WASHINGTON – House Republicans appear to be backing off some, but not all, of the steep reductions to the Medicaid program as part of their big tax breaks bill, as they run into resistance from more centrist GOP lawmakers opposed to ending nearly-free health care coverage for their constituents back home.
This is as a new report out Wednesday from the nonpartisan Congressional Budget Office estimated that millions of Americans would lose Medicaid coverage under the various proposals being circulated by Republicans as cost-saving measures. House Republicans are scrounging to come up with as much as $1.5 trillion in cuts across federal government health, food stamp and other programs, to offset the revenue lost for some $4.5 trillion in tax breaks.
“Under each of those options, Medicaid enrollment would decrease and the number of people without health insurance would increase,” the CBO report said.
The findings touched off fresh uncertainty over House Speaker Mike Johnson’s ability to pass what President Donald Trump calls his “big, beautiful bill” by a self-made Memorial Day deadline.
Lawmakers are increasingly uneasy, particularly amid growing economic anxiety over Trump’s own policies, including the trade war that is sparking risks of higher prices, empty shelves and job losses in communities nationwide. Central to the package is the GOP priority of extending tax breaks, first enacted in 2017, that are expiring later this year. But they want to impose program cuts elsewhere to help pay for them and limit the continued climb in the nation’s debt and deficits.
Johnson has been huddling privately all week in the speaker’s office at the Capitol with groups of Republicans, particularly the more moderate GOP lawmakers in some of the most contested seats in the nation, who are warning off steep cuts that would slash through their districts.
Democrats, who had requested the CBO report, pounced on the findings.
“This non-partisan Congressional Budget Office analysis confirms what we’ve been saying all along: Republicans’ Medicaid proposals result in millions of people losing their health care,” said Rep. Frank Pallone, D-N.J., who sought the review with Sen. Ron Wyden, D-Ore.
House Republican lawmakers exiting a meeting late Tuesday evening indicated that Johnson and the GOP leadership were walking away from some of the most debated Medicaid changes to the federal matching fund rates provided to the states.
Rep. Jeff Van Drew, R-N.J., said those Medicaid changes “are dead.”
Republican Rep. Nick LaLota of New York, reminded that Trump himself has said he would oppose Medicaid cuts. Instead, he said the growing consensus within the Republican ranks is to focus the Medicaid cuts on other provisions.
Among the other ideas, LaLota said, are imposing work requirements for those receiving Medicaid coverage, requiring recipients to verify their eligibility twice a year instead of just once and ensuring no immigrants who are in the U.S. without legal standing are receiving aid.
But the more conservative Republicans, including members of the House Freedom Caucus, are insisting on steeper cuts as they fight to prevent skyrocketing deficits from the tax breaks.
Medicaid is a joint program run by states and the federal government, covering 71 million adults.
Republicans are considering a menu of options to cut federal spending on the program, including reducing the share that the federal government pays for enrollees health care — in some cases it is as much as 90%.
They are also considering and setting a cap on how much the federal government spends on each person enrolled in Medicaid, though that idea also appears to be losing support among lawmakers.
While those changes would bring in billions of dollars in cost savings, they would also result in roughly 10 million people losing Medicaid coverage, the CBO said.
They appear to be off the table.
But other proposed Medicaid changes are still in the mix for Republicans, including imposing new limits on a state’s tax on health care providers that generate larger payments from the federal government. That would bring in billions in savings, but could also result in some 8 million people losing coverage, the report said.
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