A woman and her three children are staying at a charity that offers housing for expectant mothers in Fredericksburg, Virginia.

As Medicaid funding receives scrutiny, here's how it provides care for 72 million

March 27, 2025
Jahi Chikwendiu // The Washington Post via Getty Images

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As Medicaid funding receives scrutiny, here's how it provides care for 72 million

Republicans who control Congress , the popular federal-state insurance program that provides health and long-term care to millions of Americans. Lawmakers have indicated the cuts would help pay for President Donald Trump's tax policy, which is expected to include permanent tax breaks for wealthy Americans.

On Jan. 31, Trump said he would Social Security and Medicare鈥攖wo programs that disproportionately provide financial support and care for older Americans鈥攁s well as Medicaid. 

"We're not going to do anything with that, unless we can find some abuse or waste," the president said. "The people won't be affected. It will only be more effective and better."

Nearly two weeks later, reports, House Republicans formally tasked lawmakers who oversee the Medicaid budget to slash .

Medicaid serves about one in five Americans, and its supporters note it was not a key policy discussion between the major party candidates during the 2024 presidential campaign. On the receiving end of potential reductions to Medicaid are people: families鈥攊n particular pregnant people, mothers, caregivers and children. Some of these children also have complex medical needs and disabilities that advocates say could be impacted if the federal government halts some of its existing financial support.

As the future of Medicaid funding continues to be a part of the national conversation, here's what you need to know about how it currently ensures quality health and long-term care for large swaths of people.

How many people are on Medicaid, and who are they?

, a program created that is funded by both the federal government and states to provide health insurance to low-income people, children, individuals with disabilities and some older Americans. because they struggle to afford health care. 

In addition, there is the which ensures children whose parents earn too much to qualify for Medicaid鈥攂ut are also priced out of affordable private insurance鈥攁re still able to access health care. That group represents about 7.2 million children, for a total of just under 80 million people on Medicaid.

Combining Medicaid and CHIP enrollment, nearly half of all people on Medicaid, 37.6 million, are children.

Here is a breakdown of other enrollees, :

  • Parents and other adults under 65: 27.8 million
  • People with disabilities: 7.8 million
  • Individuals who are 65 and over: 5.6 million

The impact of Medicaid on women's health is in the data. The program covered 19 percent of adult women ages 19 to 64 , compared to 14 percent of men. One . Low-income parents who are on Medicaid are disproportionately women, according to Joan Alker, executive director of .

"There's a lot of ways in which gender, and women in particular, are at risk when we have these kinds of proposals for broad cuts," she said.

What services does Medicaid offer for pregnant people and new parents?

Medicaid provides health care coverage to low-income pregnant and postpartum people, a staple of the program since its inception nearly 60 years ago. Under Medicaid, pregnant people who need prenatal care are generally able to access 鈥攂enefits that improve the health of mothers and other caregivers.

"People of reproductive age really can benefit from having that steady coverage and going into pregnancy healthier," said Laura Harker, a senior policy analyst with . "So we really look at Medicaid across the reproductive journey."

The program is credited with . There are many variables to how much an uninsured person will actually pay for a birth, that a person with private insurance incurs an average of nearly $19,000 in health costs related to pregnancy, childbirth and postpartum care鈥攁nd that can translate to nearly $3,000 in out-of-pocket costs.

In short, Medicaid has served families for decades. 

"It's really hard to overstate the importance of Medicaid for kids and families," said Maddie Twomey, communications director with , a health care advocacy group. "You could rely on it at any point in your life."

Under a provision in former President Joe Biden's , states have recently been able to provide postpartum coverage for 12 months鈥攗p from a mandatory 60 days that had led to become uninsured shortly after the birth of a child.

, and these disparities

To date, have agreed to expand postpartum coverage, which experts believe could help address health disparities that cause pregnancy-related deaths. A year of postpartum coverage parents address postpartum depression, which may not appear for months, as well as medical debt.

Some policy experts caution about drawing definitive conclusions yet on the effects of the extended postpartum coverage period but agree that the U.S. maternal mortality rate remains stubbornly high鈥攐ne estimate by the Centers for Disease Control and Prevention 鈥攃ompared to .

Health advocates worry that general cuts to the Medicaid program would inevitably impact whether as many states offer extended postpartum coverage as they try to offset the federal government reducing any matching funds it has provided.  

What does Medicaid do for children?

Through Medicaid and CHIP, millions of the nation's children : checkups and emergency care, dental and vision, laboratory and X-ray services, vaccine immunizations, mental health and other services.

That results in . There are other benefits, too: and higher wages later in life. "It's one of these things that works so well, it's ultimately a really good investment," Twomey said.

Medicaid also plays a major role in care for children with complex medical needs and disabilities. Data from 2019 estimated there are 13.9 million children with special health care needs in the country. Medicaid covers almost half of them, .

Children (and adults) with such special health needs may require what's known as long-term services and supports鈥攚hich includes . attendant care, assistive technology, case management and private duty nursing which allows children to live at home with their families instead of institutionalized care. Depending on the state, Medicaid pays for many of those services when private insurance often does not.

"It is the lifeline for children with complex medical needs and disabilities, unless you're independently wealthy," said Elena Hung, executive director and co-founder of , a national advocacy organization for children with such needs.

School districts also use Medicaid dollars to provide certain medically necessary services to eligible students under . Medicaid dollars pay for professionals like speech-language pathologists, audiologists, occupational therapists, school psychologists and school social workers who provide services to eligible students. 

How else does Medicaid impact overall caregiving?

Medicaid , according to KFF. That care is key for women, . In 2021, were dually enrolled in Medicare and Medicaid, a supplemental coverage setup that helps them and others pay for more of their care needs. 

Medicaid pays for , a population that is . Many in the care workforce , and . Their low wages mean .

"It's permeating so many different aspects of our health care system that relate to caregiving," said Alker, who noted just over half of Medicaid spending goes to seniors and people with disabilities.

Over several years, most states and the District of Columbia . Getting rid of that expansion is among the proposed cuts by congressional Republicans, to the tune of $561 billion over 10 years. Alker said overall reductions to the program is likely to impact all enrollees and that it would be detrimental to children.

"They're not protecting children by pulling out hundreds of billions of dollars from the most important program there is for children's health, because states would not be able to make up for these kinds of losses," she said. "States would be left in an extremely untenable position. So fiscally, it's a huge risk to children."

Is Medicaid popular?

Yes, it's a popular program among a majority of Americans, that was conducted in January ahead of Trump's inauguration. The findings show 77 percent of respondents view the Medicaid program favorably. That included 63 percent of Republicans.

The poll also found nearly half of all people say the federal government is not spending enough on Medicare and Medicaid.

Is there fraud in Medicaid?

that Elon Musk, designated by Trump to cut the size of the federal government even though those efforts so far include trying to halt the flow of money already appropriated by Congress, has been given access to technology and spending information on Medicare and Medicaid鈥攑rograms housed under the federal health department. Musk claimed on X: "Yeah, this is where the big money fraud is happening."

The scope of fraud in health care but is not often committed by regular people who are Medicaid enrollees. According to an estimate by the Georgetown University Center for Children and Families, 95 percent of Medicaid payments are proper payments for care. There are also already systems in place, , to catch and prosecute fraud and forms of mismanagement.

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