Medicaid is a big deal in New Jersey. It’s a program that helps pay for healthcare for about 2 million people in our state, including low-income families, kids, pregnant women, people with disabilities, and seniors. But the program has problems, and New Jersey Republicans have a chance to fix it while making sure it helps those who need it most.
Right now, Medicaid costs the federal government over $850 billion a year, and New Jersey gets a big chunk of that to cover our residents. The problem? A lot of that money isn’t going to the people it was meant to help, like kids or the elderly. Instead, some of it goes to able-bodied adults who could work but don’t. There’s also waste and fraud eating up dollars that could be better spent.
Republicans in Congress, including New Jersey’s own, are working on a plan to save $880 billion over 10 years by making Medicaid work better. Here’s how they can do it and why it matters to New Jerseyans.
Medicaid was created to help the most vulnerable—think low-income kids in Newark, pregnant women in Camden, or seniors in nursing homes across Bergen County. But right now, the federal government pays states like New Jersey more to cover single, working-age adults than it does for those groups. That’s not fair. Republicans want to change this so the program focuses on the people who need it most.
For example, a study found that states like New Jersey, which expanded Medicaid under the Affordable Care Act, sometimes shift money away from kids and pregnant women to cover more adults. By fixing how federal money is split up, New Jersey could make sure Medicaid dollars go to places like Children’s Hospital of New Jersey or nursing homes in Toms River, not to people who could get insurance through a job.
One idea is to require able-bodied adults on Medicaid to work, look for work, or train for a job. This doesn’t apply to kids, seniors, or people with disabilities—just adults who can work but aren’t. A recent poll showed 62% of Americans, including many New Jerseyans, support this idea. In fact, 77% like it when they hear it means saving Medicaid for the elderly, disabled, and kids.
In New Jersey, where we’ve got bustling job markets in places like Jersey City and Princeton, this could encourage people to get back to work while freeing up Medicaid funds for those who can’t. It’s a win-win: more people working, and more help for the vulnerable.
Medicaid loses billions to fraud and mistakes. From 2015 to 2024, the federal government said $543 billion in Medicaid payments were “improper.” Some experts think it’s even higher. In New Jersey, that’s money that could be used to improve healthcare in places like Paterson or Atlantic City. Republicans want to make it easier for states to check who’s eligible for Medicaid and remove people who don’t qualify, like those who’ve moved out of state or make too much money.
They also want to make sure Medicaid isn’t covering people who shouldn’t be on it, like some non-residents. For example, California used Medicaid to cover undocumented immigrants, which New Jersey doesn’t do—but we need to keep our program focused on legal residents who truly need help.
New Jersey’s Medicaid program is huge, and it’s a lifeline for many. But if it keeps growing without changes, it could strain our state budget and lead to worse care for everyone. By focusing on the needy, adding work requirements, and cutting waste, Republicans can make Medicaid stronger for places like Trenton, Elizabeth, and rural Warren County.
Democrats might say these changes will hurt people, but that’s not the whole story. Republicans aren’t cutting Medicaid to be mean—they’re trying to make it sustainable so it’s there for our kids and grandparents in the future. If they don’t act, Medicaid could run out of money, and that would hurt New Jerseyans even more.
The GOP has a chance to show New Jersey voters they’re serious about fixing healthcare. By talking openly about these reforms—saving money, helping the needy, and stopping fraud—they can win over people in places like Morristown or Vineland. It’s not about taking healthcare away; it’s about making sure it’s there for those who need it most.
Based on an opinion piece from The Wall Street Journal, May 5, 2025.
