WASHINGTON — All of the moderate House Republicans who complained last week about Medicaid cuts in the House Republican budget voted for the budget anyway on Tuesday.
If they had balked at the budget, the moderates could easily have blocked it; their capitulation helped House Speaker Mike Johnson (R-La.) and President Donald Trump make significant progress on what could become the major domestic policy achievement of Trump’s second term.
The budget resolution calls for $4.5 trillion in tax cuts, with the foregone revenue partially replaced by spending cuts, including to programs like Medicaid, food assistance and Pell grants. The resolution itself doesn’t make the cuts however, instead, it tells confessional committees to come up with specific dollar amounts in savings from programs under their jurisdiction.
The Republicans who complained about the Medicaid cuts did not vow to vote against the budget, instead leaving their position uncertain until shortly before Tuesday’s roll call. In statements defending their votes, they pointed to the preliminary nature of the resolution. Rep. David Valadao (R-Calif.) went a step further, saying he would not necessarily support the final legislation, known as a “budget reconciliation” bill, despite his vote for the initial outline.
“I’ve heard from countless constituents who tell me the only way they can afford health care is through programs like Medicaid, and I will not support a final reconciliation bill that risks leaving them behind,” Valadao said Tuesday in remarks on the House floor. “Medicaid cuts are deeply unpopular with the American families who sent us here to deliver on President Trump’s agenda.”
Valadao was one of several Republicans, from districts with large Hispanic populations, who warned Johnson against major Medicaid cuts last week. “While we fully support efforts to rein in wasteful spending and deliver on President Trump’s agenda, it is imperative that we do not slash programs that support American communities across our nation,” the lawmakers wrote in a letter led by Rep. Tony Gonzalez (R-Texas).
In the end, the only Republican who opposed the budget was Rep. Thomas Massie (R-Ky.) ― not because the cuts are too deep, but because they’re not deep enough. Legislation fulfilling the budget outline would add trillions to the national debt.
At a press conference on Wednesday, Speaker Johnson noted that the budget resolution doesn’t even contain the word “Medicaid,” but also said Medicaid is full of fraud and waste that Republicans would address. Medicaid covers health costs for more than 70 million Americans.
The budget resolution directs the House Energy and Commerce Committee, which oversees Medicaid, to come up with $880 billion in savings, or about 11% of Medicaid’s projected costs for the next decade.
Rep. Dan Goldman (R-N.Y.) accused Rep. Nicole Malliotakis (R-N.Y.), who signed the letter to Johnson last week, of voting to cancel health insurance for thousands of her constituents.
“This is a 100% LIE by my shameless colleague as the resolution doesn’t even mention Medicaid,” Malliotakis wrote in response. “If you have Medicaid, when you make a doctor’s appointment you’ll see for yourself. It’s sad & unfortunate this slimy Democrat would instill fear & anxiety in his constituents to score cheap political points.”
Rep. Rob Bresnahan, a freshman Republican from Pennsylvania who suggested last week he wouldn’t support a budget that “guts” Medicaid, said after Tuesday’s vote that he hadn’t changed his position.
“I will fight to protect working-class families in Northeastern Pennsylvania and stand with President Trump in opposing gutting Medicaid,” Bresnahan posted on X. “My position on this has not and will not change.”
In his remarks on the House floor before Tuesday night’s vote, Valadao presented a more nuanced view of the legislative process than his colleagues did, acknowledging that the House adopting the budget could, in fact, lead to Medicaid cuts down the line.
“I understand Medicaid is not explicitly named in this bill, but achieving $880 billion in budget cuts within [the House Energy and Commerce Committee’s] jurisdiction would be really ― is not an easy task,” Valadao said.
Rep. Steve Scalise (R-La.), the No. 2 Republican in the House, spoke after Valadao, assuring him Republicans would protect “deserving” Medicaid beneficiaries.
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“His district is going to have a very loud voice as this process moves forward, to protect and make sure that people who are on these programs, who are deserving, who need these programs, are going to – frankly we ought to be focusing on getting better services to these people and root out waste, fraud and abuse,” Scalise said. “That’s what we’re focused on, protecting these people who are on these programs and need them so desperately.”