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House Republicans Propose Cuts to Medicaid to Finance Savings

Client Alert

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


Cleveland Joins the Pay Transparency Movement: What Employers Need to Know

Beginning October 27, 2025, all Cleveland employers with 15 or more employees will be prohibited from asking applicants about their pay history and will be required to include reasonable pay ranges in all job postings where the position will be performed, solicited, considered, or processed in Cleveland. The ordinance is intended to help close the gender wage gap and promote greater pay equity across the city.

New $100,000 Fee on H-1B Petitions – Legal Immigration

President Trump issued an Executive Order (EO) imposing a $100,000 payment to accompany any new H-1B visa petitions submitted after 12:01 a.m. eastern time on September 21, 2025 and will remain in place for 12 months (unless extended).

Implications of Supreme Court Stay for Business Operations in Noem v. Vasquez Perdomo

On September 8, 2025, the U.S. Supreme Court temporarily reinstated immigration officers’ authority to conduct brief stops based on factors such as location, work type, language, or appearance. This stay in Noem v. Vasquez Perdomo allows enforcement actions to resume in California pending appeal. Employers in industries like construction, agriculture, landscaping, and day labor should prepare for increased worksite disruptions and review compliance protocols.

Ohio House Bill 429: Potential Relief for Providers Facing Same-Day Reimbursement Restrictions

Ohio House Bill 429 aims to prevent third-party payers from reducing provider reimbursement for multiple procedures performed on the same day. The bill could improve payment practices for a range of specialties, including surgery and gastroenterology.

FTC Continues to Target Noncompetes

The FTC is intensifying its focus on noncompete agreements in healthcare, urging employers to review contracts for compliance. While Ohio still generally enforces noncompetes, pending legislation could limit their use.