POLITICO Nightly: How the Republican megabill goes after state Medicaid
By Joanne Kenen Activists protest proposed cuts to Medicaid on Capitol Hill on May 21, 2025 in Washington. | Tasos Katopodis/Getty Images from People's Action Institute CASH IS KING — As recently as last summer, more states were increasing health coverage for immigrants , regardless of their legal status. But under the “One Big Beautiful Bill” now wending its way through Congress, those days could soon be over. Health coverage is expensive. And the mood in the country is not particularly invested in funding such programs these days. The House Republican tax and spending bill would levy very harsh financial penalties on states that provided health coverage to undocumented people — even though they are spending their own money, not federal dollars. It is extraordinarily unusual, perhaps unprecedented, for the federal government to forbid a state from spending its own money on health (except on abortion, and there are attempts to limit some care for trans people). T...