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The Trump administration is quietly revolutionizing Medicaid

The Trump administration is approving new limits on Medicaid coverage. Photo: Wally Skalij/Los Angeles Times via Getty Images

The Trump administration and Republican governors are quietly but effectively chipping away at Medicaid, erecting both hard limits and practical barriers to coverage that will almost certainly cut the program’s rolls, and pulling it in a substantially more conservative direction.

Why it matters: Medicaid is the biggest insurance program in the country, covering more than 70 million people. It’s undergoing a substantial reinvention without any action from Congress, relying on a set of policy tools and legal authorities that have never before been used in quite the same way.