Medicare and Medicaid have been around for 61 years, but they may not make it to 62 if the GOP retains control of the U.S. Senate.

Several Republicans competing in marquee Senate races have expressed an interest in cutting or eliminating both programs, which provide health insurance to more than 123 million people. Medicaid covers low-income Americans, while Medicare is for those 65 and older or with disabilities. About 13 million people are enrolled in both programs.

Medicaid took a major hit last year when House and Senate Republicans passed the One Big Beautiful Bill Act (OBBB), a sweeping budget law that will cut $1 trillion from the program to fund tax breaks for the wealthy. About 12 million Americans are expected to lose health insurance as a result.

Florida GOP Sen. Ashley Moody celebrated OBBB’s passage, even though it will rip health insurance away from 2.2 million of her own constituents.

“Today is a historic moment for the American people—especially Florida families who will have thousands of their hard-earned money back in their pockets,” Moody said in a July 2025 press release, shortly before OBBB became law.

The law also hit hospitals and health care providers that depend on Medicaid reimbursements for revenue. These providers are often in rural or low-income areas where patients are more likely to be Medicaid recipients. A Health Justice Project analysis found that 23 percent of Florida’s rural hospitals were at risk of closure before the cuts took effect, making the outlook even worse.

A similar dynamic is at play in Alaska, where OBBB has put at least seven hospitals, clinics, and nursing homes into dire straits. GOP Sen. Dan Sullivan supported OBBB, promising it would “unleash Alaska’s private sector economy” and “benefit hard-working families.”

Sullivan has also cast multiple votes threatening Medicare, including voting to advance a 2017 budget resolution that sought to turn it into a voucher program.

Under the current system, Medicare reimburses hospitals and providers that treat Medicare enrollees. Under vouchers, Medicare recipients would receive funds directly to pay for care or purchase private insurance plans.

Health policy experts say vouchers would be unlikely to keep pace with inflation, forcing seniors to spend more out of pocket. Vouchers would also further reduce revenues for providers that treat Medicare beneficiaries.

Republican Sen. Susan Collins of Maine also voted to advance the voucher proposal. She cast a similar vote to advance OBBB, but did not support the bill in its final iteration.

Georgia Rep. Mike Collins, who is now running for the U.S. Senate, helped whip votes to get OBBB over the finish line in the House. In June, WDRW reported that the law’s Medicaid cuts were endangering access to therapy for hundreds of special-needs kids.

“I don’t know what to tell these patients and I hate it for them,” said Kate Phillips, director of patient services at TOTS, an Atlanta clinic offering pediatric speech and occupational therapy. “This is going to be catastrophic for them.”

Iowa Rep. Ashley Hinson also backed OBBB and was a member of the House Republican Study Committee when it proposed turning Medicare into a voucher program.

All of these lawmakers have also shown a willingness to cut or eliminate the Affordable Care Act (Obamacare), which could put both Medicaid and Medicare at risk. Obamacare expanded access to Medicaid and extended the solvency of Medicare.

A KFF tracking poll finds that Medicaid and Medicare are extremely popular with American voters. About 82 percent have a positive view of Medicare, while 75 percent view Medicaid favorably. About 62 percent rank health care costs as their top economic concern.

The Democratic Senatorial Campaign Committee (DSCC), which works to elect Democrats to the U.S. Senate, is making Republican hostility to Medicaid and Medicare a theme of the upcoming midterms.

“Across the map, Senate Republicans are on record supporting cuts to Medicaid and Medicare, and now that they’ve put these programs on the chopping block in order to grant tax giveaways to their billionaire campaign backers,” said DSCC spokesperson Maeve Coyle.

The Cook Political Report, which evaluates the competitiveness of elections, currently ranks control of the Senate as a tossup.

Reprinted with permission from American Journal News