House Republicans recently passed a budget resolution that aligns with President Donald Trump's campaign promises, including border security funding and tax cuts. However, the proposal has created internal divisions within the party, particularly over proposed cuts to Medicaid.
While some Republicans support reforms aimed at reducing fraud and waste, others warn that drastic reductions could harm millions of Americans who rely on the program. With a razor-thin majority, GOP leaders must navigate these concerns carefully to advance their budget goals.
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Proposed Cuts and GOP Leadership's Stance
The House GOP's budget resolution, which passed in a close 217-215 vote, includes a directive for congressional committees to find at least $2 trillion in spending cuts over the next decade. The Energy and Commerce Committee, which oversees Medicaid, is tasked with cutting $880 billion—a reduction that is widely expected to impact Medicaid beneficiaries.
House Speaker Mike Johnson (R-LA) has emphasized that cuts will focus on eliminating “fraud, waste, and abuse” rather than reducing benefits. However, the resolution does not explicitly protect Medicaid from reductions. Some conservative lawmakers, including House Freedom Caucus Chair Andy Harris (R-MD), advocate for implementing work requirements for certain Medicaid recipients.
"I think the American people do believe that able-bodied people who get welfare benefits in this country actually should be asked to work, train for work, go to school," Harris said.
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Opposition from Within the GOP
Not all House Republicans are on board with the proposed Medicaid changes. Freshman Rep. Rob Bresnahan of Pennsylvania voiced his opposition in a statement: “If a bill is put in front of me that guts the benefits my neighbors rely on, I will not vote for it.” He emphasized that Medicaid benefits are promises made to constituents, particularly low-income seniors and individuals with disabilities.
Other GOP lawmakers representing swing districts have also expressed concerns about the potential political consequences of Medicaid cuts. A group of Republican lawmakers representing large Hispanic populations, as well as representatives from districts with significant low-income populations, recently sent a letter to Johnson urging caution in altering the program. Their argument aligns with Trump's previous statements in which he pledged to protect Medicaid, though he later endorsed the House budget resolution that includes proposed reductions.
Public Response and Political Implications
The proposed Medicaid cuts have drawn criticism from advocacy groups and Democratic lawmakers. Protect Our Care, a left-leaning nonprofit, has launched an ad campaign targeting vulnerable House Republicans, warning that the cuts could strip healthcare coverage from hundreds of thousands of people in key districts.
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Meanwhile, KFF polling suggests that Americans across all parties hold favorable views of Medicaid and believe that it's a helpful resource for lower-income Americans.
What Comes Next?
The House resolution now moves to the Senate, where lawmakers must reconcile differences with a separate budget proposal. The reconciliation process will determine the final scope of spending cuts and tax policies. With such a slim majority in the House, Johnson can afford to lose only a handful of Republican votes—meaning the party's internal divide over Medicaid could ultimately shape the outcome of the budget debate.
As the debate continues, lawmakers must balance fiscal responsibility with the needs of their constituents, knowing that their decisions will likely have lasting political and economic consequences.
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