If you’re among the millions of Americans who rely on Medicaid, some reassuring news is coming your way—at least, that is, if you trust House Speaker Mike Johnson. Despite growing concern about President Trump’s health care reform bill, Johnson insists you won’t lose your Medicaid coverage unless you intentionally refuse to meet the new requirements.
Speaker Mike Johnson makes a bold promise
In a recent appearance on NBC’s Meet the Press, Johnson forcefully disagreed with estimates that nearly 5 million Americans would lose Medicaid coverage under Trump’s “big, beautiful bill.” As many as 4.8 million people would be affected, according to the Congressional Budget Office (CBO), mainly due to new work requirements for able-bodied adults.
But Johnson ignored those numbers, saying, “Those 4.8 million people won’t lose their Medicaid unless they wish to do that.” He emphasized that the bill simply mandates some people, specifically, childless adults between 19 and 64 years old, to work or volunteer for at least 20 hours a week.
Work or volunteer—Your choice
Johnson argued that these new rules are common sense. If you’re a healthy adult without any dependents, the government would simply make you contribute to your community in some way. “When people work, when able-bodied young men work, it’s good for them, for their dignity, for their purpose, and it’s good for the community,” he said.
He also added that volunteering would suffice if a job is not feasible. “If you cannot secure a job, then volunteer in your community for 20 hours, and you will be fulfilling the requirement.”
The reason for the reforms
The proposed reforms are part of a broader effort to reduce federal health care expenditures. The House Energy and Commerce Committee, which had the task of finding \$800 billion in 10-year savings, developed the reforms with that goal in mind. The Medicaid portion of the bill alone would save $625 billion over 10 years, the CBO estimated.
To Johnson, these reforms don’t destroy Medicaid—they make it more robust. He labeled the bill “an important and frankly heroic thing,” saying the reforms will better fulfill the program’s purpose: helping those who truly need it, such as the elderly, disabled, and pregnant women.
Pushback and political reality
Still, not everyone is convinced. Some legislators—especially Republicans who have had to face constituents at town halls—are feeling the heat for what is viewed by many as Draconian policies. Opponents argue that the paperwork and bureaucracy required to meet the new standards would result in coverage losses even for those who are willing to comply.
Johnson, however, is unmoved. He is confident that anyone who loses coverage will be doing so by choice, not because of the policy.
What it mean for you
If you’re on Medicaid and an able-bodied, childless adult, you may soon need to work or volunteer 20 hours a week to keep coverage. But if you’re willing to meet that requirement, Speaker Johnson says you won’t lose access.
In short, Medicaid isn’t going away—but for some, it may now come with strings attached.
