Setting the Record Straight on Medicaid and the One Big Beautiful Act

REICHMAN

Last week, I had the privilege of attending an event, where our Congresswoman Mariannette Miller-Meeks spoke passionately about how the One Big Beautiful Act is already making a difference for families, seniors, businesses, and manufacturers here in Southeast Iowa. She also took time to address the blatant misinformation being spread by many on the left—misinformation that I feel compelled to correct for my constituents.
Let me be clear: this bill does not take away Medicaid benefits from anyone who is legally eligible. The only individuals affected are those who are in this country illegally and improperly taking advantage of the system. That’s not a cut—it’s a safeguard. It’s about protecting a vital program for those who truly need it.
For years, we’ve seenabuse and fraud in Medicaid threaten its sustainability. Duplicate enrollments, payments to ineligible recipients, and lack of verification have put the program at risk. The OBBA addresses this head-on by eliminating billions in waste and fraud, ensuring that taxpayer dollars go to the vulnerable populations Medicaid was designed to serve—children, seniors, pregnant women, and individuals with disabilities.
Another point of contention has been thework requirements. Let’s talk facts. The bill introduces common-sense accountability by requiring able-bodied adults without dependents to work, volunteer, or pursue education for 20 hours a week to maintain benefits. This is not punitive—it’s empowering. It encourages self-sufficiency and helps lift people out of poverty. And importantly, those who are medically frail, pregnant, elderly, or caregivers are exempt.
These reforms are projected to save taxpayers $1 trillion over the next decade. That’s not just good policy—it’s fiscal responsibility. Congresswoman Miller-Meeks and her Republican colleagues deserve credit for passing a bill thatprotects Medicaid, reduces our national debt, and preserves benefits for future generations.
It’s unfortunate that Democrats are using scare tactics, claiming that millions will lose coverage. What they fail to mention is that many of those numbers include temporary Affordable Care Act (ACA) subsidies set to expire—a sunset provision they themselves enacted. The truth is, the OBBA is strengthening Medicaid, not gutting it.
I encourage every Iowan to read about this policy for themselves, ask questions, and reject the fear-based narratives being pushed by dishonest voices. Let’s stand together for a Medicaid system that works—for those who need it, for those who fund it, and for the future of our state.
If you have concerns or want to learn more, reach out to me or Congresswoman Miller-Meek’s office. I’d love to hear from you.
Together, we can ensure thataccountability, compassion, and fiscal responsibility remain the foundation of our public policy.
Jeff Reichman is State Senator the 50th District in southeast Iowa.