As House Republicans struggle to build near-unanimity to pass President Donald Trump’s “one big, beautiful” reconciliation bill, GOP leaders are trying to convince vulnerable Republicans that cuts to Medicaid and food assistance programs won’t cost lawmakers at the ballot box in 2026.
Speaker Mike Johnson has long acknowledged that drafting a reconciliation bill would require some political flexibility from members. But just weeks after the House approved its budget blueprint, Johnson’s conference is trending toward missing its Memorial Day deadline as leaders struggle to build consensus on a number of issues.
In an early sign of the struggle, lawmakers on key committees have already delayed markups for their portions of the bill. And even as committees begin their markups this week, there are real questions about the final product.
The Energy and Commerce Committee is charged with identifying $880 billion in cuts from programs under its jurisdiction. Achieving that number is literally impossible without Medicaid cuts. The problem is, to even get the reconciliation process to this point, leaders have had to make contrasting promises to different factions of the GOP conference.
To win over conservatives, Republican leaders have vowed to make real cuts to Medicaid. To win over more moderate members, those same leaders have promised not to substantially cut Medicaid. And senators are similarly committed to not advancing a bill that reduces Medicaid.
And yet, the language currently under consideration in the Energy and Commerce Committee would lower the Federal Medical Assistance Percentage — the percentage of Medicaid costs paid for by the federal government in states that expanded Medicaid — and institute caps on individual Medicaid costs.
Those changes would exceed what more moderate Republicans said they’d be comfortable with. (Republicans have generally said they’d accept going after “waste, fraud and abuse” in Medicaid, but those moderates have opposed cuts beyond that.)
“They need to listen to us and our concerns like they listen to the Freedom Caucus on cuts,” one moderate Republican told NOTUS.
Johnson will meet with the moderates Tuesday afternoon to discuss Medicaid cuts, two people familiar with the meeting told NOTUS.
But as another moderate Republican told NOTUS, leadership has “a lot of hard work to do.”
Plenty of Republicans have been explicit that FMAP cuts and per capita caps are politically toxic. A dozen or so such members — including Reps. Jeff Van Drew, Nick LaLota and Nicole Malliotakis — told Johnson before the House voted on their budget resolution last month that those Medicaid reductions were nonstarters.
“There’s a group of us that have been very clear when it comes to Medicaid, we are not taking away benefits from eligible recipients,” Rep. Mike Lawler told NOTUS.
The timeline is incredibly tight for House Republicans to meet their original Memorial Day deadline. Leadership has moved the goalposts to target passing the reconciliation bill by July 4, but even still, lawmakers are skeptical they can find consensus on how to reach $1.5 trillion in cuts.
Of course, Medicaid cuts aren’t the only hold-up for Johnson.
Some lawmakers on the Agriculture Committee, for example, are upset because they feel House GOP leadership misled them about the extent of cuts that their panel must achieve.
Although the House approved $230 billion in cuts to the Agriculture Committee’s budget when they adopted their reconciliation blueprint in February, one source with knowledge of the matter told NOTUS that GOP leaders repeatedly told the panel that the Senate would intervene to soften the blow in its budget.
That didn’t happen.
Instead, the House approved a budget resolution last month that included a $230 billion floor for spending cuts. That steep target puts members in the uncomfortable political situation of voting to slash food programs like the Supplemental Nutrition Assistance Program.
The person familiar with the situation said $150 billion in cuts would be a more achievable target, which this source suggested could be reached by cracking down on payment errors, misused work requirement waivers by states and increasing the work requirement age. The committee is now considering state cost-sharing for SNAP.
Complicating matters further, Agriculture Republicans are pushing GOP leaders to include portions of the farm bill in the reconciliation bill, as NOTUS previously reported.
All of these issues have nothing to do with the biggest portion of the reconciliation legislation: taxes.
The reconciliation bill will extend and add to the first Trump administration’s massive tax cuts.
The Ways and Means Committee has not yet scheduled its markup on the tax-writing elements of the bill. But already, it’s clear finding consensus won’t be easy.
Lawmakers who support increasing the state and local tax deduction caps have long been a thorn in Johnson and Ways and Means Chair Jason Smith’s sides. Members of the State and Local Tax Caucus are bullish that the reconciliation bill will increase the deduction far above the current $10,000 limit.
Johnson met with the caucus last week to discuss the deduction. But the meeting wasn’t fruitful, multiple members in attendance told NOTUS, adding that while leadership understands where they need to be, there’s no plan to get there.
Even if House Republicans can pass the reconciliation bill in their chamber, the Senate will be its own challenge.
Senate Majority Leader John Thune made clear to reporters that leadership in the two chambers are talking while the House begins drafting the bill.
“The House, obviously, is going through that process, and they’ve had several already, and more coming,” he said. “Our committees are linked up with theirs and we’re meeting regularly.”
Sen. Rick Scott acknowledged to NOTUS that the House still has “a lot of work to do,” particularly as both chambers feel the pressure of yet another issue: the debt ceiling.
The reconciliation bill would add a $5 trillion hike to the debt ceiling to avert a default sometime this summer — if Congress can pass the bill in time.
“I’m always optimistic,” Scott said of the chances of getting reconciliation done before a default. “Can’t say exactly how it’s gonna happen. But I’m optimistic.”
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Daniella Diaz, Riley Rogerson and Reese Gorman are reporters at NOTUS.
Helen Huiskes, who is a NOTUS reporter and an Allbritton Journalism Institute fellow, contributed to this report. Ursula Perano, who is a reporter at NOTUS, contributed to this report.