By Assemblywoman Shanique Speight

Federal Medicaid cuts are no longer a distant threat or a proposal under debate in Congress – they are now reality. With the passage of the recently enacted law coming down from Washington, New Jersey must face the very real consequences of reduced federal support. Right now, 1.86 million of our residents depend on Medicaid to see doctors, afford prescriptions, and get the care they need to live healthy lives. These cuts put not just our healthcare system, but the wellbeing of families, seniors, children, and entire communities at risk. Imagine a parent skipping a doctor’s visit for their child because the cost is too high, a senior rationing medication to make ends meet, or a family choosing between rent and healthcare. These are not abstract numbers; they are real people. New Jersey must strongly consider the adverse implications of changes to federal Medicaid policy and rectify the types of measures that could be put in place to soften the blow and protect our communities.

The Landscape
Medicaid is more than insurance – it is a lifeline. Children, low- and moderate-income adults, and aged, blind, and disabled New Jerseyans rely on it every day. With 65 percent of program costs covered by federal funding and 35 percent by state funds, the potential disruption is significant. Projections indicate that roughly 300,000 people could lose coverage due to new work requirements and expanded redetermination. But the impact doesn’t stop there. Even those who keep their coverage will feel the strain as healthcare providers face lower reimbursements and higher financial pressure, potentially reducing the care they can offer. This could mean longer waiting times for children’s checkups, fewer mental health services for adults, and limited options for seniors who depend on Medicaid-supported providers. The ripple effects of these federal cuts will touch everyone who depends on a system that was designed to protect the most vulnerable among us.

Additionally, we cannot talk about Medicaid without recognizing the role it plays in advancing health equity. Communities of color who make up more than half of New Jersey’s Medicaid population, will be immensely impacted. Cutting coverage doesn’t just reduce access to care—it hits communities that already face the highest barriers to health and the harshest disparities in outcomes. These communities rely on Medicaid to keep their children healthy, manage chronic conditions, and get the care they deserve. Rolling back this support would deepen existing inequities and leave those who need help the most even more vulnerable.

Act Now, Not Later

With federal Medicaid changes set to take effect in 2026, New Jersey cannot afford to wait until then to respond. The stakes are too high for families, providers, and our state systems. As Chair of the Assembly Aging and Human Services Committee, I am committed to taking proactive steps to protect access to care. Therefore, I am advancing five pieces of legislation: 1) to study the impact of federal Medicaid cuts; 2) codify existing NJ FamilyCare eligibility and protection; 3) establish a Medicaid stabilization fund; 4) create a commission to monitor the long-term effects of federal policy changes; and, 5) provide state-supported coverage and relief for those at risk of losing access. Acting now could help ensure that New Jersey families are supported, providers remain stable, our health care system is ready for the challenges ahead, and our communities are whole.