Republican control in Washington under a second Trump administration could bring big changes to state Medicaid programs through budget cuts and priorities shifting with the political winds.
President-elect Trump said little about Medicaid – or health care in general – during his campaign, leaving policy experts combing through his first term and the positions of potential allies and appointees for clues about his future approach to the joint federal-state program.
While Trump has distanced himself from Project 2025, the conservative policy roadmap authored by the Heritage Foundation, many of its recommendations overlap with the Republican Party’s adopted platform, U.S. House Republicans’ 2025 budget and a budget proposed by the conservative Republican Study Committee.