Medicaid cut fight drags on even after Trump push
Photo illustration: Sarah Grillo / Axios. Photo: Brendan Smialowski / AFP via Getty Images
President Trump sought to shut down the Medicaid debate and get the GOP megabill passed Tuesday, but House lawmakers continued to squabble over the extent of cuts to the program even after he spoke to the caucus.
Why it matters: Time is running short for Republicans to pass their bill this week, but hardline conservatives are still pushing for deeper Medicaid cuts as moderates warn they don't want further drastic changes to the bill.
- The disputes could spill over into or even delay a House Rules meeting scheduled for 1am ET Wednesday.
Driving the news: House Freedom Caucus Chair Andy Harris left the meeting with Trump telling reporters he was still opposed to the reconciliation bill as is, adding that he wants much stronger limits on Medicaid provider taxes that states use to help finance their share of the program's costs.
- Trump told lawmakers in the meeting not to "f **k around" with Medicaid, but he also left room for targeting "waste, fraud and abuse" — terms broad enough to invite multiple interpretations.
- "The president called for eliminating waste, fraud and abuse in Medicaid," Harris said. "And we have not eliminated waste, fraud and abuse."
- Conservatives have also been pushing for cuts to the federal share of Medicaid costs, or FMAP. Harris did give a little on that front.
- "We could eliminate waste, fraud and abuse without going into FMAP," he said. "But it's going to involve deep changes to the provider tax."
The other side: But moderate Rep. Rob Bresnahan told reporters Tuesday morning that he doesn't want to change the provider tax structure further.
- "That's going to be a nonstarter," he said. "There is a health care system inside of my district that is potentially closing two facilities, and it's something that we can't have in northeastern Pennsylvania and also have the erosion of care."
- Bresnahan added that any changes to FMAP were also a "nonstarter" for him.
Between the lines: Although Trump made comments protective of Medicaid, he also is calling for the current bill to be passed, which has some of the most significant changes to the safety net program in its 60-year history.
- The CBO estimates that 8.6 million more people would become uninsured under the bill, mostly from losing Medicaid, and some from losing Affordable Care Act marketplace coverage.
- But some moderates said they were on board with the current Medicaid changes, saying work requirements and increased eligibility checks made sense.
- "I think they're doing the areas that I recommended," said centrist Rep. Don Bacon.
- He took solace in the absence of deeper cuts in the bill, saying, "I was able to protect FMAP."
