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House Republicans Propose Cuts to Medicaid to Finance Savings

Client Alert
May 12, 2025

House Republicans released legislative language yesterday that highlights a key piece of their budget bill – cuts to the Medicaid entitlement program. The nonpartisan Congressional Budget Office (CBO) previously indicated that it would not be possible for House Republicans to achieve President Trump’s desired $880 billion in savings over 10 years without making substantial changes to Medicaid. That prediction came to fruition; the bill proposes Medicaid spending reductions to be achieved through policy changes that include more frequent eligibility verification, citizenship checks, tougher screenings of providers; and federal Medicaid funding cuts to states that offer coverage to residents living in the U.S. illegally.

The bill also seeks to impose work requirements for able-bodied adults aged 19 to 64 who do not have dependents, demanding they work at least 80 hours — or perform 80 hours of community service or other programs — per month. It includes exceptions for pregnant women. These requirements are more stringent than those included in Ohio’s Medicaid work requirements waiver that was recently submitted to the Federal government for approval. Ohio’s proposal applies to Medicaid expansion enrollees under age 55 who must be employed, be enrolled in school or a job training program, be in a recovery program, or have a serious physical or mental health illness to receive benefits.

These Federal Medicaid cuts threaten to force states to change how they finance their programs, to cut benefits, and/or to implement their own policy changes like adding cost-sharing requirements for beneficiaries in the program.

Following the release of the legislative language, the CBO issued a preliminary analysis finding that the health care portion of the bill would cut spending by $715 billion and would “reduce the number of people with health insurance by at least 8.6 million in 2034.”

For insights on how these Medicaid changes could affect you or your clients, contact BMD Member Daphne Kackloudis at dlkackloudis@bmdllc.com. 

MedicaidHealthcareHealthcare PolicyHealth LawDaphne Kackloudis
Client Alert

New Ohio Reporting Requirements for Non-Residential Contractors

March 18, 2026Ohio’s E-Verify Workforce Integrity Act, effective March 19, 2026, requires all nonresidential construction companies, subcontractors, and labor brokers to use E-Verify to confirm employee work eligibility on projects across the state. The law applies regardless of company size and carries financial penalties and potential restrictions on future state contracts for noncompliance. Some uncertainty remains around requirements for existing employees, making early compliance planning important.Client Alert

DOT Non-Domiciled CDL Rule

March 11, 2026A new rule from the Federal Motor Carrier Safety Administration (FMCSA) will significantly narrow eligibility for non-domiciled Commercial Driver’s Licenses (CDLs) beginning March 16, 2026. The rule limits eligibility to holders of H-2A, H-2B, and E-2 visas and eliminates Employment Authorization Documents (EADs) as qualifying proof of work authorization. As a result, many lawfully present and work-authorized immigrants, including refugees, asylees, DACA recipients, and Temporary Protected Status holders, will no longer be able to obtain or renew a non-domiciled CDL. The change is expected to affect roughly 194,000 drivers nationwide and has prompted multiple legal challenges, including a pending emergency stay request before the United States Court of Appeals for the District of Columbia Circuit.Client Alert

FinCEN Residential Real Estate Reporting Rule Now in Effect

March 6, 2026FinCEN’s new Residential Real Estate Reporting Rule, effective March 1, 2026, requires certain real estate transfers to be reported to combat financial crimes. Transfers of residential property to entities or trusts without financing may require a Real Estate Report.Client Alert

Department of Education Proposes Redefinition of “Professional Degree,” Excluding Nursing and Limiting Graduate Loan Borrowing

February 20, 2026The U.S. Department of Education has issued a Notice of Proposed Rulemaking that would redefine “professional degree” programs under the One Big Beautiful Bill Act. The proposal excludes nursing from the recognized list and would impose new borrowing limits for graduate students while eliminating the Grad PLUS program. Public comments are due by March 2, 2026.Client Alert

First-of-Its-Kind Federal Ruling Finds Use of Consumer AI Tool May Destroy Attorney-Client Privilege

February 17, 2026On February 10, 2026, Judge Jed Rakoff of the U.S. District Court for the Southern District of New York issued a first-of-its-kind ruling finding that documents generated by a criminal defendant using a consumer AI platform were not protected by attorney-client privilege after being shared with counsel. The court treated the AI tool as a third party, concluding that entering sensitive information into a publicly available platform may waive confidentiality. The ruling also suggests that the work product doctrine may not apply where AI-generated materials are created independently by a client rather than at counsel’s direction. The decision signals that parties should exercise caution when using consumer AI tools in connection with legal matters.
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