UPDATE, May 22, 2025: After a marathon session Thursday, the U.S. House of Representatives passed the budget bill by one vote. West Virginia’s two U.S. Representatives, Riley Moore and Carol Miller, both Republicans, voted for the plan.

About 40,000 West Virginians could lose health insurance and thousands more, help paying for food, under the bill.

The bill also moves up by three years the date for poor West Virginians receiving Medicaid to meet new federal work requirements.

Miller said the budget will ensure “that American families are once again put at the forefront of our country’s economic policies.”

Moore said the bill “delivers major victories for the American people.”

As Congressional Republicans propel a tax plan that would benefit the wealthy at the expense of health insurance and food for the poor, West Virginia’s federal delegation has largely been supportive.

The budget reconciliation bill is the key piece of legislation to pass much of President Donald Trump’s domestic agenda. Along with making the 2017 tax cuts permanent, the bill calls for cuts to Medicaid and SNAP along with increases in military and border security spending.

Negotiations are underway in the House as some of the most conservative Republicans want deeper spending cuts. It also has to pass the Senate before becoming law.

Under the bill, an estimated 40,000 West Virginians could be tossed off Medicaid, while 28,000 families with children could lose their Supplemental Nutrition Assistance Program benefits, previously known as food stamps. In West Virginia, 28% of the population receives Medicaid and 16% receives SNAP.

With so many people depending on these programs, experts and advocates say portions of the state’s economy — hospitals and grocery stores — are at risk.

Proposed cuts to Medicaid and SNAP, mainly through new federal work requirements, would save $800 billion and $300 billion respectively over the next 10 years. Nationally, 8.6 million people would lose healthcare coverage and 11 million could lose their SNAP eligibility.

Earlier in the process, all four members of West Virginia’s federal delegation voted in favor of moving the plan forward.

Cuts to these programs that West Virginians rely on to stay alive would go towards tax cuts that mostly benefit those with the most money.

A West Virginia family earning an average income would continue saving $47 a paycheck, based on numbers cited by the U.S. House committee that wrote the tax portion of the legislation.

During a press conference last week, Sen. Shelley Moore Capito doubled down on support for the tax cuts, saying she will vote for them again. She said she’s in favor of imposing new federal work requirements on Medicaid recipients between the ages of 19 and 64.

“We don’t want people on Medicaid that don’t qualify for it,” Capito said. “There are people on Medicaid who absolutely have no other choice and need, and have to have, this program for their families and for themselves.”

U.S. Rep. Riley Moore, her nephew, who represents the northern half of the state, also voiced support for work requirements during an interview on MetroNews Talkline last week.

When confronted with the potential of 40,000 West Virginians losing Medicaid, Moore said it was a drop in the bucket compared to the 8.6 million people nationally who could lose their coverage.

“If individuals don’t want to look for jobs, if they don’t want to look for work, then yes, you could lose Medicaid,” Moore said. “But this is fairly straightforward and simple.”

Several years ago, Arkansas tried implementing a work requirement, and all it resulted in was 18,000 losing health insurance with no data showing increases in employment, according to the Kaiser Family Foundation.

Ellen Allen, executive director of West Virginians for Affordable Healthcare, said the vast majority of people relying on Medicaid are already employed. But onerous paperwork requirements to verify eligibility will have people lose their coverage on technicalities.

Sen. Jim Justice, R-W.Va., listens as President Donald Trump speaks during an event on energy production in the East Room of the White House, Tuesday, April 8, 2025, in Washington. (AP Photo/Alex Brandon)

During an interview on Fox News last week, Sen. Jim Justice said while West Virginia has a lot of people on Medicaid — they’re the right kind of people, not “illegals.” The Senator said he supports saving money where they can.

“We can’t have everybody on Medicaid just to say ‘yay, yay, yay,’” Justice said. “If you’re not deserving, then you shouldn’t be there.”

But it’s more than just the recipients who benefit from Medicaid, or even SNAP.

Allen noted that hospitals depend on Medicaid for payment from low-income patients — if that population becomes uninsured, she warned it could result in hospital closures. In any given community, those hospitals serve people living in mansions and under bridges alike.

Caitlin Cook, director of advocacy for Mountaineer Food Bank, pointed out that country stores in remote parts of the state rely on a good portion of SNAP to stay profitable — cuts could mean they go out of business.

