Will Trump’s budget cuts slash Medicaid coverage for Utahns? Rep. Kennedy, a physician, says no.

All four of Utah’s congressional representatives voted for a federal budget framework that health care advocates worry could slash billions of dollars in Medicaid spending in the next decade.

But two were emphatic that the budget congressional committees must now propose won’t result in people losing their health care — or necessarily result in cuts to Medicaid.

“The budget resolution’s just a kickoff,” said U.S. Rep. Mike Kennedy, a Republican representing the state’s 3rd Congressional District.

Kennedy, a physician and attorney, said anyone advocating against Medicaid cuts before seeing the actual proposals either doesn’t know what they are talking about or is lying about what they do know. Rep Burgess Owens, a Republican who represents Utah’s 4th District, said there is misinformation circulating about what the budget does.

Yet experts have said the math the House voted to approve is impossible without cuts to Medicaid.

They are particularly concerned in Utah because a law passed in 2019 means winding down or completely removing Medicaid expansion – and coverage from thousands of Utahns — if the federal government starts paying less than 90% of the cost.

“Our clients rely on Medicaid for health coverage,” said Daryl Herrschaft, who directs Utah Health Policy Project’s Take Care Utah program. “Whether they’re lower-income individuals, people with disabilities, or people in long-term care, those who rely on Medicaid would face serious harms if Medicaid were cut.”

Utah’s Medicaid expansion sunset clause

The U.S. House of Representatives voted last month 217-215 to approve a budget framework that calls for various committees to cut billions in spending during the next ten fiscal years, which run from Oct. 1 to Sept. 30.

The budget resolution instructs the House Committee on Energy and Commerce to find at least $880 billion in cuts in fiscal years 2025 through 2034.

Reductions must come from the programs over which the committees have jurisdiction. In the case of the House Energy and Commerce Committee, that includes Medicare and Medicaid.

According to a report from the Congressional Budget Office, projected spending for everything in the committee’s jurisdiction other than Medicaid and the Children’s Health Insurance Program totals up to $381 billion during the ten fiscal years.

And when Medicare is set aside, Medicaid accounts for 93% of the funding under the committee’s jurisdiction, the nonpartisan office found.

That’s concerning to advocates in general, but especially because of one program: Medicaid expansion.

The 2010 Affordable Care Act encouraged states to expand Medicaid programs to cover more low-income Americans who didn’t get health insurance through their jobs. Forty states — including Utah — and the District of Columbia agreed, extending health insurance since 2014 to an estimated 21 million people.

In exchange, the federal government pays 90% of the cost to cover the expanded population. That’s far higher than the federal match for other Medicaid beneficiaries, which averages about 57% nationwide.

Utah and eight other states have what are known as trigger laws related to Medicaid expansion. In this case, federal funding falling below 90% of the cost of expanded coverage is the trigger to sunset Utah’s expansion program.

More than 75,000 Utahns get coverage through Medicaid expansion, according to Voices for Utah Children.

“The rise in the number of uninsured people would lead to more uncompensated care, hurting health care providers as well as state and local budgets,” the organization wrote in a post.

“Medicaid is a vital program that keeps Utahns healthy,” said Matt Slonaker, executive director of Utah Health Policy Project. “This size of a cut to Medicaid would mean coverage loss for thousands of Utahns.”

Half of Utah’s federal funds are tied to Medicaid

Utah Health Policy Project, a nonpartisan nonprofit organization, added that cuts would shift the burden to states.

Medicaid is jointly funded by the federal and state governments, with states’ funding determined by the Federal Medical Assistance Percentage, or FMAP — the share of Medicaid costs covered by the federal government.

For the upcoming fiscal year, Utah’s FMAP is set at 62.46%. That means for every $1 Utah spends on Medicaid, the federal government spends $1.66.

Though Utah is less reliant on federal funding than other states, about half of the funding the state does receive supports Medicaid, according to a report from the Kem C. Gardner Policy Institute.

Losing that would cripple the state’s budget, Voices for Utah Children argues, and leave small towns and rural communities without a “vital lifeline to health care.”

“Without the vital funding that Medicaid brings, we’ll see increased healthcare costs for all Utah taxpayers and enormous, unsustainable pressure on our state budget and communities’ ability to access care,” one of the organization’s policy analysts wrote.

Governors have asked for a seat at the table as Congress considers potential program cuts.

“Without consultation and proper planning, congressionally proposed reductions to Medicaid would impact state budgets, rural hospitals and health care service providers,” National Governors Association Chair Colorado Governor Jared Polis and Vice Chair Oklahoma Governor Kevin Stitt said in a statement.

‘Fearmongering’ and sowing chaos

Republicans insist people won’t lose coverage.

And for Kennedy, it’s personal. He is a family medicine doctor at Premier Family Medical Group and said he has seen thousands of patients with Medicaid coverage.

“The idea that somebody like me would throw those people out into the cold winter of no type of health care is ridiculous,” Kennedy said. “I’m deeply committed to those people and making sure they are held harmless.”

Kennedy called the focus on Medicaid “fearmongering” and an attempt to “sow chaos” and prevent President Donald Trump’s plan from going through. He said the narrative is about moving “a political message with others who don’t read budget resolutions.”

U.S. House Speaker Mike Johnson made similar remarks in an interview with CNN, saying all the attention on it is because it’s “the Democrats’ talking point.” Republicans are focused on eliminating fraud, waste and abuse, he said, not people’s health care.

“This budgetary framework will allow us to craft pro-family and competitive tax policies, find substantive savings across federal government programs, support our national security strategy, unleash domestic energy production, and roll back burdensome regulations — all while taking meaningful steps to address our crippling deficit,” Rep. Blake Moore, who represents Utah’s 1st Congressional District said in a statement.

The Salt Lake Tribune did not receive a response to a request for comment from 2nd Congressional Rep Celeste Maloy.

Moore and Maloy are Republicans, and Moore sits on the House Budget Committee and helped craft the resolution outlining the budget framework.

Megan Banta is The Salt Lake Tribune’s data enterprise reporter, a philanthropically supported position. The Tribune retains control over all editorial decisions.