With President Donald Trump’s “Big Beautiful Bill” passed and signed into law, cuts to Medicaid are coming and the only debate is over what those cuts will mean. Supporters of the bill say it cuts federal waste and gives states the responsibility to administer health care to those who need it. Opponents, like U.S. Rep. Jake Auchincloss, D-Newton, say it will drastically cut access to health care for millions of people and drive up the cost of health insurance for millions of others.

“Biggest health care cuts in American history,” is how U.S. Rep. Jake Auchincloss, D-Newton, described President Donald Trump’s “Big Beautiful Bill” on Sunday morning as he joined WCVB’s “On the Record” with hosts Ed Harding and Sharman Sacchetti.

“Obviously Medicaid is the government program that is going to bear the brunt of it, but this legislation is going to raise health care costs for everybody, because when you kick people off the Medicaid rolls, they still get sick,” Auchincloss said. “But instead of getting primary or preventative care, they go to hospital emergency rooms, which are the most expensive site of care. The hospital treats them—that becomes uncompensated care—and the hospitals have to cross-subsidize that with higher insurance premiums.”

With the bill passed and signed into law, Auchincloss said Democrats will have to fight it on many fronts as it’s implemented and, for the Medicaid cuts, he’s recommending a bold move: a Medicaid waiver.

The state requests waivers from Medicare and Medicaid for certain requirements when the state has alternative ways of handling things that go above and beyond federal protocol. Auchincloss said Massachusetts’ federal delegation is working with Gov. Maura Healey on a waiver request now.

“That waiver has become more important than ever, because we now need to own and be more autonomous with how we deliver Medicaid here in Massachusetts, to see if we can cut some of these ridiculous strings that they’ve attached with paperwork requirements, and have more ownership over population health management, value-based care, good primary behavioral care management,” Auchincloss said. “This waiver has become now critically important, and we have to be in lock-step with the governor.”

Many of the impacts of the “Big Beautiful Bill” were scheduled to hit after the 2026 midterm elections, so Auchincloss said Democrats need to keep talking to voters about the bill and its associated cuts to health care through the election season.

“A waiver would allow the state to create a new funding structure for hospitals and protect MassHealth, which is tied to Medicaid, from the Trump administration.

“The tether between MassHealth and the federal government now has become a liability, and we need the waiver to help us gain more agency about our future,” Auchincloss said.

About that Markey primary rumor…

Speaking of talking to voters, is Auchincloss planning to run for U.S. Sen. Ed Markey’s Senate seat? He’s not giving a definitive “yes” or “no” on that, but he says right now he’s planning to run for reelection to his House seat next year.

Markey is a Democrat who has served in the Senate since 2013 and previously served in the House for 40 years. He’ll be 80 years old for the 2026 election, which has had people speculating on whether he’ll retire or whether a Democrat will challenge him in a primary.

And that’s led to rumors that Auchincloss, 37, may launch a bid for Markey’s Senate seat.

When the Massachusetts 4^th District congressman sat down with WCVB’s “On the Record” Sunday morning, hosts Ed Harding and Sharman Sacchetti prodded him about that.

“Why wouldn’t you take on Sen. Markey?” Sacchetti asked near the end of the interview after mentioning a recent list Markey released of state legislators endorsing him.

“I represent more than 100,000 who are on Medicaid at a time when Medicaid has been cut. That’s what I’m talking to state senators about. I represent more than 100,000 Jews at a time when antisemitism is surging in Massachusetts. That’s what I’m talking to state senators about. Double that number of people in my district are burdened by housing rent and mortgage costs. That’s what I’m talking to state senators and state reps about. We’re focused on the here and now.”

Sacchetti pushed back, saying she didn’t hear a “no.” Auchincloss replied that he’s focused on running for his current seat.

And then Harding interrupted with what he admitted may be an “indelicate” follow-up, asking if Markey is too old to serve in the Senate.

“When you run for office, you open yourself up to indelicate questions,” Auchincloss said, without answering the point about Markey’s age. “I don’t think there’s an unfair question to be asked, and the voters will have to decide what they think is the priority.”

You can check out the whole interview online.