95,000 D.C. residents at risk of losing Medicaid due to Trump bill

Axios

18-07-2025

About 95,000 D.C. residents are at risk of losing health care coverage through Medicaid due to the Republican spending bill recently approved in Congress, the District estimates.
Why it matters: President Trump's so-called " big, beautiful bill" impacts about 32% of D.C.'s Medicaid recipients, the District says, while also posing funding threats to hospitals and clinics across the region.
The big picture: There are about 300,000 D.C. residents on Medicaid.
To comply with the new law, D.C. (and other states) will need to build an employment verification system, so that residents 19-64 years old can document they completed 80 hours of work or service a month to be Medicaid eligible.
"That is the biggest concern that I have," Wayne Turnage, D.C.'s deputy mayor for health and human services, told NBC4 in an interview. "It will bring some cost to implement."
The work requirement takes effect on Dec. 31, 2026.
Between the lines: The new federal rule comes as the D.C. Council is poised to pass the mayor's budget that takes 25,000 residents off Medicaid.
More than 20,000 of those people will automatically be moved into a federal program called the Basic Health Plan, per NBC4.
Zoom out: In Maryland, 175,000 people are projected to lose Medicaid coverage, according to the state Department of Health's new analysis.
"Passage of this bill means families will lose access to essential health care, and hospitals and clinics will face funding shortfalls," David McAllister, a spokesperson for Maryland's Health Department, told the Washington Post.
A congressional analysis estimated about 166,000 people in Virginia will lose Medicaid, in addition to 136,500 people losing Affordable Care Act coverage.
What we're watching: Virginia hospitals are bracing for cuts to Medicaid payments that they rely on for funding. That's expected to begin in 2028, Axios Richmond reports.