Illustration: Tiffany Herring/Axios
Internal GOP divisions over Medicaid cuts are deepening across both chambers as the House heads toward a budget resolution vote as soon as Wednesday afternoon.
Why it matters: The tensions highlight how difficult it will be to write the actual reconciliation bill, even if the House GOP leadership rounds up the votes to adopt Senate amendments to its budget resolution.
What they're saying: Sen. Josh Hawley on Tuesday shared with Axios details of a conversation he had last week with President Trump, during which Hawley said the president "was just adamant that we're not doing Medicaid benefit cuts."
- "He's very clearly defined on that," Hawley said, while acknowledging the tensions on the Hill. "And obviously you're gonna have some people who really want to do Medicaid cuts."
- Hawley said, though, that he and Trump did not drill down to what exactly would qualify as a benefit cut.
Between the lines: Although the Senate is more sensitive to Medicaid cuts, there are also uneasy House members, including New York Rep. Nicole Malliotakis and Nebraska Rep. Don Bacon.
- "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," Bacon previously told Axios.
- "Working poor who are working … should not be cut, disabled should not be cut, senior citizens should not be cut, hospitals shouldn't be hurt," New Jersey Rep. Jeff Van Drew told Axios last week, though notably he said it is "OK to look at" changes to Medicaid expansion.
The other side: At the same time, the Senate's updated budget is encountering resistance in the House as conservative members push for guarantees of significant cuts, with some explicitly pointing to Medicaid.
- Reps. Chip Roy, Andy Harris and Eric Burlison wrote in a Fox News op-ed last month that "lawmakers must reform Medicaid. To do anything less borders on malfeasance."
- They called for lowering the federal share of costs (FMAP) for the Medicaid expansion population, which has drawn pushback from some in the Senate GOP.
- "The Senate budget does not reduce deficits," Roy told reporters Tuesday. "The Senate budget would increase deficits. The Senate needs to produce a plan to us with seriousness and resolve to reduce deficits."
The bottom line: Trump on Tuesday floated an eventual deficit cut target "hopefully in excess of $1 trillion."
- That is both less than the $2 trillion pushed for by conservatives, and enough that Medicaid would likely remain in the hot seat.
