House clears budget hurdle with Medicaid fight ahead

The House cleared a major hurdle Thursday with the adoption of Senate amendments to its budget resolution, but competing promises to different groups of lawmakers mean key decisions on Medicaid lie ahead.

Why it matters: A resolution calling for $1.5 trillion in cuts puts a target on the safety net program, but it's unclear how big the bullseye is.

Driving the news: House budget hardliners said they were reassured by a public statement from Senate Majority Leader John Thune that the Senate is "aligned with the House" in pushing for savings.

• But Thune left some wiggle room, stopping short of a firm commitment to hit the House's $1.5 trillion target.
• "He was willing to go on record that he was going to work with the House to hit our numbers and that's what we need to hear," said conservative Rep. Andy Ogles after the 216–214 vote.
• "We made tremendous progress over the last two days in making certain that whatever we do on reconciliation, we don't increase this country's budget deficit," said House Freedom Caucus Chair Andy Harris.
• He added that the group was happy it got assurances from Thune that he "agreed with the House numbers."

The other side: But leadership also made commitments going the other direction.

• Some moderate House members huddled on the House floor with Speaker Mike Johnson to discuss Medicaid, before casting their votes for the resolution, said Rep. Jeff Van Drew.
• "That group that you saw around him [was saying] we will not vote for any cuts to qualified legal recipients of Medicaid," Van Drew told reporters, saying that Johnson agreed to not cutting Medicaid benefits for "qualified, legal recipients."
• "I'm sick and tired of it, it's getting old," Van Drew said. "We said that to him.… Don't think that we're just going to roll over and go along."
• Van Drew said he does not want to lower the 90% federal match for the Medicaid expansion population, but left open addressing "future growth" of the program in some way.

What they're saying: Johnson reiterated after the vote that Republicans are not going to cut Medicaid benefits, though how that's defined hasn't been fleshed out.

• House Republicans made clear they do favor Medicaid changes like work requirements, allowing more frequent eligibility checks by undoing a Biden-era rule, and by targeting "waste, fraud and abuse."

Between the lines: There is tension between the goal of hitting $1.5 trillion in cuts with the pledge to also not harm any Medicaid benefits.

• "Senate Republicans passed the budget resolution on a promise of fewer cuts to Medicaid," Democratic Sen. Ron Wyden wrote on X. "House Republicans are set to pass it on a promise of deep cuts to the tune of $1.5 trillion dollars. Both things cannot be true."