Lawler. Photo: Tom Williams/CQ-Roll Call via Getty Images
Vulnerable GOP lawmakers are deflecting questions about their openness to Medicaid cuts to help pay for the party's massive tax cut measure.
Why it matters: Republicans can lose only a handful of votes in both the House and Senate, putting pressure on swing votes, and any Medicaid changes are sure to be controversial given potential coverage losses.
What they're saying: "We're far away from going through all the payfors," Rep. Mike Lawler, who hails from a New York swing district and could run for governor, told Axios when asked about including Medicaid.
- "I'm not negotiating in the press on this," he added.
The big picture: House Republicans have discussed far-reaching changes to the Medicaid program, including new caps on how much is spent per person in the program, an idea that was in the 2017 ACA repeal-replace bill.
- Another possible proposal would reduce how much the federal government pays for the Medicaid expansion, which would cause some states to automatically end the expansion because they have "trigger" laws.
Driving the news: "I know there's talks about some Medicaid reform; I'd like to see the details, what that actually looks like," said Rep. Nick LaLota, another swing district member from New York.
- "I have to look at it," Sen. Thom Tillis, one of Senate Democrats' top targets in 2026, told Axios, noting that he had heard of some discussion of "block granting."
- "I'm very familiar with North Carolina's waivers and Medicaid program, so as long as I feel like it doesn't come into conflict with the legislative priorities for Medicaid in the state, I'd be open to it," he added.
- Pressed on whether there is a concern about people losing coverage, Tillis responded: "Well, that's the question. I have to be convinced that it comports with our strategy in North Carolina."
The other side: The Democratic group Protect Our Care launched an eight-figure ad campaign Tuesday targeting vulnerable Republicans, warning of health care being "ripped away."
Between the lines: It is not yet certain whether Republicans will seek to include Medicaid cuts in a reconciliation package, but a revenue loss of as much as $4 trillion from tax cuts gives them reason to look for payfors.
- Some key House lawmakers have argued that the country's debt calls for actions to reduce Medicaid spending.
- Sen. Lisa Murkowski, a key moderate vote who is not up for reelection this cycle, expressed the most concern about cuts.
- "I come from a state where Medicaid expansion has been really, really very key, so if it's going to be part of reconciliation, [it's something] I would be looking very critically at," she said.
- Sen. Shelley Moore Capito, along with then-Sen. Rob Portman, expressed concerns about Medicaid cuts being too steep during the 2017 repeal effort.
- "There's big drivers [of debt], Medicaid's one of them," Capito told Axios last week. "I would have to see specifically what they would be cutting."
