RFK Jr. Says Medicaid Spending Is Rising - Critics Say That Masks Deep Cuts

Health and Human Services Secretary Robert F. Kennedy Jr. told Senators Wednesday that Medicaid is not being cut, citing projections that overall spending on the program will rise over the next decade.

Democrats and health policy experts say the claim masks nearly $1 trillion in reductions compared with what Medicaid would otherwise receive, sharpening a central political and policy fight over the program.

"Only in Washington is it considered a cut," Kennedy told Sen. Ben Ray Luján, a New Mexico Democrat, as lawmakers clashed over the proposals during a hearing.

Low‑income Americans who rely on Medicaid could lose coverage under work requirements and financing changes, even as total federal spending continues to grow. Supporters of the administration say the changes target waste, fraud and abuse, not benefits, and argue that work requirements will encourage employment while strengthening the program's long‑term sustainability.

Critics Say Rising Spending Masks Real Reductions

Health policy experts counter that Kennedy's argument relies on a misleading use of topline figures. While overall Medicaid spending is projected to increase, they say that growth largely reflects inflation, rising health care costs and population changes - not expanded coverage or improved benefits.

"This is an old, sort of tired argument that's been used by conservatives to justify spending cuts by saying, well, if spending is still growing in nominal terms, somehow there wasn't a cut," Edwin Park, a research professor at Georgetown University's Center for Children and Families, told the Associated Press. "The federal government is spending nearly a trillion dollars less than it otherwise would have in the absence of the legislation."

Budget analysts typically measure cuts against a baseline - what the program would have cost if existing law remained unchanged. By that standard, the Congressional Budget Office estimates federal Medicaid spending will be reduced by close to $1 trillion over the next decade compared with prior projections, even as absolute spending continues to rise.

The Kaiser Family Foundation, a nonpartisan health policy research group, has similarly concluded that the bulk of the projected savings comes from work requirements and restrictions on how states raise their share of Medicaid funding. KFF analysts say those provisions are expected to drive coverage losses over time, particularly among low‑income adults subject to new reporting rules.

Work Requirements at the Center of the Debate

The administration has argued that work requirements will help people transition off public assistance, but critics say evidence from earlier state experiments suggests otherwise. Past efforts, including one in Arkansas, resulted in thousands losing coverage largely because of administrative hurdles, not an unwillingness to work.

A February analysis by the RAND Corporation found that state Medicaid budgets are projected to decline by hundreds of billions of dollars over the next decade under the new law, with some states facing reductions of 5% or more. RAND, a nonprofit, nonpartisan research organization that studies public policy issues, warned that funding declines and lower enrollment could strain hospitals, nursing homes and other safety‑net providers, even as demand for services continues to grow.

Kennedy has dismissed such warnings as political attacks, saying Democrats are inflating the impact ahead of the midterm election and ignoring projected spending increases. He has also argued that Medicaid reforms are necessary to address rising federal deficits and modernize the program.

Critics respond that those macro‑level arguments offer little comfort to families who could lose coverage or states forced to cut services.

"The question isn't whether Medicaid spends more dollars in 2034 than it did in 2024," Park said. "The question is whether the program is doing less than it would have under the law we already had. And by that measure, these are very real cuts."

As the budget fight intensifies, Medicaid is emerging as a central political fault line, with Republicans emphasizing fiscal restraint and Democrats warning that millions of low‑income Americans could pay the price.

Reporting by the Associated Press contributed to this article.

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This story was originally published April 22, 2026 at 5:50 PM.