- The War on Medicaid Is Moving to the States Moyers and Company by Greg Kaufmann — Recent congressional proposals to repeal and replace the Affordable Care Act would have reduced Medicaid enrollment by up to 15 million people, and, despite being defeated, congressional Republicans aren't done yet: It's likely they will attempt to gut the program during the upcoming budget debate. Meanwhile, more than half a dozen conservative governors are trying to take a hatchet to the program — at the open invitation of the Trump administration — through a vehicle known as a "Medicaid waiver." Waivers are intended for state pilot projects designed to improve health care coverage for vulnerable populations. But that's not what conservative governors are pursuing.