On June 1, 2025, House Speaker Mike Johnson (R-La.) appeared on NBC News’ "Meet the Press" to defend the controversial Medicaid and health care reforms embedded in the Republican-led "big, beautiful bill." Addressing widespread concerns that millions of low-income Americans would lose Medicaid coverage under the proposed legislation, Johnson insisted that "4.8 million people will not lose their Medicaid unless they choose to do so."
Johnson’s remarks come amid fierce debate over the bill’s provisions, which include imposing work requirements on childless adults aged 19 to 64 to maintain Medicaid eligibility. The bill also seeks to shorten the open enrollment period for the Affordable Care Act (ACA) and implement stricter eligibility checks and address verifications for Medicaid recipients.
During his interview with NBC’s Kristen Welker, Johnson dismissed independent projections suggesting that millions would lose coverage due to the new work and reporting requirements. He argued that requiring able-bodied individuals, particularly young men, to work or volunteer for 20 hours a week is a reasonable and "commonsense" policy. "You’re telling me that you’re going to require the able-bodied, these young men, for example, OK, 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. The American people are not buying it," Johnson said.
He went further, stating that complaints about losing coverage mainly stem from individuals’ inability to complete paperwork rather than the policy itself. "The people who are complaining that these people are going to lose their coverage because they can’t fulfill the paperwork, this is minor enforcement of this policy, and it follows common sense," he added. Johnson also emphasized that the bill is designed to protect Medicaid for the most vulnerable populations, including young, single pregnant women, the disabled, and the elderly. He criticized able-bodied workers on Medicaid who are not working despite being capable, saying, "When people work, when able-bodied young men work, it’s good for them, for their dignity, their purpose, and it’s good for the community." If a job is not available, he suggested volunteering in the community to meet the requirement.
Johnson’s defense of the bill comes as the legislation faces significant pushback both from Democrats and within the Republican Party itself. At recent town halls, Republican lawmakers supporting the bill, such as Reps. Mike Flood (R-Neb.) and Ashley Hinson (R-Iowa), have been met with boos and protests. Senator Joni Ernst (R-Iowa) also faced criticism from constituents after defending the Medicaid cuts, remarking grimly that "we all are going to die."
Even some Senate Republicans have voiced opposition. Senator Josh Hawley (R-Mo.) penned a New York Times op-ed condemning the strategy of slashing health insurance for the working poor as "morally wrong and politically suicidal." Senator Rand Paul (R-Ky.) echoed this sentiment on CBS’ "Face the Nation," calling the Medicaid provision a "bad strategy" and suggesting Republicans should have focused solely on tax reforms without entangling themselves in the debt and spending fight.
On the other side of the aisle, Democrats have seized on the bill’s Medicaid provisions as a major point of attack. Senator Raphael Warnock (D-Ga.) warned that the so-called "work reporting requirements"—which mandate that recipients regularly prove compliance—will lead to millions losing coverage due to bureaucratic hurdles rather than actual noncompliance. Warnock cited a study from Georgia showing that such reporting requirements are effective at removing people from coverage but do not increase employment. "They’re going to throw poor people away," Warnock said emphatically.
Independent experts and organizations have backed these concerns. Jennifer Tolbert, deputy director of the Program on Medicaid and the Uninsured at the Kaiser Family Foundation, noted that states with similar work requirements have seen coverage losses among eligible individuals who struggle with reporting and documentation. The left-leaning Center for Budget and Policy Priorities estimates that up to 14.4 million people could lose coverage over the next decade if these provisions take effect. The Congressional Budget Office (CBO) projects that federal Medicaid spending would be cut by $723 billion and 7.6 million people would lose coverage by 2034, largely due to the new work requirements and stricter eligibility checks.
Further complicating the debate are claims from Donald Trump’s former Office of Management and Budget director Russ Vought, who asserted without evidence that "no one will lose [Medicaid] coverage as a result" of the House’s budget proposal. Vought also alleged that "one out of every five or six dollars in Medicaid is improper" and claimed that "illegal immigrants" are on the program. However, data from the Centers for Medicare and Medicaid Services show that only 7.66 percent of payments were considered "improper" in 2024—a category that includes overpayments, underpayments, and payments lacking sufficient information, not necessarily fraud. Moreover, federal Medicaid funds generally cannot be used to cover undocumented immigrants except in emergency situations, though some states use their own funds to provide limited coverage.
Research underscores the importance of Medicaid coverage for low-income populations. A National Bureau of Economic Research study found that Medicaid expansions increased enrollment by 12 percent and reduced mortality among low-income adults by 2.5 percent. New enrollees were 21 percent less likely to die compared to before gaining coverage, highlighting the life-saving potential of the program.
Despite the controversy, Johnson expressed confidence that the bill would advance through the Senate and be signed into law by President Donald Trump before Independence Day. "We’re going to get this done. The sooner the better," Johnson said. "We’re going to get it to the president’s desk, and he’s going to have a — we’re all going to have a glorious celebration on Independence Day, by July 4, when he gets this signed into law."
The unfolding debate over Medicaid cuts and work requirements encapsulates the broader struggle within the Republican Party and the nation over how best to balance fiscal responsibility, social safety nets, and support for vulnerable Americans. While proponents argue that the reforms promote personal responsibility and reduce waste, opponents warn of devastating consequences for millions who rely on Medicaid for essential health care.
