Reps. Roy, Fitzgerald Introduce Legislation to End Medicaid Discrimination Against the Most Vulnerable
May 9, 2025
Washington, D.C. — Reps. Chip Roy (TX-21) and Scott Fitzgerald (WI-05) introduced HR 3321, the "Ending Medicaid Discrimination Against the Most Vulnerable Act" today.
This bill would end the grossly outsized subsidy of the able-bodied under Obamacare’s Medicaid expansion compared to the vulnerable population for whom the program was created.
Congressman Roy said:"Obamacare's Medicaid expansion perpetuates a scam in which states get seven times as much money from the federal government for able-bodied adults than the traditional Medicaid population including, pregnant women, children, disabled people, and the elderly.
Texans have to pay for a program that is being abused by Democratic strongholds to fund Medicaid expansion for illegal aliens and the able-bodied while racking up trillions in federal debt. The federal government should not further penalize the ten states, including Texas, that have held the line and not expanded Medicaid.
Congress has no excuse for failing to seize the moment to address this failing Obamacare policy just as Republicans have said they would for the last 15 years. If we do not, we will be one step closer to a fully socialist healthcare system."
Congressman Fitzgerald said: “For too long, taxpayers in Wisconsin and other states that made a conservative choice to not fully expand Medicaid under Obamacare have been forced to subsidize a program they do not use. It’s time to address this unfair funding structure. We must also address waste, fraud, and abuse within the program and ensure its long-term sustainability for those who need it most.”
The "Ending Medicaid Discrimination Against the Most Vulnerable Act" would:
This bill would end the grossly outsized subsidy of the able-bodied under Obamacare’s Medicaid expansion compared to the vulnerable population for whom the program was created.
Congressman Roy said:"Obamacare's Medicaid expansion perpetuates a scam in which states get seven times as much money from the federal government for able-bodied adults than the traditional Medicaid population including, pregnant women, children, disabled people, and the elderly.
Texans have to pay for a program that is being abused by Democratic strongholds to fund Medicaid expansion for illegal aliens and the able-bodied while racking up trillions in federal debt. The federal government should not further penalize the ten states, including Texas, that have held the line and not expanded Medicaid.
Congress has no excuse for failing to seize the moment to address this failing Obamacare policy just as Republicans have said they would for the last 15 years. If we do not, we will be one step closer to a fully socialist healthcare system."
Congressman Fitzgerald said: “For too long, taxpayers in Wisconsin and other states that made a conservative choice to not fully expand Medicaid under Obamacare have been forced to subsidize a program they do not use. It’s time to address this unfair funding structure. We must also address waste, fraud, and abuse within the program and ensure its long-term sustainability for those who need it most.”
The "Ending Medicaid Discrimination Against the Most Vulnerable Act" would:
- Permit states to reduce Medicaid expansion eligibility from 138% to 100% of the federal poverty level (FPL). Individuals above 100% FPL would become eligible for ACA exchange coverage with generous premium tax credits.
- Gradually phase down the 90% federal reimbursement rate over eight years for ACA Medicaid expansion enrollees. The federal match would decline by uniform percentage points—5 points annually in higher-income states and 2 points annually in lower-income states—until it aligns with each state’s regular FMAP.
- End the additional 5-percentage-point FMAP bonus for late expansion states included in the American Rescue Plan Act.
Co-sponsors of the bill in the House of Representatives include Representatives Brandon Gill [TX26], Andy Ogles [TN05], Victoria Spartz [IN05], Byron Donalds [FL19], Michael Cloud [TX27], Andy Harris [MD01], Lauren Boebert [CO04], Keith Self [TX03], Clay Higgins [LA03], Josh Brecheen [OK02], Scott Perry [PA10], Paul A. Gosar [AZ09], Tom Tiffany [WI07], Andy Biggs [AZ05].