Medicaid Cuts Loom: Patients and Advocates Prepare for the Fallout

With the Congressional mega-bill which eliminates $1 trillion from Medicaid, becoming law, individuals who have depended on this state-federal health coverage program and their supporters are working urgently to understand when and how the impact will be felt.

Several of the law's modifications remain without a clear schedule.

"This legislation was drafted quite quickly," noted Tami Jackson, a policy analyst with the Wisconsin Board for Individuals with Developmental Disabilities (BPDD), during a conversation about the law on Thursday morning at the Wisconsin State Capitol.

There are different implementation deadlines for various parts of Medicaid that aren't all synchronized," Jackson stated. "Therefore, you'll receive this in stages.

Janet Zander from the Greater Wisconsin Agency on Aging Resources restated commitments made by members of Congress who supported the bill openly.

It's very simple to hear what's being said—'This won't affect us here in Wisconsin. We aren't doing anything that will negatively impact elderly individuals, those with disabilities, or low-income households,'” Zander stated. "We who work within these programs understand that this couldn't be further from the truth.

A new regulation requires individuals enrolled in Medicaid to either work or actively prepare for employment—despite most of them already being employed—or receive approval as an exemption from this obligation.

The deadline for implementing this clause, January 1, 2027, is within 18 months, according to Jackson. It may take as long as a year before the federal Department of Health and Human Services (HHS) issues an administrative regulation outlining how states should handle the obligation.

This leaves little room to address "20 or 30 unresolved issues" regarding how to make individuals show they are employed, meet eligibility criteria for an exception, or confirm their exemption status, Jackson stated.

New obligations will also place additional pressures on the agencies responsible for carrying out Medicaid modifications within each state, along with local organizations that assist individuals in understanding the program.

If you're increasing the amount of work and what individuals must accomplish, as well as boosting the number of staff required for this, it means counties will end up handling significantly more at the local level," Jackson stated. "This will make it worse regarding how many people lose their health insurance.

Additional items do not specify an implementation date—this is typically understood to mean they come into force upon the bill being signed, stated William Parke-Sutherland, director of government affairs at Kids Forward.

"This legislation, often referred to as a tax and budget-related measure, is actually focused on overhauling healthcare, representing the most significant modifications to the healthcare framework since the introduction of the Affordable Care Act," Parke-Sutherland stated.

The national healthcare law was given four years for implementation. With the recent Medicaid updates, "we have no time at all."

But the probable long-term impact remains dire, advocates said — making it harder for people to get coverage and keep coverage.

Combined with the expected reduction in Medicaid access and the anticipated loss of Affordable Care Act coverage for low-income individuals who will no longer receive premium subsidy support after this year ends, up to 17 million Americans may face a lack of health insurance and long-term care benefits, according to Zander.

The State Department of Health and Human Services The Office of State Health Services The Division of Public Health within the state government The state agency responsible for health services The department overseeing public health at the state level The governmental body handling health-related matters statewide The state-run organization focused on healthcare provision The official entity managing health services across the state The division dedicated to health initiatives under the state administration The bureau tasked with delivering health services throughout the state estimated in April At minimum, 52,000 people living in Wisconsin might be without Medicaid benefits. The modifications introduced by the Senate into the legislation are expected to raise these numbers, as reported by supporters.

Safety nets: traditional and modern approaches

Approved by the U.S. Senate and the House of Representatives and enacted into law by President Donald Trump, the bill has introduced additional challenges for the country's support systems, such as Medicaid and the national food assistance initiative, SNAP.

Previous obstacles were already quite significant, advocates noted.

Kathleen Cummings is employed at the Columbia County Aging and Disability Resource Center, where she helps individuals aged 60 years and above apply for Medicaid and various other assistance programs. Depending on their yearly earnings and overall assets, certain individuals enrolled in Medicare may also be eligible for Medicaid to help pay for their additional Medicare expenses.

Cummings shared the story of a woman who became eligible for Medicaid but later reached out because she started receiving medical bills. According to Cummings, the woman unintentionally didn't renew her Medicaid coverage as the renewal notice she received ended up mixed among other Medicaid-related correspondence.

Currently, the client is eligible for retroactive coverage for expenses from the past three months. However, under the new law, "this will change to 30 days, meaning we won't be able to apply for backdated coverage for costs related to her specific case moving forward," Cummings stated.

Another client has had extensive treatment for lung cancer, she said. The man “is just barely, barely over the federal poverty level” — about $1,300 a month.

A number of my clients take pride in making the most out of their resources," Cummings stated. "However, when an illness such as lung cancer arises, he then encounters numerous expenses for which his insurance provided only minimal assistance.

She is assisting the man in applying for Medicaid benefits retroactively for three months to cover those expenses, she mentioned. "Once he provides evidence that he was eligible, which he will be able to do, he should be able to have some of these charges covered."

Nicole Robarge is employed by the Columbia County ARDC, assisting individuals between the ages of 16 and 59 who meet eligibility requirements for federal Supplemental Security Income (SSI) disability benefits and additional support programs.

Robarge mentioned that the current process for a disability application typically lasts between 12 and 18 months before a determination is made. She noted that up to 85% of applications are initially rejected, with approximately 20% being reversed during an appeal, which adds an additional 18 to 24 months. A subsequent appeal involving a hearing before an administrative law judge may require yet another two years.

In Wisconsin, receiving SSI approval automatically makes an individual eligible for Medicaid. However, until the SSI determination is finalized, the applicant must submit a separate application for Medicaid, according to Robarge — which can be significantly harder due to disabilities.

She retrieved the Medicaid form, which now needs to be filled out every year—a 41-page booklet that measures half an inch in thickness.

"Can you picture receiving one of these through the mailbox and having a mental impairment or a physical condition, perhaps even having suffered a stroke?... Or maybe you're illiterate," Robarge stated.

I purchased a home and encountered fewer forms. I also bought a vehicle and faced less documentation compared to filling out one of these," she said. "It's frustrating and risky... This initial obstacle is significant, and that's even before obtaining the documents required to prove what they're requesting.

Unexpected effects of reducing Medicaid benefits

The latest legislation risks exacerbating these delays, according to supporters — preventing individuals from receiving Medicaid benefits despite meeting the eligibility criteria.

Medicaid is an extremely complex program," stated Lisa Hassenstab, public policy manager at Disability Rights Wisconsin. "What we've observed in this legislation is that all these small adjustments and unforeseen effects occur because individuals aren't aware of how the program works. Without understanding its nature, they also fail to grasp the true implications of these modifications.

A point raised by supporters is that the law will not safeguard public funds.

"It doesn't offer me protection," stated Tyler Engel, who relies on his Medicaid benefits to maintain greater independence within the community through support from his caregivers.

This legislation reduces costs because individuals who are currently qualified for healthcare will have their providers unpaid," Parke-Sutherland stated. "It cuts expenses by ensuring those who qualify for health coverage through federal assistance do not receive it or end up paying higher fees. This is the sole method through which this bill achieves cost savings.

Two-thirds of individuals enrolled in Medicaid are employed, making them taxpayers as well, according to Jackson.

It's a transfer of costs to taxpayers," stated Jackson, explaining that when individuals lack Medicaid coverage, "someone else ends up covering those expenses—whether through unpaid medical services, medical bankruptcies, or increased premiums for private insurance or group plans.

If you cease funding care, individuals' caregiving requirements do not disappear," Parke-Sutherland stated. "You continue to bear the cost. Therefore, this does not benefit taxpaying citizens.

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Reductions in Medicaid Funding: Patients and Advocates Prepare for the Impact was initially published on July 14, 2025, at 9:58 AM.

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