What he means is that they are going to make it so difficult to obtain and maintain Medicaid that people will just drop out because of the massive red tape:
The rural hospital thing, however, is going to bite him in the ass and it will happen pretty quickly:
While hospital profit margins have reached their highest levels in three decades due to higher commercial insurance payments, hospitals that serve more low-income patients and fewer patients with commercial coverage continue to struggle financially. This is particularly the case for hospitals in rural areas and “safety net” hospitals, which serve a disproportionate share of underserved populations.
In rural areas, an existing hospital closure crisis has already reduced access to care for communities across the country, chiefly in states that did not expand Medicaid under the ACA. A previous CAP analysis indicated that House Republicans’ proposed Medicaid cuts would threaten rural hospitals everywhere—in particular, the nearly 200 hospitals already at immediate risk of closure in Medicaid expansion states. Indeed, these proposals would grow uncompensated care burdens to levels that would threaten the financial survival of providers serving the nation’s most vulnerable Americans.
Since Republicans are not to be held responsible for anything they do, I’m not sure this will blow back. But if anything does, this could be it. Individuals going uncovered is sort of a moving target. Closing your local hospital is an obvious consequence. Democrats just have to make sure that the local GOP MAGA Rep who voted for this monstrosity wears it like a brand in the middle of their forehead.