks during the Semafor World Economy Summit 2025 at Conrad Washington on April 23 in Washington, DC.
Kentucky Gov. Andy Beshear speaks during the Semafor World Economy Summit 2025 at Conrad Washington on April 23 in Washington, DC. (Kayla Bartkowski | Getty Images)

In an interview with Morning Edition, Gov. Andy Beshear of Kentucky, one of the governors who signed the statement, called Republicans’ bill a “bad plan that is going to hurt families” and warned Republicans that they will face electoral backlash.

Beshear also discussed his state’s reliance on Medicaid, where cuts to the program will hurt the most and how Democrats can push back against the GOP while being fully out of power in Washington.

This interview has been lightly edited for length and clarity.


Interview highlights 

Michel Martin: So what are your biggest concerns should this bill become law? How do you see it playing out in your state? What are your top three worries?

Gov. Andy Beshear: My biggest concerns are the people who need health care coverage are going to lose it. Medicaid covers the people we love the most, our parents and our kids. Half of Kentucky’s kids are covered by Medicaid, and 70% of our long-term care costs are covered by Medicaid.

And so when the analysis that is coming out about this bill shows that millions of people will lose their health care. One set of analysis set up to eight and a half million. That’s almost double the entire population of my state. It means that kids will lose health care. It means that seniors will lose health care. And what that means is that families will struggle to make up those dollars and to make up that care.

Now, Medicaid is something that also drives and fuels rural health care. And if you remove coverage for millions of people, you remove significant revenue going into those hospital systems. So what we’ll see are layoffs. We will see closures and we’ll see folks that live in rural America having to drive hours just to see a doctor.

And then finally, the cuts to snap are just mean and cruel. You know, my faith teaches me that there should be enough food for everyone. The miracle of the fishes and the loaves is in every single book of the gospel. And in a country where we grow food for all of our people, a program like SNAP just makes sure that we don’t have hungry kids, that we don’t have hungry families, and that ultimately everybody has the basic food that they need to get healthy and to get into that workforce.

Martin: So Republicans argue two things. One is that there’s a lot of fraud and waste in Medicaid. And the second is that the program has expanded beyond what it was intended for. And if you address those things, it’ll preserve the program for the people who really need it. What do you say to that?

Beshear: If you’re worried that there’s fraud and abuse, there are units that are already out there that are going after bad providers. I ran one of them. Just about every attorneys general office has one. And if you want to ferret out fraud, better fund those units and you will get those results. But what this plan tries to do is to add burdens to those that are on Medicaid to fill out forms more often, to check the right box, to create just more challenges so that someone will not fill out something correctly and they’ll lose coverage for a certain period of time. It’s what I’m also concerned that this administration is trying to do on Social Security by shutting down offices and shutting down the call center and making those on a fixed income drive an hour or two to show up to an office and to not have the right forms. This is an effort just to make it harder for people who already qualify to get the health care that they need.

Martin: So there are some people within the Republican Party who wanted more aggressive cuts to Medicaid who think these cuts don’t go far enough and things that they wanted are not in this bill, like, for example, per capita limits on Medicaid spending. So this represents a compromise from their perspective. Are there things that Democrats should be willing to consider in order to address their concerns?

Beshear: I think you should always be willing to consider a plan that’s out there. But the more hardline Republicans would have it almost eliminated, if not fully eliminated, rural health care. You look at rural hospital systems that are the second largest employer in most of the counties that they’re in after the public school systems. Many of them have up to 40% of their total revenue in Medicaid. Major slashes to Medicaid, even this plan, threaten that rural health care. And I think that rural Americans ought to be able to see a doctor, ought to be able to go to a clinic, ought to be able to see a nurse practitioner in their own communities. And so what I’d say to those hard liners is go out and talk to the people in your communities. They are not for this. People understand Medicaid in a different way than they did 20 years ago. They realize how important it is to their local economy and to their family.

Martin: Given the Republican Party’s control of both houses of Congress and the White House, is there really anything that Democrats can do beyond issuing statements like the one that the Democratic governors did to stop this?

