Possible GOP Opposition to Medicaid Cuts May Impact House Budget Vote Tomorrow

Overview

On Tuesday, House Republicans are anticipated to cast their votes on a budget proposal that aims to initiate the legislative journey to implement President Donald Trump’s policy initiatives. However, nearly $1 trillion in proposed cuts to Medicaid has raised concerns among some Republican lawmakers, which may jeopardize the resolution’s approval.

House Speaker Mike Johnson (R-LA) engages with media as he walks from his … [+] office at the U.S. Capitol on February 24, 2025, in Washington, DC. (Photo by Kent Nishimura/Getty Images)

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Essential Details

The fiscal year 2025 budget plan is projected to result in around $800 billion in Medicaid cuts over the next ten years, contributing to a total of $2 trillion in spending reductions intended to finance $4.5 trillion in tax cuts, alongside increased funding for defense and border security.

Medicaid, the federal healthcare program, delivers coverage to over 72 million Americans.

Although the resolution does not explicitly demand Medicaid cuts, cautious lawmakers have indicated that it would be nearly impossible to meet the $880 billion reduction assigned to the Energy and Commerce Committee without impacting Medicaid spending.

Moderate Republicans from precarious districts, particularly those with a significant number of constituents who rely on Medicaid, have voiced their opposition to any cuts to the program.

Eight House Republicans, including Representatives David Valadao (R-CA) and Nicole Malliotakis (R-NY), who either belong to the Hispanic Conference or represent areas with large Hispanic populations, cautioned in a letter to Speaker Johnson earlier this month that “cutting Medicaid would have detrimental effects, especially for rural and mostly Hispanic communities,” while also urging that the Supplemental Nutrition Assistance Program (SNAP) be preserved.

Representative Don Bacon (R-NE), whose district supported Kamala Harris in the last election, has also expressed reservations regarding the proposed Medicaid cuts, requesting assurance from House leaders that the $880 billion in budget cuts assigned to the Energy and Commerce Committee would not disproportionately reduce Medicaid funding, as reported by Roll Call previously.

Johnson has previously indicated that instituting work requirements for Medicaid could be one strategy for reducing expenses, and Republicans have considered limiting federal funding allocated to states for administering Medicaid.

How Many Votes Can Republicans Lose to Approve the Budget Resolution?

If all Democratic members oppose the spending proposal, Republicans can spare only one vote under their narrow 218-215 majority in the House. As of Tuesday morning, at least three members—Reps. Tom Massie (R-KY), Tim Burchett (R-TN), and Victoria Spartz (R-IN)—have declared their disapproval of the resolution, emphasizing the necessity for deeper cuts. Burchett also expressed a desire for a permanent extension of Trump’s 2017 tax reductions.

What Is House Speaker Mike Johnson’s Stance on Medicaid Cuts?

When questioned by Politico about potential amendments to the budget addressing Medicaid concerns, Johnson replied, “no,” explaining that the resolution merely sets overarching spending targets for House committees and does not include explicit provisions related to Medicaid. He characterized the resolution as “just the initial step in the process… the detailed legislation will follow.” He added later that “I believe we’re in a good position,” commenting on the support for the proposal and indicating that productive discussions are ongoing.

What Other Provisions Are Included in the House GOP Budget?

The plan proposes a $4 trillion increase to the federal debt ceiling, which may pose an issue for some Republicans, including Burchett and Massie, who have historically opposed raising the debt limit. Additionally, the budget would extend Trump’s 2017 tax cuts and allocate an extra $300 billion for border security and defense.

How Does the House Budget Compare to the Senate’s Plan?

The Senate’s budget resolution, which passed last week, does not propose Medicaid cuts. Instead, it outlines a spending strategy supporting Trump’s policies on border security, defense, and energy, deferring discussions on tax policy to a later stage and dividing the spending plan into two separate components.

What Are Trump’s Views on the Spending Plans in the House and Senate?

On Wednesday, Trump advocated for “one big, beautiful bill,” as outlined by the House version on his Truth Social platform. However, he later expressed support for the Senate’s agenda as an alternative, stating on Fox News radio, “it provides you with options.”

What Are Trump’s Opinions on Medicaid?

In a recent Fox News interview, Trump asserted that Social Security, Medicare, and Medicaid would “be strengthened… none of these programs will be impacted,” a statement that contrasts with his endorsement of the House Republican budget proposal.

What Has Elon Musk Said About the House GOP Budget?

In response to a post from Massie on X, Musk commented, “that sounds bad,” referring to concerns that the budget plan would exacerbate the deficit rather than alleviate it.

What Happens If the Budget Resolution Gets House Approval?

If passed, the Senate will subsequently vote on the resolution. Approval from the Senate would initiate the legislative process necessary to enact Trump’s agenda, establishing spending targets for his various policy priorities. Following that, the relevant committees in both the House and Senate would draft appropriate legislation aligned with these targets.