Addressing the Dishonesty Around Medicaid Cuts
According to the Congressional Budget Office, an estimated 10.9 million people will lose their health insurance by 2034 due to the provisions within the One Big Beautiful Bill Act (Wyden-Pallone-Neal_Uninsured_Letter_6-4-25). Of that total, about 7.8 million would lose coverage specifically due to changes in Medicaid. It’s important to be clear from the outset: there is no issue with the CBO’s estimate itself. The CBO scored this bill using its standard models and transparent assumptions, just as it has for legislation from both parties over the years. My concern is not with the CBO’s work, which is generally thorough and evenhanded, but with how many people are interpreting these numbers without understanding what they truly mean.
Too many news outlets report this estimate as an inevitable fact, as if 7.8 million people losing coverage is set in stone and nothing will happen to change it. This is a clear example of what I see as the media’s deeper government bias. While many on the right argue that the media has a “liberal bias,” I think that misses the mark. More precisely, the bias runs toward a belief that if the government stops doing something, like funding a particular program, then it simply won’t get done at all. In this view, there’s no room to imagine alternative solutions or private sector efforts that might fill the gap.
In his magnum opus The Law, the great French intellectual Frédéric Bastiat summarized this mindset succinctly saying, “Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society. As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all. We disapprove of state education. Then the socialists say that we are opposed to any education.” In the same way, much of the media coverage implies that if Medicaid is reduced, those who rely on it will have no other way to get health insurance, ignoring any possibility of alternatives outside government programs.
The problem isn’t just that much of the media lacks the imagination to consider alternatives to government programs. They also overlook the specific reasons behind some of these Medicaid changes. For example, certain provisions in the bill are designed to remove people who are abusing the system and should not be enrolled in Medicaid in the first place. The most prominent of these is the new Medicaid work requirements. According to the CBO, implementing these requirements would increase the number of uninsured by 4.8 million by 2034. Yet is the media actually examining what this number really represents?
What the CBO is really saying is that the burden of work requirements would discourage some people from enrolling in Medicaid. That’s very different from claiming “the government is taking away people’s health insurance”, which is a misleading way to frame it. Whenever taxpayer dollars fund welfare programs, we should ensure that only those truly in need receive help, rather than allowing others to get a free ride. This isn’t just common sense, it’s also the only way for the government to be a responsible steward of public money.
If someone wants to argue that Medicaid work requirements are bad policy or even immoral, that’s a valid and worthwhile debate to have. In fact, The Wall Street Journal has published two sobering articles highlighting how such requirements often fail in practice (What Medicaid Work Requirements Mean for Enrollees’ Coverage - WSJ and Medicaid Work Requirements Have Mostly Failed. The GOP Is Still Pushing Them. - WSJ). There’s ample evidence that the paperwork burden can prevent people who genuinely need Medicaid from enrolling. But again, that’s not the same as the government stripping people of their insurance. Failing to meet requirements and being actively cut off by the state are not equivalent.
The media has a responsibility to report the truth and provide proper context. In covering the Medicaid changes in the One Big Beautiful Bill, many outlets have done the public a disservice. If they want to maintain credibility, they need to make clear that these numbers are estimates and not guaranteed outcomes. They should also acknowledge that markets can offer solutions when government programs fall short. Most importantly, they must distinguish between the government actively revoking people’s insurance and simply adding conditions for eligibility. And, quite frankly, they should remind readers that Medicaid is one of the largest drivers of our national debt and will inevitably need reform.
I’ll leave you with another quote from Bastiat: “Government is the great fiction through which everybody endeavors to live at the expense of everybody else.” Social Security, Medicare, and Medicaid will all have to be reformed eventually. The media should acknowledge that reality and instead of dismissing any attempt to make changes, they should focus their criticisms on how to improve those reforms and ensure they work better for the people who truly need them.
