Fact Check: The U.S. Congress has the authority to modify federal health programs like Medicaid
What We Know
The U.S. Congress has the constitutional authority to legislate and modify federal health programs, including Medicaid. This authority is rooted in the Constitution, specifically under the Spending Clause (Article I, Section 8), which grants Congress the power to tax and spend for the general welfare of the United States. Medicaid, established in 1965, is a federal-state partnership program that provides health coverage to eligible low-income individuals and families. Congress can alter the program's funding, eligibility criteria, and benefits through legislation.
Recent legislative actions, such as the One Big Beautiful Bill Act (H.R.1), demonstrate Congress's ability to modify Medicaid. This bill, passed by the House on May 22, 2025, includes significant provisions that would cut Medicaid and the Children’s Health Insurance Program (CHIP) funding by an estimated $863.4 billion over the next decade, reflecting Congress's direct influence on these programs (Georgetown University).
Analysis
The claim that Congress has the authority to modify federal health programs like Medicaid is supported by both constitutional provisions and legislative history. The Spending Clause allows Congress to set conditions on federal funding, which includes the ability to impose cuts or changes to Medicaid. The recent passage of H.R.1 illustrates this authority in action, as it proposes substantial cuts to Medicaid funding and alters eligibility requirements, which could increase the number of uninsured individuals by approximately 10.9 million by 2034 (Georgetown University).
The sources used in this analysis are credible. The Congressional Budget Office (CBO) provides non-partisan estimates and analyses of the fiscal impacts of legislation, making it a reliable source for understanding the implications of changes to Medicaid. Additionally, the information from Congress.gov is an official government resource that details legislative actions and statuses, ensuring accuracy regarding the legislative process (Congress.gov).
However, it is essential to consider potential biases in reporting, particularly from sources that may have political motivations. For instance, the Georgetown University report focuses on the negative impacts of the proposed cuts, which may reflect a particular viewpoint on health policy. Nevertheless, the factual basis regarding Congress's authority remains intact.
Conclusion
Verdict: True
The claim that the U.S. Congress has the authority to modify federal health programs like Medicaid is accurate. This authority is constitutionally grounded and has been exercised through recent legislative actions, such as the H.R.1 bill, which proposes significant changes to Medicaid funding and eligibility. The evidence supports the conclusion that Congress can indeed alter these programs as it sees fit.
