Republicans on the House Energy and Commerce Committee set out to find at least $880 billion in spending cuts for their reconciliation bill. According to the panel’s chair, Rep. Brett Guthrie, his committee found even more, while somehow not making the most politically sensitive cuts to Medicaid that conservatives have called for.
Even so, there are plenty of Medicaid reductions.
In early bill text that was released Sunday night, Republicans lay out provisions that would impose work requirements on able-bodied Medicaid recipients, establish eligibility checks every six months, ban Medicaid funds from going to gender-affirming care for trans minors and block some federal funds from going to states that “provide health care coverage for illegal immigrants under Medicaid.”
The bill also would sunset an additional 5% of funding in the Federal Medical Assistance Percentage that goes to states which newly choose to expand Medicaid. “This provision would apply prospectively, not affecting states currently receiving an enhanced federal match under this authority,” a section-by-section summary of the text says.
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But notably, the committee did not lower the percentage the federal government pays to state Medicaid programs — a hard no for most Republican moderates.
Conservatives have aggressively pushed for deeper cuts to FMAP, though Speaker Mike Johnson said last week that Republicans wouldn’t touch the FMAP breakdown. (Republicans can only lose a handful of members if the bill is going to pass the House.)
Whether the proposed cuts do enough for conservatives remains to be seen. But in a call with House Republicans breaking down the text on Sunday night, Guthrie told the conference that the committee found “north of $900 billion” in cuts, per a source on the call.
When asked if he’d support a bill that doesn’t completely reform Medicaid, one of the staunchest fiscal hawks in the House, Rep. Chip Roy, said it was too soon to say.
“There are a lot of things that I want, and you can’t get everything you want,” he said Thursday.
Again, conservatives will find plenty to like in the proposed legislation. The bill includes language that would ban health providers who offer abortion, which legally cannot be paid for with government money, from receiving Medicaid funds — setting the stage for a new political battle between conservatives and GOP moderates who oppose “defunding” providers like Planned Parenthood.
“I think it was made clear where a number of members stand on this issue,” one House Republican told NOTUS last week, referring to a private meeting in which multiple moderates told Johnson they oppose defunding Planned Parenthood. “At the end of the day, to me, you already have the Hyde amendment in place. To go beyond that is not something that I support.”
“The fact is that numerous organizations provide critical health care services for women outside of the issue of abortion, and to cut off funding for those services in any way creates a challenge,” the member continued.
Planned Parenthood’s president and CEO Alexis McGill Johnson said that cutting Medicaid funding for the organization would lead to health centers across the country being forced to close.
The bill also would make steep cuts to energy programs in the Inflation Reduction Act.
The Energy and Commerce Committee plans to meet Tuesday to mark up its portion of the reconciliation bill. Johnson has pushed key committee chairs to finish parts of the text this week in an effort to pass the legislation by Memorial Day in the House.
The House Ways and Means Committee and the House Agriculture Committee will also mark up its portions of the massive bill on Tuesday, though legislative text for their portions hasn’t been released.
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Oriana González, Daniella Diaz, and Reese Gorman are reporters at NOTUS.
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