U.S. Rep. Carol Miller has yet to publicly say anything about how these cuts could have an impact on her district, which represents the southern half of the state and some of the most impoverished counties. Rep. Miller, Rep. Moore and Sen. Justice did not respond to questions from Mountain State Spotlight.

From left, Rep. John McGuire, R-Va., Rep. Carol Miller, R-W.Va., Rep. Marjorie Taylor Greene, R-Ga., and Rep. Pat Fallon, R-Texas, listen as President Donald Trump addresses a joint session of Congress at the Capitol in Washington, Tuesday, March 4, 2025. (Win McNamee/Pool Photo via AP)

The Facing Hunger Food Bank serves much of the same area of the state. Cyndi Kirkhart, the organization’s CEO, said when people lose SNAP, they rely more on food banks. But the current proposal also cuts federal aid to food banks, which leads to an even tighter squeeze — less resources and more demand.

“We’re willing to be a good foot soldier and support families in need, but you have to help us,” she said.

During Capito’s press conference, the senator argued the cuts in spending would save money to pay for SNAP and Medicaid in the future.

But just as important are tax cuts, she said. Taxpayers and business owners can “keep more of their dollars” and grow the economy through spending or investment.

Tax breaks do result in more economic growth in terms of investment and innovation, said Jared Walczak, an analyst with the Tax Foundation, a center-right think tank in Washington, D.C. However, maintaining government services — even social welfare programs — is just as important.

“There will always be people on those programs and they will always need to be funded,” Walczak said. “These are significant cuts that are being anticipated.”

Samantha Jacoby, an analyst at the progressive-leaning Center on Budget and Policy Priorities, said she’s skeptical of any claims about tax cuts doing anything more than giving more money to the wealthiest.

She noted the argument for economic growth is typically rooted in corporate, not personal income, tax reductions.

“They’re not even the sort of tax cuts that would have any kind of trickle down effect, even for people who believe in trickle down economics,” Jacoby said.

Groups gathered in Charleston on Thursday evening for a town hall to discuss the issues they feel could arise if any of the proposed federal cuts came to Medicaid, Medicare, Social Security, SNAP and other programs.

Kate Waldeck is a pediatric critical care doctor, and she said she came to speak her voice today because she feels if any cuts to these services are made, it could lead hospitals and clinics to close, and families would have more medical debt.

“The reality is that here in West Virginia, one third of our pediatric patients are on Medicaid or on CHIP,” Waldeck said. “At the hospital where you have a higher population of patients who may have cancer, certain disabilities, prematurity, that gets up closer to 50%.

“A budget reconciliation that cuts federal funding to Medicaid is not actually going to reduce the cost or the expenses of taking care of these children. It’s going to shift it to the hospitals and to the clinics and to the parents,” she said.

Sen. Shelley Moore Capito, Sen. Jim Justice, Rep. Carol Miller and Rep. Riley Moore were all invited to this town hall and organizers said they we’re hopeful one of them would show up so their concerns would be heard.

“Although Medicaid is not mentioned in this budget reconciliation, it is simply too large to not be cut with the goal of $800 billion in reductions that trump has set out, Waldeck said. “Currently, our state representatives have not stood up to speak out against any cuts to Medicaid, despite other republicans from states like Utah and Texas doing that.”

Some House Republicans have spoken out saying they will not support President Trump’s legislation if Medicaid cuts are included.

“Our representatives are here as public servants and the public in West Virginia is dependent on this health care,” Waldeck said. “Medicaid provides health care for working adults and it provides health care via the CHIP program, as well, for children.”

LOADING ERROR LOADING

WASHINGTON — Republicans’ big plan to cut taxes, fund border security and defense spending and fulfill all the key parts of President Donald Trump’s domestic agenda will rely on deep cuts to Medicaid.

But Republicans are risking a massive political backlash by cutting a program many of their constituents rely on.

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Medicaid provides health insurance coverage to 72 million Americans, including millions of children, and is a vital safety net in many states full of Trump supporters. Louisiana, Kentucky, Mississippi, West Virginia and Arkansas are all among the 10 states with the largest shares of Medicaid recipients, according to the nonpartisan Henry J. Kaiser Family Foundation.

