Medicaid, which is jointly funded by states and the federal government, has always operated under pressure, but this moment feels different. The program is facing a unique period of change, defined by factors that are significant on their own but far more consequential together. Centrally, the 2025 health care cuts to Medicaid and beyond, to the tune of $1 trillion over the next decade, will add nearly 10 million people to the uninsured ranks. These cuts will also trigger state budget holes and new funding gaps for the nation’s health care safety net.

The funding cuts are compounded by new administrative burdens for consumers because of new Medicaid work reporting requirements and other red-tape hoops people will need to jump through to get and keep coverage. Paperwork is a tried-and-true method for reducing enrollment, undermining decades of bipartisan efforts to streamline enrollment while ensuring program integrity through data-driven verification of eligibility. State Medicaid agencies will also feel the pinch as they operate with steep new administrative costs and fewer resources, and health providers who continue to serve low-income populations will be faced with patients churning in and out of coverage and a rise in uncompensated care.

The “old Medicaid rubric” doesn’t make sense anymore. It’s one that we’ve moved beyond for good reason through the Affordable Care Act expansion. The vast majority of Americans support and value their Medicaid coverage, including their expansion coverage, as vital to keeping their families safe, healthy and financially secure.

For those of us at The 80 Million, our name represents a vital segment of the American population — nearly one-fifth of the nation — who rely on Medicaid for their health, financial security and in some cases, survival. Today, the program stands at a critical inflection point. As Medicaid faces what many policy experts consider its most significant existential threat since its inception, we are expanding our coverage to meet the moment. Starting May 6, we are launching a special eight-episode podcast series to explore the seismic changes reshaping Medicaid and health care access more broadly in our country.

Hosted by Senior Managing Director Patti Boozang, Season 1 of The 80 Million Podcast is about what's at risk at this moment in Medicaid, fiscally, operationally and politically, and where the program needs to adapt deliberately — not just to survive, but to get stronger. This is a time that demands solutions. Over the next decade, Medicaid is expected to see nearly $1 trillion in federal funding cuts from H.R. 1, new administrative hurdles that make getting and maintaining Medicaid coverage difficult, and federal policy shifts that limit the ability of states to raise revenue through state-directed payments and provider taxes.

This new series reflects the very best of what defines our health group — deep expertise, meaningful collaboration and a commitment to shaping the future of care for the 80 million Americans who rely on Medicaid. Across the season, Patti brings together colleagues from Manatt Health and nationally recognized leaders to explore the most pressing challenges and opportunities facing the program today. Produced by Amanda Eisenberg, The 80 Million Podcast digs into technological innovations, FWA, and the operational and fiscal tradeoffs states are facing right now.

Subscribe to The 80 Million here. Episodes will be available starting May 6 where you get your podcasts and, for subscribers, in your inbox each week!