In a sweeping legislative gamble, Congress is eyeing a plan that would boost Medicare payments by 2026—while slashing Medicaid in ways critics say could endanger millions.
At a Glance
- Medicare payments would rise 75% in 2026, following a 3% drop in 2025
- Democrats seek permanent physician pay reform instead of temporary increases
- Medicaid cuts could eliminate coverage for millions or raise patient costs
- $715 billion in savings projected over 10 years from ACA and Medicaid changes
- Reconciliation process allows bill to bypass filibuster—if both chambers align
Budget Tug-of-War in Washington
In a pivotal domestic policy fight, lawmakers are wrangling over a proposed budget package that raises Medicare reimbursements while trimming Medicaid spending to offset the costs. Under the House Committee on Energy and Commerce’s plan, doctors would see a 75% hike in the Medicare conversion factor by 2026, softening the blow of a 3% drop projected for next year.
Still, critics like Rep. Raul Ruiz (D-CA) call the proposal “woefully underfunded,” warning that short-term boosts fail to solve long-term underpayment for providers battling inflation. The plan’s savings—totaling an estimated $715 billion over a decade—would come largely from Medicaid and Affordable Care Act rollbacks, raising alarms about accessibility.
Watch a report: Congress Debates Medicare Hike, Medicaid Cuts.
Public Safety or Political Sacrifice?
The proposed Medicaid cuts, though less extreme than those demanded by ultraconservative lawmakers, are still deeply controversial. In a blistering rebuke, Sen. Bernie Sanders declared that “thousands of low-income and working people will die” if the current draft becomes law.
The changes would tighten eligibility and reduce federal support, shifting costs to states and beneficiaries. Anders Gilberg, a key voice at the Medical Group Management Association, warned the cuts could have “negative repercussions for physician reimbursement” by weakening patient coverage and increasing uncompensated care.
Despite the backlash, House Republicans maintain that the bill reflects a delicate balance—preserving Trump’s fiscal priorities while avoiding deeper structural changes to Medicaid. Their strategy relies on reconciliation, a fast-track process requiring simple majorities but airtight coordination between chambers.
Future of U.S. Healthcare Hangs in Balance
The legislative blueprint also targets Medicare Advantage programs and explores shifting Medicare from fee-for-service to value-based models. Former Medicare Chief Mark Miller says these discussions could reshape the program’s foundation, but the path forward remains murky.
While physicians cautiously welcome the 2026 boost, most see it as a stopgap—hardly enough to cover inflation or the costs of care delivery. And with millions of Medicaid recipients on edge, the broader health system could face destabilizing aftershocks.
As negotiations continue, the fight over this bill represents more than a fiscal ledger. It’s a battle over national priorities, the future of care access, and the moral costs of balancing budgets on the backs of the sick and poor.