No Republican lawmaker has outright said they would oppose the GOP budget plan over Medicaid cuts, but several have suggested they’d rather not yank health care away from their less wealthy constituents.

“Large cuts to Medicaid would hurt a lot of people in my state — and we voted overwhelmingly for President Trump,” Sen. Shelley Moore Capito (R-W.Va.) said in an interview with HuffPost this week.

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The debate over the future of Medicaid and other safety net programs is already roiling the GOP, as Republicans as hunt for savings to help pay for the $4.5 trillion in tax cuts President Donald Trump has demanded.

In the House, a group of moderate Republicans representing districts with sizable Hispanic populations warned Speaker Mike Johnson (R-La.) this week against imposing severe cuts to programs like Medicaid and federal food assistance. Johnson only has a narrow one-seat majority in the chamber, and a group of deficit hawks have been demanding he push for even sharper spending cuts, complicating efforts to pass Trump’s agenda.

In the Senate, Republicans seem sensitive to coming attacks about cuts to health care programs. During a marathon session of votes on their budget plan Thursday night, GOP senators adopted an amendment aimed at protecting Medicare and Medicaid. It was an effort to preemptively refute Democrats’ midterm election ads: See, we support Medicaid too.

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But Democrats opposed the amendment, maintaining that it was written with a loophole that would allow for cuts to millions of beneficiaries. They offered a slew of other amendments to protect the program and prevent tax cuts for the wealthy, but those were voted down by the GOP majority.

West Virginia’s junior senator, Jim Justice, a former Democrat-turned-Republican, said he doubted “those sweeping changes that will really hurt people” would actually happen.

“Do I really believe that President Trump is going to do something that is really detrimental to millions of seniors? I think I don’t believe it. I don’t believe that’ll happen at all,” he said.

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Other Republicans have drawn a harder line against cuts to health coverage. Missouri Sen. Josh Hawley told HuffPost: “I don’t like the idea of massive Medicaid cuts. We should have no Medicare cuts of any kind.”

Trump’s first-term attempts to repeal Obamacare — which would have rolled back Medicaid significantly and also stripped away protections for people with preexisting conditions — led to the lowest approval ratings of his tenure, and provided Democrats with the attack ads they needed to win back the House in 2018. The party is more than prepared to run the same playbook ahead of the 2026 midterm elections.

“Republicans have made it crystal-clear that gutting Medicaid is one of their main strategies for paying for their massive tax cuts,” Sen. Chuck Schumer (D-N.Y.) said this week.

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The House Republican budget plan, which Trump has endorsed, calls for slashing as much as $880 billion from Medicaid to help finance the tax cuts. Half of Medicaid spending benefits people eligible due to old age or disability.

Lawmakers have not yet detailed how, exactly, they would achieve the savings, but House Speaker Mike Johnson (R-La.) has suggested they would reduce Medicaid spending partly through imposing limits on benefits to people who can’t show they’re working.

“Work is good for you. You find dignity in work. And the people that are not doing that, we’re going to try to get their attention,” Johnson said last week.

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Tracy Hartnett is a 47-year-old Medicaid beneficiary in Jane Lew, West Virginia. She said she previously worked part-time as a cook in a public school, but her learning disability makes it difficult to hold a job — especially given that most of her energy goes toward taking care of her 70-year-old mother.

“My job is basically going up and visiting my mom in the nursing home and making sure she’s being taken care of the right way,” Hartnett told HuffPost. “There’s just no way I could go back to work with trying to take care of a family member that needs a lot of help.”

Medicaid pays for both Hartnett’s health expenses and her mother’s nursing home. The program covers a quarter of adults in West Virginia and most of the state’s nursing home residents.

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A new work requirement would likely only apply to “able-bodied” adults and not people with disabilities, though it’s possible even disabled Medicaid enrollees would have to prove to the state why they should keep their coverage.

“They would be exempted, but they would have to still do the paperwork and prove they’re unfit to work,” Kim Musheno, a Medicaid expert with The Arc of the United States, a civil rights organization for people with disabilities, told HuffPost. “It’s very difficult for people with intellectual and developmental disabilities to jump through these hoops.”

