Source: Punchbowl News
If you’re looking for a sign that House Republicans are getting worried about cuts to Medicaid, here it is.
A dozen House Republicans are warning GOP leaders that they won’t back a reconciliation package that includes massive cuts to Medicaid, according to a letter first obtained by Punchbowl News.
It’s an escalation of what’s going to be the most difficult problem for Republicans as they try to pass President Donald Trump’s agenda in the coming months.
These moderate Republicans, many of them in key swing seats, are going to be locked in a battle of wills with conservative hardliners who want to slash federal spending, including Medicaid and other social safety net programs.
The fate of Republicans’ behemoth reconciliation bill — which will also carry key GOP priorities like tax cuts, a Pentagon spending hike and more border security funding — is linked to the Medicaid standoff.
Remember, House Republicans’ reconciliation plan includes cutting $880 billion under the House Energy and Commerce Committee’s purview, much of which will likely have to come from Medicaid.
The message: The moderate Republicans’ letter to House GOP leadership and Energy and Commerce Committee Chair Brett Guthrie (R-Ky.) says Medicaid cuts could threaten nursing homes and hospitals, especially in rural and underserved areas.
Here’s the key part:
“We support targeted reforms to improve program integrity, reduce improper payments, and modernize delivery systems to fix flaws in the program that divert resources away from children, seniors, individuals with disabilities, and pregnant women — those who the program was intended to help.
“However, we cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations.”
The House Republicans who signed onto the letter include: Reps. David Valadao (Calif.), Don Bacon (Neb.), Jeff Van Drew (N.J.), Rob Bresnahan (Pa.), Juan Ciscomani (Ariz.), Jen Kiggans (Va.), Young Kim (Calif.), Rob Wittman (Va.), Nicole Malliotakis (N.Y.), Nick LaLota (N.Y.), Andrew Garbarino (N.Y.) and Jeff Hurd (Colo.).
It’s not clear exactly where these members will draw the line just yet, or if it’ll be the same across the group. There’s a general acceptance, for the most part, of cutting “waste, fraud and abuse” in Medicaid programs. But Republicans will clash over the specifics in the weeks ahead and that’s where things get tricky.
“There’s reasonable actions we can support like work requirements for able bodied adults without children and auditing the Medicaid list,” Bacon told us. “But there will not be the votes to cut Medicaid for those who need it or to the hospitals that we need to preserve.”
Kim said in a statement that a reconciliation package “that does not protect vital Medicaid services for the most vulnerable citizens in my community will not receive my vote,” adding she’s made that clear to constituents and GOP leadership.
Some of the GOP lawmakers who signed onto this letter – Van Drew, Malliotakis and LaLota – huddled with Speaker Mike Johnson on the House floor during the budget resolution vote just before recess. After their lengthy chat, they touted promises from Johnson that Medicaid cuts won’t go too deep.
Van Drew later told reporters that Johnson promised not to cut Medicaid for individuals who are “qualified” to receive the benefit. LaLota told us that the speaker vowed to take a “compassionate approach.”
But Johnson also told conservatives agitating for massive spending cuts that he’s committed to slashing $1.5 trillion or more. That sets up a brutal fight in late April and May. Some members are bound to end up feeling jilted.
The politics: This group of more centrist Republicans is signaling that they’re willing to play hardball to avoid Medicaid cuts, which would have big impacts back home. These sorts of members aren’t usually the ones to threaten to take down major legislation. But there are enormous political and policy stakes at play here.
Across the Capitol, a number of GOP senators — including several with large Medicaid populations — also have warned party leaders against making draconian cuts to the popular program.
Democrats have been hammering Republicans over the potential Medicaid cuts, saying it will jeopardize the health of millions of children and low-income families.
We’ve reported the hefty investment in ad buys that House Majority Forward, the HMP-aligned organization, launched against Republicans last month. This is going to be one of the most prominent messaging wars heading into the 2026 cycle.
We’ll also note the Medicaid ads are coming from all sorts of groups and organizations. The American Cancer Society Cancer Action Network is running digital ads on the potential Medicaid cuts, including in Louisiana. Several California labor unions are running ads saying rural hospitals rely on Medicaid funding.
Democrats have tied the Medicaid cuts to Republicans’ tax plans, making the case that the GOP will slash the health care program while also preserving lower tax rates for wealthier Americans
In a sign the Democratic attacks are working, some White House officials are talking about letting taxes go up or creating a new top tax rate for some of the wealthiest Americans, as Bloomberg reported.
We don’t expect Republicans to ditch decades of GOP orthodoxy around tax cuts. GOP leaders have made extremely clear they don’t want to raise tax rates — even for the rich. But with unrelenting pressure from conservatives to slash social safety net programs as part of the tax bill, Republicans are in a very difficult spot.
