Early this morning, after a grueling overnight session, the House Energy and Commerce Committee advanced a critical piece of the GOP’s broader tax legislation: a health care provision that includes sweeping reforms to Medicaid. The plan proposes to slash federal Medicaid spending by hundreds of billions of dollars over the next decade—part of a larger conservative effort to shrink the size of government and rein in the federal deficit. While Democrats decried the move as cruel and reckless, Republicans championed it as long-overdue fiscal discipline. As an independent Christian conservative, I aim to look beyond the partisan reaction and address a deeper question: does this legislation promote justice, stewardship, and compassion in keeping with biblical values?

Stewardship and the Moral Case for Fiscal Restraint

The United States is grappling with a fiscal crisis of historic proportions. With national debt exceeding $35 trillion and interest payments now rivaling military spending, the question is no longer whether reform is needed—but how soon, and how bold. Medicaid, which has grown dramatically since the Affordable Care Act’s expansion, now covers over 90 million Americans and consumes a vast share of both federal and state budgets.

Republicans are right to emphasize the biblical principle of stewardship. Scripture teaches that resources are not limitless, and that faithful management is a moral obligation (Luke 16:10-12). A government that perpetually spends beyond its means is not exercising care over what has been entrusted to it, it is mortgaging the future of its children. Responsible reform of entitlement programs, including Medicaid, is essential if we are to ensure long-term stability and protect the most essential government functions.

Furthermore, decentralizing Medicaid through block grants or per capita caps would give states more control, allowing them to tailor programs to their unique populations. This aligns with the principle of subsidiarity—an idea that authority and care should reside at the most local level possible. Scripture assumes the primacy of the family, community, and local church in acts of charity, with government as a last resort, not the first.

Restoring Work and Dignity

Another hallmark of the GOP proposal is the introduction of work requirements for able-bodied, childless adults on Medicaid. Far from punitive, this provision reflects a biblical anthropology that sees work as a good, not a curse. In Genesis 2:15, God places Adam in the garden “to work it and keep it.” In the New Testament, Paul bluntly writes, “If anyone will not work, neither shall he eat” (2 Thessalonians 3:10). These verses affirm that meaningful labor is part of God’s design for human flourishing.

The modern welfare state, however, too often rewards passivity and dependency. This is not compassion—it is a subtle cruelty that undermines dignity and saps the human spirit. When properly administered with exemptions for the disabled and primary caregivers, work requirements serve not as punishment but as a path to restoration. They encourage recipients to reenter society not merely as dependents, but as contributors, endowed with purpose and potential.

Guarding Against Waste and Abuse

Another Christian virtue reflected in the GOP plan is accountability. Medicaid, like many sprawling federal programs, is plagued by inefficiency, fraud, and abuse. Tens of billions of dollars are lost annually through improper payments or ineligible enrollees. The Republican reforms aim to address these issues by tightening eligibility and strengthening oversight.

From a biblical standpoint, justice requires that aid be given where it is due—and withheld where it is not (Proverbs 11:1). Charity and integrity must go hand in hand. A system that allows—or worse, ignores—fraud and corruption undermines trust, squanders resources, and robs the truly needy. If reforms can root out waste and ensure that help reaches those in genuine need, they should be welcomed.

Compassion Must Not Be Lost in the Numbers

Yet amid the legitimate calls for efficiency, we must not lose sight of the human cost. The Congressional Budget Office projects that millions of people could lose Medicaid coverage under the proposed cuts. While some may find new jobs or private coverage, others—especially the elderly, disabled, and low-income families—could be left exposed. This raises serious moral questions.

Jesus said, “Whatever you did for one of the least of these brothers and sisters of mine, you did for me” (Matthew 25:40). Christian compassion is not limited to spiritual charity—it includes concern for the sick, the poor, and the marginalized. Any policy that risks cutting off life-saving care to the most vulnerable must be approached with extreme caution.

Moreover, states that have implemented work requirements, like Arkansas, have seen thousands lose coverage due to paperwork problems—not because they refused to work. In some cases, recipients were working but failed to report it through complex bureaucratic systems. If reform leads to greater injustice through red tape or administrative confusion, it fails its own stated goal. Conservatives should champion not only lean government, but just government.

Collateral Damage to Rural and Underserved Communities

The reality is that many hospitals—especially in rural and inner-city areas—depend heavily on Medicaid reimbursements to remain open. A sharp reduction in funding could force some facilities to close or scale back services, affecting not just Medicaid recipients but entire communities. These hospitals often serve as critical safety nets for people of all income levels.

Christian ethics demand a holistic view of life and care. Defending the unborn is vital but so is protecting those already born who struggle with chronic illness, mental health issues, or addiction. The sanctity of life doesn’t end at birth—it demands a consistent ethic that values the whole person in every season of life. True compassion is costly, and we must be willing to bear that cost when the alternative is widespread human suffering.

Balancing Stewardship and Mercy

The GOP’s Medicaid reform proposal is a step in the right direction when it comes to fiscal integrity, the restoration of personal responsibility, and the proper ordering of government. It reflects real courage in confronting one of the largest drivers of unsustainable debt. It embraces many principles Christian conservatives can affirm: stewardship, subsidiarity, accountability, and work as a moral good.

However, the current legislation does not yet adequately account for the needs of the most vulnerable. It risks creating unintended harm through poorly implemented work requirements, loss of essential services, and the destabilization of care providers in fragile communities. Reform is needed—but it must be refined.

Christian conservatives should support Medicaid reform that reflects both justice and mercy. As Micah 6:8 reminds us, we are called “to do justly, and to love mercy, and to walk humbly with [our] God.” That means crafting policy that uplifts the poor without entrenching dependency, that rewards work without punishing the infirm, and that cuts waste without sacrificing compassion.

With the right revisions, this bill could achieve that balance. But until then, our call is clear: affirm the principles, critique the excesses, and demand that reform be both righteous and realistic.