When I came to Congress, I promised the people of Virginia’s 2nd Congressional District that I would pursue practical solutions to improve the lives of working families — without the drama, the headlines, or the politics. That commitment is reflected in the House’s recently passed “big, beautiful bill,” a practical, solutions-oriented piece of legislation that restores accountability to our safety net programs.
Unfortunately, misinformation has clouded the bill’s intent, particularly when it comes to Medicaid. Let me set the record straight: This legislation does not cut Medicaid for those who truly need it. Instead, it strengthens the program for low-income families, seniors, and individuals with disabilities while rooting out waste and holding bad actors accountable.
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Here’s what the bill actually does. It protects coverage for children, pregnant women, seniors, and individuals with disabilities. It requires states to verify eligibility every six months, a step most Americans already assume is standard. It closes loopholes that allow non-citizens without legal status or with unverifiable identity to enroll in Medicaid. And it enhances oversight to reduce waste, fraud, and abuse, ensuring the program serves those who truly rely on it.
The need for reform is real. In fiscal year 2023, the federal government made an estimated $50.3 billion in improper Medicaid payments, accounting for 8.58% of all Medicaid spending. Notably, 82% of these improper payments were due to insufficient documentation, systemic problems that must be addressed.
During the COVID-19 pandemic, emergency rules blocked states from removing ineligible individuals from Medicaid rolls. That was a necessary step during the public health emergency, but it also caused a surge in ineligible enrollment. As of mid-2023, up to 24 million people, many of whom no longer met the eligibility criteria, were projected to lose Medicaid coverage during the unwinding process.
This bill doesn’t “kick people off.” It ensures that those who qualify stay covered, while empowering states to clean up outdated enrollment lists and remove deceased individuals, duplicate IDs, and non-residents, issues flagged by the Department of Health & Human Services Office of Inspector General in multiple reports.
It also reintroduces commonsense accountability. This bill encourages able-bodied adults to work, volunteer, or pursue job training rather than remain dependent on government assistance indefinitely. With 4.8 million able-bodied adults on Medicaid who have the potential to work, this policy helps people build independence and self-sufficiency while ensuring resources go to those who truly need them: children, pregnant mothers, the elderly, and disabled Americans.
One of the most debated provisions is the work engagement requirement. Here’s the truth: It only applies to able-bodied adults without dependents and includes broad exemptions for pregnant women, veterans, people with medical limitations, full-time caregivers, students and former foster youth, individuals experiencing homelessness, and those undergoing substance abuse treatment.
The data support this approach. A recent analysis from the American Enterprise Institute shows that non-disabled, childless Medicaid recipients spend an average of 4.2 hours per day, or 126 hours per month, watching TV or playing video games. That’s far more than the 80-hour monthly community engagement requirement proposed under this bill.
This is not about punishment; it’s about fairness. Medicaid was never meant to be a permanent support system for those who can work but choose not to. As a nurse practitioner who’s helped Medicaid patients navigate the system firsthand, I know how vital the program is, and I’m committed to protecting it for those who need it most.
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And let’s be clear: Democrats want American taxpayers to fund free healthcare for illegal immigrants, while millions of our own citizens struggle to afford coverage. Right now, 1.4 million illegal aliens are receiving Medicaid benefits. This bill puts Americans first by ensuring Medicaid serves only citizens and legal residents who deserve these benefits, not those who break our laws.
Don’t believe the spin. Believe the facts. This bill preserves Medicaid as a robust safety net for the most vulnerable, ensures accountability for taxpayer dollars, and promotes the dignity of work. That’s a vision for government that’s compassionate, responsible, and sustainable.
Jen Kiggans represents Virginia’s 2nd Congressional District in the U.S. House of Representatives.