Medicaid Cuts Explained: 6 Myths That Could Put Kidney Patients in Danger

Myths around Medicaid cuts are dangerous, especially for people with kidney disease. Here’s what you need to know and do right now.

• Myth #1: “No one will actually lose coverage.”
• Myth #2: “Talk of cuts is fearmongering—it won’t happen.”
• Myth #3: “All dialysis patients are automatically exempt from work requirements.”
• Myth #4: “These cuts will only affect undocumented immigrants."
• Myth #5: “If you work, you don’t have to worry about losing coverage.”
• Myth #6: “I’m not even on Medicaid. I’m on [insert state plan name], so this doesn’t apply to me.”
• What Kidney Patients Should Do Now
• The Bottom Line

Multiple independent analyses predict millions losing Medicaid. The Congressional Budget Office (CBO) estimates that 11.8 million people will lose coverage due to work requirements alone.

Kidney patients are highly vulnerable: nearly half of the patients on dialysis rely on Medicaid. Loss of coverage threatens their access to lifesaving treatment.

✔ Key takeaway: Coverage loss will be widespread—as a result, kidney patients may lose access to services and providers.

The “One Big Beautiful Bill,” signed July 4, 2025, officially includes work requirements, new copays for some Medicaid recipients, more frequent eligibility checks, and changes to Medicaid policies to limit what Medicaid will cover in the period before you enrolled.

Work‑requirement pilots in Arkansas and Georgia have already caused thousands to lose coverage, many of whom were complying or exempt but were tripped up by paperwork and technicalities.

✔ Key takeaway: These are real changes that will take effect in the next 18 months and not just rhetoric. Kidney patients face a substantial risk.

Work requirements that require patients to demonstrate they are working, volunteering, or participating in work programs for at least 80 hours per month, or be enrolled in school at least half-time, to maintain coverage will apply to able-bodied adults ages 19–64 without dependents, unless they meet narrow exemptions (e.g., “medically frail”). 

While kidney failure may qualify a person as exempt, the burden of proof is on the patient, and many chronically ill individuals may lose coverage due to incomplete documentation and more frequent eligibility checks.

✔ Key takeaway: Don’t assume you’re exempt from work requirements. Act early, get help from a social worker, and document your condition.

Undocumented immigrants are already ineligible for full federal Medicaid. These cuts primarily impact Medicaid funding and eligibility for low-income U.S. citizens and lawful residents, including many kidney patients.

The Congressional Budget Office forecasts that up to 11.8 million people may lose Medicaid coverage under the new law. Of those, approximately 1.4 million are undocumented immigrants who currently receive state-funded care. The remaining millions are lawful residents or U.S. citizens who stand to lose coverage due to new work requirements, coverage redeterminations, and reduced eligibility.

In other words, the overwhelming majority of people affected by these cuts are not undocumented immigrants, but Americans, many of whom are vulnerable due to age, disability, or chronic illness.

✔ Key takeaway: Kidney patients with legal status aren’t safe. The impact is widespread.

Even kidney patients who are working can lose Medicaid under new rules. If you don’t report work hours on time or in the correct format, or if your employer doesn’t provide proper verification, you can still be dropped. In past state programs, many working people lost coverage simply due to paperwork problems, not because they were out of compliance.

✔ Key takeaway: Employment alone isn’t enough. Paperwork, reporting, and verification will be crucial to maintaining coverage.

Medicaid goes by different names in different states, but it’s all Medicaid. 

For example, Medicaid is called: 

• Medi-Cal in California
• MassHealth in Massachusetts
• Husky Health in Connecticut
• SoonerCare in Oklahoma

Whether your plan is managed by the state or a private insurer, if it’s part of your state’s Medicaid program, you are subject to federal Medicaid rules and cuts.

✔ Key takeaway: If your plan helps low-income individuals access healthcare and is funded by your state government. It’s Medicaid, regardless of the label.

Find your State Medicaid Program.

1. Get documentation ready: medical records to prove exemptions like "medically frail"
2. Talk to your social worker or case manager about applying for Social Security Disability Insurance (SSDI)or other waivers that may help you maintain your coverage.
3. Budget for new copays, up to $35 per service for some enrollees
4. Advocate—reach out to lawmakers and support organizations like the National Kidney Foundation

Get our Kidney Patient Action Guide to Trump’s “One Big Beautiful Bill”.

Medicaid cuts under the new federal law are not limited to undocumented individuals, won’t spare most dialysis patients automatically, and are projected to strip millions of Americans, including vulnerable kidney patients, of coverage and care. Even those who are working or enrolled in state-branded programs are at risk. Knowing the facts and preparing now can make a life‑saving difference.

Ready to join the fight to improve kidney care for all? Become a Voices for Kidney Health advocate today.