A dozen House Republicans sent a letter to Speaker Mike Johnson as other top GOP leaders outwardly stated they “cannot and will not support” a final reconciliation bill that includes Medicaid cuts.
Newsweek has reached out to Speaker Johnson’s press team for comment via email on Wednesday.
Why It Matters
The GOP holds a narrow 220-213 majority in the House, meaning Johnson, a Louisiana Republican, has little wiggle room to lose members on party line votes. Earlier in April, the House narrowly approved a budget framework that critics say could lead to significant cuts to Medicaid, though GOP leaders have said the program would face reforms, not cuts.
Johnson has repeatedly advanced legislation that supports President Donald Trump’s economic agenda despite narrow margins, including a budget plan committing to $1.5 trillion in cuts to federal programs and services, which narrowly passed 216-214 last week.
Nearly 80 million people rely on Medicaid for health insurance, according to Medicaid data from October 2024. Approximately 72 million are enrolled in Medicaid, while 7.2 million are covered through the Children’s Health Insurance Program (CHIP). Democrats have consistently raised concerns about potential cuts to the federal health program under the Trump administration.
What To Know
On Monday, a dozen House Republicans authored a letter to GOP leaders Johnson, Majority Leader Representative Steve Scalise of Louisiana, Majority Whip Representative Tom Emmer of Minnesota, and House Energy and Commerce Chair Representative Brett Guthrie of Kentucky, which was first obtained by Punchbowl News.
The letter—signed by GOP Representatives David Valadao of California, Don Bacon of Nebraska, Jefferson Van Drew of New Jersey, Rob Bresnahan Jr. of Pennsylvania, Juan Ciscomani of Arizona, Jen Kiggans of Virginia, Young Kim of California, Robert Wittman of Virginia, Nicole Malliotakis of New York, Nick LaLota of New York, Andrew Garbarino of New York and Jeff Hurd of Colorado—said the respective House members represent districts with “high rates of constituents who depend on Medicaid,” expressing their “strong support” for the program.
“Balancing the federal budget must not come at the expense of those who depend on these benefits for their health and economic security,” the twelve GOP representatives wrote.
The House Republicans noted that they are in support of “targeted reforms” of Medicaid including improving “program integrity, reduc[ing] improper payments, and moderniz[ing] delivery systems to fix flaws in the program that divert resources away” from the intended recipients.
AP Photo/J. Scott Applewhite
The Trump administration has repeatedly emphasized its goal of “stopping waste, fraud and abuse,” a message tied to its broader push to shrink the federal government and reduce spending. Much of that effort has been guided by recommendations from the Department of Government Efficiency (DOGE), a task force led by billionaire Elon Musk, the world’s wealthiest man.
“However, we cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations,” the Republicans said in their letter.
Medicaid gives health coverage to many individuals and families, including children, parents, people who are pregnant, elderly people with certain incomes, and people with disabilities. Many of the lawmakers who signed the letter represent swing districts or rural areas.
The members of Congress wrote: “Many hospitals—particularly in rural and underserved areas—rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone. Providers in these areas are especially at risk of closure, with many unable to recover. When hospitals close, it affects all constituents, regardless of healthcare coverage.”
They concluded the letter emphasizing their commitment to preserving Medicaid and identifying “responsible savings through deregulation, streamlining federal programs, and cutting administrative red tape,” rather than through program cuts.
What Does the Budget Reconciliation Framework Say About Medicaid Cuts?
The budget reconciliation framework itself does not directly mention any cuts to Medicaid and Medicare, but it does instruct the House Energy and Commerce Committee to slash the Department of Health and Human Services budget by $880 billion over 10 years, something that analysts say cannot be done without cuts to Medicaid. Medicaid is jointly financed by states and the federal government but administered by states within federal rules.
Democrats have repeatedly warned against Republican budget proposals encroaching on Medicaid. In March, during Trump’s joint congressional address, several Democrats held “Save Medicaid” signs and Al Green was removed from the chamber after shouting and disturbing the speech, saying that Trump has “no mandate” to cut Medicaid. The president did not mention Medicaid during his lengthy address.
What People Are Saying
House Speaker Mike Johnson, a Louisiana Republican, told Newsweek in an email on Wednesday: “Through budget reconciliation, House Republicans will strengthen, sustain, and secure Medicaid so we can preserve it for the vulnerable American populations it was designed to serve. Unlike our Democrat colleagues, we are committed to making commonsense reforms and rooting out waste, fraud, and abuse to make Medicaid work more efficiently and effectively.”
Representative Don Bacon, a Nebraska Republican, told Punchbowl News: “There’s reasonable actions we can support like work requirements for able bodied adults without children and auditing the Medicaid list. But there will not be the votes to cut Medicaid for those who need it or to the hospitals that we need to preserve.”
President Trump posted to Truth Social following the House vote passing the budget plan: “Congratulations to the House on the passage of a Bill that sets the stage for one of the Greatest and Most Important Signings in the History of our Country. Among many other things, it will be the Largest Tax and Regulation Cuts ever even contemplated. MAKE AMERICA GREAT AGAIN!”
Democratic House Leader Hakeem Jeffries said in an April 10 statement: “The budget resolution that passed the House today will set in motion some of the most extreme cuts to healthcare, nutritional assistance and the things that matter to everyday Americans in our nation’s nearly 250-year history. It’s a disgrace.”
Representative Alexandria Ocasio-Cortez, a New York Democrat, in a statement: “This is heist on Medicaid, a heist on Medicare recipients, a heist on public health care in order to continue to finance Elon Musk’s defense contracts.”
Representative Steve Scalise, a Louisiana Republican, said on a Tuesday appearance on Fox Business’ Mornings with Maria: “This whole reconciliation process is a two-step process. You first have to pass the budget. We’ve now done that. The House and Senate had some minor differences. We got an agreement on those two and some really important commitments from the Senate so that now we’re both talking the same language, in essence, when we start the reconciliation process when we return from Easter. So we have a very aggressive time frame.”
What Happens Next
The budget resolution’s passage set the stage for a reconciliation process, which is not subject to a filibuster and allows legislation to pass with a simple majority giving Republicans a key procedural advantage in advancing their economic agenda. The process continues to move forward, but lawmakers will continue debate specific spending cuts and measures to be included.
Update 4/16/25, 4:05 p.m. ET: This article has been updated to include Speaker Johnson’s comment.
