Senate Republicans are all over the board on whether they want Medicaid cuts or if they’ll even happen — but proposals made by members of their own party may force them to figure out their position soon.
“We haven’t cut rates yet. What are you talking about?” Sen. John Kennedy of Louisiana said on Wednesday when asked how cuts could affect his constituents. “You’re asking me a hypothetical.”
Cuts to entitlement programs like Medicaid are explicitly on the table — put there by their colleagues in Congress’ other chamber. House Republicans’ budget plan lays out a $2 trillion cut to entitlement programs that has Medicaid funding as its clearest target.
But Republican senators largely said that they also want more clarity before trying to figure out how cuts to Medicaid could affect their constituents’ health care coverage. Even as they anticipated that Democrats would force them to vote on related messaging proposals during the Senate’s marathon voting session, which they did, they were reluctant to say whether they would support such cuts.
“They’re all hypothetical right now. Ask me when they start cutting,” Alabama’s Sen. Tommy Tuberville said on Wednesday. “We have to look at everything that we’re spending and decide where we’re gonna make cuts.”
Other Republicans even denied that their party is considering Medicaid cuts in the first place — in response to a question about them, Missouri’s Sen. Eric Schmitt said, “Nobody’s talking about that.”
The idea of cuts puts Republicans in an especially precarious political position. It’s still unclear exactly where President Donald Trump stands on cuts to entitlement programs, and Medicaid is a popular government program — 77% of Americans say they have a favorable view of it, according to KFF Health polls.
States with lower-than-average per-capita incomes also get more federal help covering Medicaid expenditures — which means GOP lawmakers’ states have more to lose from changes to how the program’s funded.
By supporting a symbolic amendment during the Senate’s budget resolution process Thursday night “relating to protecting Medicare and Medicaid,” Republicans tried to fend off speculation that they would offset costs from extending tax cuts by reducing how much the federal government chips in for states’ Medicaid programs. Every Republican, except both of Utah’s senators, voted to adopt it.
But four other Medicaid amendments were shot down by most Republicans, with only Sens. Josh Hawley and Susan Collins joining Democrats on some of the others aimed at protecting Medicaid benefits.
Hawley said while the House Republicans’ consideration of “deep cuts to Medicaid” sounded “concerning” to him, he denied Trump’s endorsement of House Republicans’ plan meant that the White House supported those proposed cuts: It just means that “he wants one bill.”
“I understand the White House has cautioned House Republicans on Medicaid,” Hawley said.
He’s said he thinks Trump is signaling that he wants Congress to protect federal Medicaid spending — telling reporters that he’s “with the president” on his concerns about the House’s proposed cuts.
Trump said Tuesday night during a Fox News interview that Medicaid, like Medicare, would not be “touched.” But the next morning, in a move that blindsided senators, Trump also endorsed the House Republicans’ budget plan.
In statements sent to Politico on Wednesday night, the White House attempted to clarify that Trump’s administration is “committed to protecting” Medicaid “while slashing the waste, fraud and abuse within the program.”
“The president has said that he doesn’t want to touch Medicare, Medicaid or Social Security. We’ll just need to understand what that means exactly,” Sen. Jon Husted of Ohio told NOTUS on Wednesday. “If there’s a proposal that’s before me, I’ll react to it, but I’m not going to react to the noise that’s going on.”
One Republican senator acknowledged his party’s looking at changes to the program but didn’t think those changes would look like cuts.
“We’re not gonna cut Medicaid. We’re actually going to make it survive really well,” Sen. Bernie Moreno said.
Still, some senators representing poorer states were on board with potential cuts or at least adjusting the rate at which the federal government chips in.
Sen. Rand Paul serves on the Senate’s Health, Education, Labor and Pensions Committee and represents Kentucky, which receives $2.50 from the federal government for every dollar it spends on its residents’ health care coverage.
“We’re short of money up here. We spend about $2 trillion more than what comes in. Because of that, in order to try to have more fiscal responsibility, we need the states to pay more. Most of the proposals that are up here are for the states to share the burden equally,” Paul told reporters Wednesday.
Another HELP committee member, Kansas Sen. Roger Marshall, whose state receives $1.54 from the federal government for every dollar it spends on Medicaid, said he knew from his experience as a physician that “those dollars are not being wisely used.”
“Medicaid’s probably the most broken system the federal government is involved with,” Marshall said. “Community health centers are a much better option.”
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Emily Kennard is a NOTUS reporter and an Allbritton Journalism Institute fellow.