Congress Approves $1 Trillion Medicaid Cuts in GOP-Led States Amid Governor Silence

President Donald Trump's 'One Big Beautiful Bill Act,' approved by Congress, includes historic Medicaid cuts totaling more than $1 trillion over 10 years, alongside tax breaks and reductions in poverty programs. The legislation imposes stricter enrollment requirements, such as work mandates, primarily affecting states that expanded Medicaid under the Affordable Care Act, 19 of which are led by Republican governors. Despite the significant fiscal impacts on their states, many of these GOP governors have remained publicly silent, providing political cover to Republican lawmakers seeking to reduce Medicaid coverage for millions who gained it in the past decade. Attempts by Democrats to amend or exempt certain states, such as Alaska, from cost-shifting provisions were unsuccessful, and the bill passed narrowly with Vice President JD Vance breaking a Senate tie. Experts note this silence contrasts with the 2017 effort to repeal the ACA, when Republican governors played a key role opposing Medicaid cuts. The new policies are intended by supporters to ensure Medicaid is used as temporary assistance, but critics warn of severe consequences for vulnerable populations.