President Donald Trump reportedly told House Republicans not to “f—k around” with Medicaid in a negotiating session late Tuesday night, reflecting the danger of cutting a public-health program that covers one in four Americans. Planned changes to the program in the GOP’s “big beautiful bill” are estimated to throw over 7 million people off the Medicaid rolls.
As House Republicans negotiate how much to cut Medicaid in order to expand tax cuts for wealthy Americans, President Donald Trump had a warning for them.
“Don’t f—k around with Medicaid,” Trump told Republicans late last night, according to unnamed sources quoted in Politico, Axios and other outlets.
“We want to strengthen Medicaid, strengthen Medicare,” Trump later told reporters. Asked directly about working-class voters who supported him, the president said, “They won’t lose insurance,” and added that he would cut drug prices.
Trump’s latest statements sides with the MAGA wing of the party, exemplified by former advisor and podcaster Steve Bannon’s exhortation against taking a “meat axe” to the program.
“A lot of MAGAs on Medicaid,” Bannon said in February. “If you don’t think so, you are dead wrong.” Dozens of Republicans agree with him, having expressed concern to House and Senate leadership.
The statements are an admission of just how politically risky it has become to cut the largest health-insurance program in America as Republicans juggle a wish list of high-cost items in the bill, including making the 2017 tax cuts permanent, boosting defense spending even further, and cutting taxes for Social Security income, multi-millionaire inheritances, and high-income blue-state residents.
“President Trump and Republicans are working to protect and preserve Medicaid for the Americans who need it most: low-income families, pregnant women, disabled individuals, and seniors,” White House spokesperson Kush Desai said in an email to Fortune. “Medicaid should not and cannot be a welfare program for illegal immigrants, fraudsters, and able-bodied adults who can work but choose not to.”
However, given the math of finding $880 billion in spending cuts, Democrats and policy advocates say there’s no way to avoid cutting Medicaid coverage.
The program covers 72 million people, or one in four Americans, and half of all children in the U.S. (It’s also one of the more cost-effective insurance programs; by comparison, Medicare covers about 4 million fewer people at an additional cost of $300 billion.)
Roughly 20 million Medicaid patients identify as Republican, according to health-policy research outfit KFF, including many rural and poor residents in deep-red states such as Arkansas, Kentucky, and Louisiana.
In its current shape, the GOP bill would throw 7.6 million people off Medicaid, according to the Congressional Budget Office (CBO). It would primarily accomplish this by expanding paperwork requirements, including putting in more frequent eligibility checks and asking adults without children to prove they are working. Another 2.2 million with private health insurance through Affordable Care Act marketplaces would lose that coverage due to changes in the bill, the CBO said.
This story was originally featured on Fortune.com