Musheno pointed to Arkansas, one of several states that was allowed to set up a work requirement for Medicaid during the first Trump administration. About 25% of the population subject to the requirement lost coverage, according to KFF. Studies showed some enrollees were confused by the requirement or weren’t even notified of the change.

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“A lot of people in Arkansas didn’t know about the new work requirements and didn’t fill them out, and they were pushed off,” Musheno said.

The Arkansas program came to an end when a federal judge ruled it was incompatible with Medicaid’s mandate to promote better health care for low-income Americans. A work requirement attached to a recent expansion of Georgia’s Medicaid expansion survived a different legal challenge, and is in place today.

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The Supreme Court hasn’t ruled on work requirements yet, so their legality remains an unsettled matter — and could also depend on any new legislation Congress passes.

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In January, Arkansas Gov. Sarah Huckabee Sanders (R) announced she would ask the Trump administration to let her bring the work requirement back, even if Congress doesn’t change the law.

In early March, Sen. Shelley Moore Capito looked into the camera and told anyone watching that she wouldn’t kick any West Virginians off Medicaid.

“I want to make sure that our benefits are still there for that 500,000 people,” Capito told WCHS.

For his part, Sen. Jim Justice told Axios last month that he had concerns about cuts to Medicaid, which serves nearly 30% of the state’s population.

Last weekend, Capito and Justice voted to move along a budget plan that would require $880 billion in cuts over the next decade, largely to Medicaid.

When offered an amendment to prevent those cuts, the two Republicans voted with their party against it. Had they switched their votes, it could’ve stopped the cuts.

Capito and Justice’s offices did not reply to a request for comment.

West Virginia could lose over half a billion federal dollars under this proposal, according to one analysis released last month. On a per capita basis, the state would have the largest cut in the nation.

And state Republicans have already shown they’re ready to throw thousands off Medicaid if Congress cuts the program.

This is part of a move by federal lawmakers to make President Donald Trump’s 2017 tax cuts permanent. The richest Americans would get a quarter of a million dollars knocked off their tax bills. The poorest 49 million taxpayers would only save $70 on average.

In West Virginia, many people with low incomes and persistent health problems rely on Medicaid to get treated by doctors and receive their medications. Just as many also rely on Social Security and Medicare, a government health insurance program for those age 65 or older.

Trump said earlier this year that none of the three would be touched.

For the last decade, thousands of West Virginians have been able to get health care through the expansion of Medicaid under the Affordable Care Act.

Currently, for every $1 the state chips in for that population, the federal government kicks in $9.

At the end of a routine House Finance Committee meeting late last month, Republican leadership suddenly proposed a trigger law.

If Congress cut federal funding, more than 160,000 West Virginians would be tossed off the Medicaid expansion.

“That was the first time we’d ever laid eyes on it,” said Del. John Williams, a Democrat from Monongalia County.

After another Democrat threatened to bring the House’s work to a standstill, Republicans held a Thursday afternoon meeting to take testimony.

Healthcare advocates told lawmakers that the trigger bill would not only lead to an increase in uninsured West Virginians, but could collapse entire hospital systems.

As quickly as it had been proposed, leadership shelved the trigger bill just days later.

House Deputy Speaker Matthew Rohrbach, right, speaks with Finance Chair Vernon Criss, left. Photo by Perry Bennett / West Virginia Legislature

Del. Matthew Rohrbach, a doctor and deputy speaker, said it was a message to Congress. But he’d received word over the weekend that federal lawmakers would not touch that part of the Medicaid program.

“They’ve heard us loud and clear,” said Rohrbach, a Republican from Cabell County.

“That’s not the deal that the states made when we did expanded Medicaid,” he added.

But now those assurances don’t seem so firm.

In comments to MetroNews this weekend, Capito said she’s seeking for the states – who partially fund the program – to pick up a bigger piece of the tab.

“We hadn’t heard that before,” said Rich Sutphin, executive director of the West Virginia Rural Health Association.

Health care workers at rural hospitals and clinics rely on Medicaid funding, and he said they were just able to catch their breath after the state’s trigger bill was shelved.

In a hallway outside the House Finance Committee, Rohrbach let out a long sigh. He said if Congress cuts Medicaid, that trigger could come back.

“We’re going to see where it goes,” he said.

Just Thursday morning, the U.S. House approved the federal budget framework, taking another step towards slashing Medicaid.