Support for President Donald Trump's "one big, beautiful bill" could be on thin ice with fiscally conservative House Republicans now that Speaker Mike Johnson, R-La., is ready to make concessions on cutting federal Medicaid shares to states in order to gain the support of centrists.
Johnson and his leadership team met with centrist holdouts for nearly two hours Tuesday night to discuss pathways on reconciliation, which Republicans are using to pass one bill to codify Trump's agenda, the Washington Examiner reported Wednesday.
Republicans supportive of Medicaid are concerned the proposed $1.5 trillion in overall spending cuts would run roughshod over the government program for low-income individuals, particularly as fiscal hawks claim that significant reforms to Medicaid are needed to earn their vote on the bill.
The overall spending cuts include $880 billion from the Energy and Commerce Committee, and the plan proposed by centrists on Tuesday would amount to $400 billion or $500 billion, the Examiner reported. It is a deviation from the plan that centrist lawmakers overwhelmingly opposed: cutting the federal cost share for states that expanded Medicaid under the Affordable Care Act and capping federal payments to such states.
GOP leaders are signaling to centrist members that some committees might go above their designated savings instructions, giving the Energy and Commerce Committee some breathing room as it tries to reach $880 billion in savings.
Johnson's decision to side with centrist Republicans on their Medicaid red lines could hamper his efforts to reach the deadline for passing the reconciliation bill, which is May 26, Memorial Day.
The conservative House Freedom Caucus warned the GOP leadership that its votes are contingent on strong reform to programs such as Medicaid and Social Security. Johnson can only afford to lose three votes to pass the reconciliation bill along party lines, provided all members are present.
"Not tackling substantive reforms to save Medicaid doesn't just mean defending Obamacare policies discriminating against the vulnerable in favor of able-bodied adults with no children and no jobs," the Freedom Caucus wrote Wednesday in a post on X. "Under the House budget resolution, it also means scaling back the President's campaign promises on tax relief. Reconciliation has to help solve the budget deficit and debt, not make it worse. Which means you need savings to pay for tax relief. Medicaid is where you get it. Without it, the math doesn't math."
Rep. Chip Roy, R-Texas, a member of the Freedom Caucus, wrote a letter to his colleagues on May 1 stressing the need for Medicaid reforms.
"Now is the time to act," Roy wrote. "By addressing discrimination against the vulnerable, ending money laundering, and restoring accountability, we can make sure Medicaid does not bankrupt the federal government. We have to give states better incentives to reduce spending and not further expand Medicaid.
"If the House budget reconciliation package does not include structural Medicaid reform that achieves desired Republican outcomes, we will be setting up massive tax increases and benefit cuts in the future. For once, Congress should stop procrastinating, using excuses, and finally fulfill the Republican agenda."
Michael Katz ✉
Michael Katz is a Newsmax reporter with more than 30 years of experience reporting and editing on news, culture, and politics.
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