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A new twist in the Medicaid fight

Speaker Mike Johnson appears to be ruling out some of the more controversial proposed Medicaid cuts.

Ben Leonard

The Medicaid firefight continues: In a closed-door meeting late Tuesday, Speaker Mike Johnson and GOP leaders sought to assuage moderates’ fears about changes to the health safety-net program to help finance their party-line megabill.

“We’re coming up with options — we’re discussing them, hashing through them, debating them,” Rep. Nicole Malliotakis (R-N.Y.) told reporters afterward. “They’ll come back with a revision.”

Lawmakers coalesced around implementing work requirements and stricter eligibility checks — once every six months as opposed to annually — and cracking down on coverage for noncitizens. Notably, in post-meeting comments to reporters, Johnson appeared to rule out making major slashes to funding for states that have expanded Medicaid under the Democrats’ 2010 health law, backing away from some of the more controversial proposed cuts.

“I feel better about it,” said one vulnerable House Republican who attended the meeting.

But even if leaders are able to appease moderates, they risk also stoking a fire among conservatives itching to significantly overhaul Medicaid, including in the expansion states. Sparks flew nearly instantly, with Rep. Chip Roy (R-Texas) hammering Johnson’s stance.

“So - the GOP leadership position is to defend OBAMACARE policies…” Roy said in a post on X Tuesday night. The House Freedom Caucus also said in a post that not making major changes to the expansion program would be continuing to discriminate “against the people Medicaid is supposed to serve — pregnant women, the disabled, kids in poverty, etc.”

House Energy and Commerce Republicans are scheduled to meet privately Wednesday morning — their second huddle this week — on how they plan to hit their $880 billion deficit reduction target in President Donald Trump’s “big, beautiful bill.” It’ll be a high-wire act for Johnson and GOP leaders to get both moderates and conservatives on board ahead of a markup targeted for next week, and key House GOP lawmakers are likely to head to the White House for meetings with Trump in the coming days as they attempt to finalize their game plan.

“We have to make sure that we know where the president is on this and also where the Senate is,” Rep. Juan Ciscomani (R-Ariz.) told reporters Tuesday. “We can’t be just unilaterally moving this without knowing where they’re going to be and then have some surprises there at the end.”