Here's how Medicaid cuts could threaten healthcare access for young adults

Proposed federal cuts to Medicaid could have serious consequences for millions of young adults in the U.S., a demographic already vulnerable due to financial instability and limited access to employer-sponsored insurance. Here's how.

In May 2025, the House of Representatives narrowly approved the reconciliation package by a 215-214 vote, creating nearly $790 billion in cuts to Medicaid over the next decade.

According to the Congressional Budget Office, the proposed provisions could result in 7.6 million people losing coverage by 2034 as Donald Trump pulls off another political masterstroke.

Unsurprisingly based on other Republican policies, young adults, roughly 30% of whom rely on Medicaid for healthcare coverage, would be among the hardest hit.

This group is generally healthier than older adults, but their need for reproductive, mental, and behavioral health services remains substantial and Access to such services during young adulthood is also essential for preventing chronic conditions in older age.

A recent analysis by the Urban Institute underscores the specific threats facing Americans aged 18 to 24 if sweeping changes included in the One Big Beautiful Bill Act are ed into law and healthcare is one of them.

The Urban Institute highlights that young adults are particularly susceptible to being disenrolled from Medicaid due to their higher mobility, lack of experience navigating government systems, and precarious employment situations.

How could Trump's Medicaid cuts impact people?

The proposed legislation includes several policy shifts that would impact young adults' ability to retain coverage and access care:

As the Senate debates the bill, the Urban Institute warns that these policy changes would erode Medicaid's role as a foundation for young adults to achieve economic and personal stability.

Higher Cost Sharing Requirements

Under the bill, adults covered under Medicaid expansion earning over 100% of the federal poverty level would face increased out-of-pocket costs.

This could significantly reduce healthcare access for young adults, many of whom fall within this income bracket.

Research shows that even modest increases in healthcare costs lead to reduced utilization of medical services and greater financial strain.

More Frequent Eligibility Reviews

The bill mandates semiannual eligibility checks, up from the current annual requirement.

This poses a bureaucratic challenge for young adults, who are more likely to change addresses or jobs. These istrative burdens often result in coverage losses even when individuals remain eligible.

Address Verification Measures

States would be required to regularly beneficiaries' addresses to prevent dual enrollment.

However, because young adults tend to move more frequently than older individuals, they are at a higher risk of losing coverage due to outdated information.

Work Requirements Starting in 2026

The legislation would impose 80-hour monthly work, school, or volunteer activity requirements for able-bodied adults without dependents.

Though designed to promote employment, prior experiments with such requirements showed that enrollees often lost coverage not because they were unemployed, but because they failed to meet complex reporting procedures.

This could lead to increased medical debt and reduced access to preventive care.

Restrictions on Reproductive Health Providers

The bill would block Medicaid payments to community providers that offer abortion services, including many family planning clinics.

These providers deliver essential services such as contraception, STI testing, and wellness exams. The restriction would particularly affect young women who rely on these facilities for primary preventive care.

Reduced Funding Pathways for States

By freezing provider tax mechanisms, the bill limits how states can fund their share of Medicaid costs.

This could result in reduced provider payments, leading fewer healthcare providers to accept Medicaid. As a result, access to services for all Medicaid enrollees, including young adults, could decline sharply.

Elimination of Expansion Incentives

The legislation removes temporary enhanced funding that encourages states to adopt Medicaid expansion.

With young adults already experiencing the highest rates of uninsurance (about 11%) and limited employer-based options, this change would limit future coverage opportunities.