Moderates pressed to back budget despite Medicaid concerns
Illustration: Allie Carl/Axios
With just hours to go, House GOP leaders are trying to win over holdout Republicans by portraying a vote for their budget resolution as a necessary procedural step that will leave specific Medicaid cuts for later.
Why it matters: The question is whether enough wavering moderates will buy in without knowing how the blueprint will overhaul the safety net program. Some appear to be coming around.
What they're saying: Speaker Mike Johnson told reporters Monday night that "Medicaid is not mentioned anywhere in the resolution" and "all these discussions about policy will be had in the weeks ahead of us as we come up with the actual legislation."
Reality check: It will be difficult, if not impossible, to find $880 billion in savings from the Energy and Commerce Committee without major changes to Medicaid. New work requirements and spending caps are on the table.
Driving the news: GOP holdouts raised enough concerns that a group of moderates met for hours with House leadership and Energy and Commerce Chair Brett Guthrie after Monday evening votes.
- New York Rep. Nicole Malliotakis said afterward that "we're getting to a place where we're more comfortable" and that she had shifted from "undecided" to a "lean yes."
- She said earlier Monday that leadership had told her there are "not going to be Medicaid recipients removed unless they are not fulfilling the work requirements or they're not citizens."
- "This is merely a procedural vote that sets us on a path to ultimately vote on a reconciliation bill," said New York Rep. Nick LaLota, echoing leadership's framing. "That's the time to have a fight, not now."
Yes, but: The political fallout could be huge. If states receive less federal Medicaid funding, they could be forced to slash program rolls, even if Congress doesn't directly kick people off the program.
Catch up quick: Guthrie has been discussing policy options to overhaul the Medicaid program with the GOP conference since January.
- He's a fan of per capita caps, but if moderates object, it's not clear what other policy options could provide enough savings to hit the budget's targets.
- Rep. Buddy Carter, the E&C health subcommittee chair, told reporters Tuesday morning that the $880 billion is "a lot of money" but that "we would agree with the president, we're going to make sure Medicaid is taken care of."
The bottom line: Republicans can afford to lose only one vote, with all members present. Johnson acknowledged today the timetable still could slide: "There may be a vote tonight, there may not be — stay tuned."
- Conservatives worried that the cuts do not go far enough could pose an even bigger problem for the whip count.
- "You can't cut taxes without cutting spending, and they're not really cutting spending," said Rep. Thomas Massie, who has already said he's a "solid no" against the resolution. "It's insane, we're going to increase the deficit with this plan."
What we're watching: If Johnson can't make the math add up, it's possible the vote could be postponed.
