U.S. House Speaker Mike Johnson (R-La.) vehemently denied claims on Sunday that a newly passed House bill, dubbed President Trump’s “big beautiful bill,” would result in 4.8 million Americans losing Medicaid coverage and negatively impact rural hospitals.
In an interview on NBC’s Meet the Press with Kristen Welker, Speaker Johnson asserted that the legislation, which is now headed to the Senate, aims to strengthen the Medicaid program by reducing fraud, waste, and abuse, rather than enacting cuts.
Concerns have been raised, notably by the American Hospital Association, which issued a warning that “the sheer magnitude of the level of reductions to the Medicaid Program alone will impact all parties hospitals, especially in rural and underserved areas, will be forced to make difficult decisions about whether they will have to reduce services, reduce staff and potentially consider closing their doors.” Republican Senator Josh Hawley of Missouri also echoed these concerns, calling the bill a “hospital tax.”
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When directly asked by Welker if the House bill puts rural Americans at risk, Speaker Johnson responded unequivocally, “No, and you can underscore what I’m about to tell you there are no Medicaid Cuts in the big, beautiful Bill. We’re not cutting Medicaid. What we’re doing is strengthening the program.”
The core of the debate revolves around a proposed requirement in the bill that would mandate able-bodied individuals to work or volunteer 20 hours per week to maintain Medicaid eligibility. Opponents argue this requirement could disproportionately affect vulnerable populations and lead to significant coverage losses.
Speaker Johnson pushed back on these assertions, stating that the concern about 4.8 million people losing coverage is based on a misunderstanding of the bill’s intent and impact.
He clarified that this figure refers to “able-bodied workers” who, in his view, should contribute to society if they are capable. “If you are able to work and you’re not, and you are riding on the public wagon, you need to help pull it,” Johnson stated. He emphasized the flexibility of the 20-hour requirement, noting it can be fulfilled through volunteering in the community or participating in job training programs.
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“This is no draconian requirement,” Johnson said, “All we’re requiring in the legislation is 20 hours a week, you can volunteer in your community. You can be in a job training program, or you can get to work.” He specifically directed a message to “young men around the country who are taking advantage of the system,” arguing that such a work requirement is “a very popular thing among the American people because it comports with common sense.”
Welker pressed Speaker Johnson on the 4.8 million figure, noting it is a Congressional Budget Office (CBO) estimate of how many people would lose Medicaid if the bill becomes law. She also questioned whether Johnson had proof that these individuals were engaging in fraud, as he had suggested.
Speaker Johnson clarified his position, asserting, “Those 4.8 million people will not lose their Medicaid unless they choose to do so.” He maintained that the work requirement is easily met and that objections to it are unfounded. “I will go into any town hall in any District in America and explain what this is, and every single person will nod their head and go, ‘Oh, that makes sense.’ You’re telling me that you’re going to require the able-bodied, these young men, for example, 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.”
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Regarding the issue of fraud, Johnson reiterated that there is “a tremendous amount of fraud in Medicaid. It’s undisputed tens of billions of dollars every year are lost in fraud to Medicaid.” He also cited an additional 1.2 million people who he claimed are “totally ineligible to be on the program” and evidence of individuals “enrolled in multiple programs in multiple States simultaneously, and they are cheating the system.”
Speaker Johnson concluded by stating that the legislation “preserves Medicare, strengthens Medicaid for the people who actually need it and deserve it, and we’re going to get rid of the fraud, race, and abuse, and that is a long time overdue.” The bill now moves to the Senate, where it is expected to face further scrutiny and debate.
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