House Republicans are expected to vote on a spending blueprint Tuesday that would kickstart the legislative process for enacting President Donald Trump’s policy agenda—but nearly $1 trillion in potential cuts to Medicaid has made some Republicans uneasy, threatening to derail its passage.
House Speaker Mike Johnson (R-LA) speaks with reporters as he walks to the House Chamber from his ... [+]
The fiscal year 2025 spending plan would likely lead to about $800 billion in cuts from Medicaid over the next decade, part of $2 trillion in overall spending cuts to help pay for $4.5 trillion in tax cuts plus boosts in defense and border spending.
The federal government’s Medicaid program provides health care coverage to more than 72 million Americans.
While the resolution doesn’t explicitly call for cuts to Medicaid, skeptical lawmakers have warned there’s virtually no other way to achieve the $880 billion in cuts the resolution tasks the Energy and Commerce Committee with finding without slashing Medicaid spending.
Moderate Republicans in vulnerable districts and those where significant portions of their constituents are on Medicaid have expressed resistance to any Medicaid spending cuts.
Eight House Republicans, including Reps. David Valadao, R-Calif. and Nicole Malliotakis, R-N.Y., who are members of the Hispanic Conference or represent districts with sizeable Hispanic populations warned in a letter to House Speaker Mike Johnson earlier this month that “slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities,” while also advocating for the Supplemental Nutrition Assistance Program—often known as food stamps—to remain protected.
Rep. Don Bacon, R-Neb., who represents a district that voted for Kamala Harris in November, also expressed concerns about the potential Medicaid cuts and said he has asked House leadership to prove that the $880 billion in cuts the budget instructs the Energy and Commerce Committee to find “won’t overly cut Medicaid,” Roll Call reported.
Johnson has previously suggested tying work requirements to Medicaid could be one way to cut the program, and Republicans have mulled limiting the amount of money given to states to administer Medicaid.
Assuming all Democrats vote against the spending plan, Republicans can afford to lose just one vote under their 218-215 majority in the House. At least one, Rep. Victoria Spartz, R-Ind., has already said she will vote against the bill, writing Sunday on X that the spending cuts did not go far enough, while Rep. Tom Massie, R-Ky., has said privately he’ll oppose the deal, according to Politico.
Johnson said “no” when asked by Politico on Monday whether he would amend the budget to alleviate concerns about Medicaid cuts, noting that the resolution only includes topline spending goals the relevant House committees are required to use as a blueprint for making cuts and doesn’t include anything “specific about Medicaid.” The resolution, Johnson said, “is merely the starting point for the process . . . the legislation comes later.” Johnson said he is optimistic Republicans have the votes to pass the resolution Tuesday.
A $4 trillion increase to the federal debt ceiling, another potential sticking point for some Republicans, including Reps. Tim Burchett, R-Tenn., and Massie who have historically resisted any increase to the debt limit. The spending plan would also extend Trump’s 2017 tax cuts and include an additional $300 billion for the border and defense.
The Senate plan, passed last week, does not include Medicaid cuts. The Senate budget resolution omits tax policy but sets the spending agenda to enact Trump’s border, defense and energy policies, punting negotiations on tax policy to a later date and breaking up the spending plan into two separate measures.
Trump has called for “one big, beautiful bill” as proposed by the House, he said Wednesday on Truth Social, though two days later he said he was supportive of the Senate agenda as a backup plan, telling Fox News radio “it gives you optionality.”
Trump said last week in an interview on Fox News that Social Security, Medicare and Medicaid would “be strengthened . . . none of that stuff is going to be touched,” a stance that contradicts his endorsement of the House Republican budget proposal.
The Senate will vote on the measure. If approved, it would kickstart the legislative process for enacting Trump’s agenda by setting spending goals for his various policy priorities. The relevant House and Senate committees would then draft legislation according to those goals.
Republicans’ plans for Medicaid have a political problem (Politico)
Mike Johnson’s moment of truth (Politico)
Medicaid Cuts Pose Budget Conundrum for Valadao and Republicans Nationwide (New York Times)