Republican leaders trying pass the bulk of President Donald Trump's agenda through Congress are hoping to do it at minimal political cost, given their small majorities in the House of Representatives and U.S. Senate. But one controversial policy could end up costing them big in next year's midterm elections.
Semafor reported Thursday that the Republican budget reconciliation bill currently being debated in the House could include as much as $880 billion in cuts to Medicaid when the final version is sent to the Senate (assuming it passes). And whether the bill passes through the lower chamber of Congress will depend on whether a dozen or so hard-liners who are insisting on steep cuts to Medicaid vote for it.
However, should Medicaid funding be significantly reduced, some Republicans are worried that their low-income and disabled constituents will drive them out of power in next year's elections. And Democrats are gearing up for a campaign cycle focused on casting Republicans as a party that put health insurance for the most vulnerable Americans on the chopping block to cut taxes for the wealthiest Americans.
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"Deep cuts to Medicaid will be a political loser for any member who supports them," Sen. Jon Ossoff (D-Ga.), who is up for reelection next year, told Semafor. "But even more worrying: It will hurt a lot of my constituents."
The scope of Medicaid cuts up for debate is largely between whether Republicans want to make wholesale cuts to the popular program, or take a smaller approach that rolls back some elements of the 2010 Affordable Care Act (also known as "Obamacare") and imposing stricter work requirements on Medicaid recipients. But even curtailing some provisions of Obamacare could carry a significant political cost. Rep. Richard Neal (D-Mass.), who is the ranking member of the House Ways and Means Committee, observed that even though Democrats lost their House majority in 2010 after Obamacare was signed into law, Republicans could now be the party that loses theirs for threatening it.
"We paid a price for it at the polls. But in short order, they paid a price for trying to get rid of it," Neal said.
Sen. Mark Kelly (D-Ariz.) likewise said that if Republicans end up cutting Medicaid: "[T]his will be one thing we talk about more than anything else."
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Semafor further reported that some Republicans seem keenly aware of the political consequences for going after Medicaid. Sen. Thom Tillis (R-N.C.), who is running for another six-year term in 2026 in a purple state, said there is still "a lot of work" to do on the current reconciliation bill before he would support it. And when asked about Medicaid cuts could impact his constituents, Rep. Brian Fitzpatrick (R-Pa.) cautioned "none of that's final right now."
Sen. Joni Ernst (R-Iowa) is also likely to have a tough reelection race next year. She's so far been quiet on her support for a bill that would cut Medicaid, only saying that she's eager to "hear from Iowans on this before making any hard and fast decisions."
"Hopefully we’ll see some changes," Rep. Ryan MacKenzie (R-Pa.) said of the current reconciliation bill,
Click here to read Semafor's full report.
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