House Speaker Mike Johnson is facing dissent from nearly every corner of his conference on the Senate’s budget resolution.
But “nearly” is not “every.”
Vulnerable Republicans concerned about Medicaid cuts — primarily, though not exclusively, moderates and front-liners — plan to back the Senate-adopted budget despite continued worries about the impact on Medicaid.
The budget resolution calls for $880 billion in cuts to programs under the purview of the House Energy and Commerce Committee. President Donald Trump and Speaker Johnson have made repeated assurances that Republicans won’t cut direct Medicaid benefits. But according to the Congressional Budget Office, it’s impossible to reach that $880 billion number without major Medicaid cuts.
In February, when the House first adopted a budget, Johnson got moderate holdouts on board by promising that the Senate would amend the legislation, with vulnerable Republicans believing that $880 billion figure would be more fantasy than reality in the end.
But the Senate largely declined to rule on the Medicaid cuts, opting to offer a target for cuts in the Senate that amounts to a few billion dollars and a target for the House that leaves the $880 billion intact.
And even though House conservatives are concerned that the eventual cuts in a reconciliation bill will look more like the Senate’s numbers, vulnerable Republicans are coming along for the ride — for now.
“We’re going to get to all that nuance when we get to reconciliation, we’re merely at the resolution stage,” Rep. Nick LaLota said while leaving the House GOP conference meeting Tuesday morning.
“We’ll see how it irons out in the bill. If the bill doesn’t meet the moment, I’ll vote no,” he said.
Johnson and House Majority Leader Steve Scalise met last night with a group of Republicans who remained concerned about Medicaid cuts. According to one member in the room, the group went beyond “so-called mods” and also included members in districts that Trump won by 20 to 30 percentage points. This lawmaker said even Republicans in safe districts are “sincerely concerned about proposals on Medicaid,” adding that Johnson and Scalise lacked specifics on Medicaid cuts or how the Energy and Commerce Committee could get to $880 billion without touching benefits.
“There was emotional and political understanding offered that the members’ concerns would be reflected in the ultimate reconciliation bill. But the specificity was lacking,” the member told NOTUS.
“Apparently Congress is now a counseling session,” this person added.
During the meeting, Scalise emphasized that cuts would target waste, fraud and abuse.
“When you actually see what we’re trying to do to bring integrity to the program, to bring savings to the program, frankly, to help shore up programs like Medicaid that were being heavily abused so that works better for the truly disabled, pregnant women, people who need it — that’s the direction we’re going, and frankly, it’s been a long time coming,” Scalise told NOTUS on Tuesday afternoon.
Rep. Nicole Malliotakis, who was also at the Monday night meeting, said she and other Republicans in the room made it clear to Johnson and Scalise that they’d support instituting work requirements for recipients, ensuring that undocumented immigrants are not receiving benefits and supporting more regular checks on recipient eligibility. But at the same time, she said this group wouldn’t support lowering the Federal Medical Assistance Percentage, which determines the federal share of Medicaid costs for states, nor would they support caps on Medicaid or changes to eligibility that would remove benefits.
“I imagine most of the people in the room will vote for the resolution because we understand that, again, this is just going to be moving the process forward and we’ll end up somewhere in the middle between the Senate and the House,” Malliotakis said.
“It just needs to be done, and then we can fight out the rest,” she said.
GOP Sens. Susan Collins, Lisa Murkowski and Josh Hawley all backed an amendment last week that would strike out the $880 billion cut to programs under Energy and Commerce. But their votes weren’t enough to make the change. (Collins ultimately voted against the Senate budget, along with Sen. Rand Paul, who opposed it because he said the cuts didn’t go far enough.)
But other Republican senators said even though they voted for the budget and not the amendment, that didn’t mean they would be disengaging from the debate over Medicaid cuts.
“I’m not a rubber stamp, now, don’t you think that for one second,” freshman Sen. Jim Justice said. “I didn’t come here with all this white hair just to sit on the bench and say, ‘How’s everything going?’”
Justice said there’s agreement that “ridiculous waste” in both Medicaid and the federal government at large needs to be addressed. But, he said, cuts beyond that are more complicated.
“Just don’t do anything that really cuts into the bone and really, really, really hurts, because the very second we do that, we’re going to start losing Toby and Edith,” he said. “That’s what I call our voters.”
“When we lose Toby and Edith,” Justice continued, “then the next thing that’s gonna happen, you mark it down, you’re going to have elected officials start diving in the ditch, and this whole thing is going to implode.”
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Katherine Swartz is a NOTUS reporter and an Allbritton Journalism Institute fellow.