Protecting Medicaid Now and Into the Future

Protecting Medicaid Now and Into the Future

This blog was written before the 2024 election, but discusses policy proposals that are currently gaining traction. For that reason, we are including it in our Medicaid Defense series.


Since it was signed into law in 2010, Congressional Republicans have sought to repeal the ACA over 70 times. Yet despite saying they would replace the ACA, they’ve never had an actual plan or even the concepts of a plan of what would take its place. For Medicaid, repeal of the ACA would result in repeal of Medicaid “expansion” which has provided coverage to millions of individuals previously ineligible. Project 2025 includes not only repealing the ACA (p. 469) but also to allow states to drastically restructure Medicaid into a block grant or per capita cap (p. 466).

NHeLP has spent its entire 55-year history protecting Medicaid as well as access and coverage more broadly for low-income and underserved individuals. We will continue to do so, regardless of the outcome of November’s elections. In particular, why do we spend so much of our time, energy and resources to preserve and protect Medicaid? Medicaid helps people live healthier and more economically secure lives. It increases the diagnosis and early treatment of chronic conditions, enhances educational achievement and future earnings for covered children, reduces health care inequities, and provides comprehensive, high-quality, and cost-effective care. Medicaid coverage is tailored to the unique needs of individuals and families with low-incomes, but still costs less per beneficiary than private insurance. Medicaid’s core beneficiary protections make the program work for enrolled populations, including children, parents, pregnant people, low-income workers, older adults, and people with disabilities. Despite Medicaid’s proven success and efficient use of funds, detractors repeatedly seek to cut or cap funding for the program. Both Project 2025 and past Republican Congressional proposals to repeal the ACA seriously jeopardize the health and financial security of the more than 80 million people who benefit from Medicaid and CHIP.

As we prepare to either promote or protect Medicaid post-election, we updated a series of fact sheets that outline the importance of Medicaid related to various populations groups and services Medicaid covers. In particular, we focused on how funding caps in particular would impact Medicaid. The data from the “Medicaid Fast Facts” document and information from the 14 fact sheets emphasize the vital nature Medicaid plays in ensuring the health of those enrolled as well as their communities and states, regardless of politics or election results.

Here are links to the updated and new fact sheets:


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