Illustration: Natalie Peeples/Axios
House Republicans from competitive districts are raising concerns about the prospect of large Medicaid cuts — and are pointing to recent comments from President Trump to reinforce their case.
Why it matters: House GOP leaders' hopes of passing a reconciliation package could be sunk with two defections, assuming Democrats are unified in opposition.
- But it will be difficult to achieve cuts like those laid out in the Republican budget resolution without major changes to the safety net program.
Driving the news: The House budget calls for as much as $2 trillion in cuts to mandatory spending, but moderates are sounding the alarm that they don't want Medicaid benefits for their constituents harmed.
- "I think President Trump made clear it's all right to do work requirements, it's all right to make sure we have valid people, but any significant cuts to Medicaid as it would affect a patient, he would oppose," Nebraska Rep. Don Bacon, who represents one of the most competitive House districts, told reporters last week after the budget was released.
- "I think he's got the right gut instinct on this," Bacon added.
- "President Trump has said he really doesn't want to touch Medicaid, so I'm not sure how they're gonna come up with the cuts," said New York Rep. Andrew Garbarino.
What they're saying: Trump made waves at the end of January by telling reporters that he wanted only to cut "abuse or waste" in Medicaid, not anything that would "affect" beneficiaries.
- Those comments leave considerable wiggle room, though, and it's not clear exactly what changes would meet Trump's standard.
- Speaker Mike Johnson similarly sought to reassure his caucus and the public last week, saying that only "non-benefit-related reforms to the program" are on the table.
- But with a budget that calls for at least $880 billion in cuts from the Energy and Commerce Committee, which oversees Medicaid, the math could force major changes to the program that would require states to squeeze benefits or have people lose coverage.
Between the lines: The budget sets only the overall goal for cuts, so the specifics of what changes would be made to Medicaid to reach that number are not yet clear.
- Another New York Republican, Rep. Nick LaLota, said he is waiting to see the details.
- "It's too early right now in this budget resolution. It doesn't get specific on things like [Medicaid]," he told reporters. "We're gonna see in the budget reconciliation [bill] what the specific proposals are."
- One vulnerable freshman, Pennsylvania Rep. Rob Bresnahan, fired a public warning shot on X. "If a bill is put in front of me that guts the benefits my neighbors rely on, I will not vote for it," he wrote.