Beshear: We can speak up and we can speak out and so can all of the American people. This is a really bad plan that is going to hurt families. And when you look at anything from polling numbers to what I hear in communities, they are going to react and react negatively to this Republican plan. This is going to cost Republicans not just in swing districts, but in many districts their seats. And so I hope they don’t do it. I hope they don’t do it to preserve health care for families. But if it takes electoral pressure, then so be it.

The radio version of this story was edited by Arezou Rezvani. The digital version was edited by Treye Green.

Transcript:

A MARTÍNEZ, HOST:

Health Secretary Robert F. Kennedy Jr. visits Capitol Hill today to tell lawmakers why he wants less money for his agency, the Department of Health and Human Services. NPR’s Selena Simmons-Duffin spoke with three former health secretaries to hear how they think Kennedy is handling the job.

SELENA SIMMONS-DUFFIN, BYLINE: After just six weeks as secretary of health and human services, Robert F. Kennedy Jr. declared that the org chart was, quote, “incomprehensible” and the whole agency needed an overhaul. In late March, he posted a video on social media.

(SOUNDBITE OF ARCHIVED RECORDING)

ROBERT F KENNEDY JR: HHS has more than a hundred communications offices and more than 40 IT departments, and dozens of procurement offices and nine HR departments.

SIMMONS-DUFFIN: Five days later, 10,000 staffers were fired – not just in HR and IT, but physicians, statisticians, whole centers at CDC and food safety labs were shuttered. The process was chaotic, and Kennedy added to the confusion by suggesting that as many as 20% of those fired could be brought back. He told CBS in April that going through each job line by line wouldn’t have worked.

(SOUNDBITE OF ARCHIVED RECORDING)

KENNEDY: It takes too long, and you lose political momentum.

SIMMONS-DUFFIN: Kennedy is the 26th secretary of health and human services. Tommy Thompson was the 19th. He was health secretary under President George W. Bush.

TOMMY THOMPSON: I’m not one of those that’s going to criticize the administration or Bobby Kennedy for cutting back because I think it’s necessary in government at all levels.

SIMMONS-DUFFIN: He does say he wished Kennedy’s team would learn a bit more about the department before they made the cuts, and…

THOMPSON: I hope that they don’t cut programs that are absolutely necessary for public health.

SIMMONS-DUFFIN: Two other former health secretaries, Kathleen Sebelius, who served under President Obama, and Donna Shalala, who served under President Clinton, both tell NPR they are alarmed by Kennedy’s approach to the agency. Here’s Sebelius.

KATHLEEN SEBELIUS: I think it’s horrifying to not really understand or know what it is that you’re doing and what impact it could have on the lives and well-being of people across this country, and then try to fix it after the fact. That makes no sense to me.

SIMMONS-DUFFIN: Shalala emphasizes there will be economic consequences to these moves.

DONNA SHALALA: If you look at the power of just NIH to drive the economy, it’s not just a bunch of laboratories with a bunch of scientists. It’s the next generation of scientists and engineers. I don’t know where Elon Musk is going to get his engineers in the future if you have drastic cuts in science and in technology.

SIMMONS-DUFFIN: She says when she was secretary, HHS saved the government money by beefing up oversight to identify fraud and abuse.

SHALALA: There’s no evidence that when they’re breaking down the government with a hammer and bludgeoning these agencies, they know how to put them back together with a new strategy. There’s no evidence of that.

SIMMONS-DUFFIN: Kennedy does have defenders. Roger Severino served in HHS in the first Trump administration and is now with the conservative think tank The Heritage Foundation.

ROGER SEVERINO: HHS lost its way. It lost its vision from making sure the outcomes were there of improving longevity and quality of life, and instead, it turned into a money-dispensing machine. It was an ATM. Why? Because special interests have captured HHS, and RFK Jr. is committed to ending it.

SIMMONS-DUFFIN: So is Kennedy rooting out special interests and streamlining the mission of HHS, or is he battering the agency and hampering scientific progress? Lawmakers in two hearings today will have a chance to pose some of these big questions to Kennedy. His answers could determine which of these major changes Congress makes permanent in the new budget.

Selena Simmons-Duffin, NPR News, Washington.

 

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