Speaker Mike Johnson (R-La.) on Tuesday said one controversial proposal to cut federal Medicaid funding was off the table and another would likely be excluded from the bill containing President Trump’s domestic policy priorities.
Both had been red lines for a number of moderate and vulnerable Republicans, leaving the GOP closer to an agreement on which Medicaid cuts will be included in the final product. Still, lawmakers said Tuesday no final decisions had been made on one of the most hot-button issues facing the far-reaching package.
The forward progress comes after weeks of debate between hard-line conservatives — who want to implement steep cuts to the social safety net program to help reach their spending cut target of at least $1.5 trillion — and moderates, who are wary of making such changes.
Leaving a nearly two-hour meeting with moderates late Tuesday afternoon, Johnson said a controversial plan to directly reduce the enhanced federal match for states that expanded Medicaid, known as the Federal Medical Assistance Percentage (FMAP), was off the table.
Johnson also said the bill would likely exclude “per capita caps,” which would throttle federal funding without technically changing benefits. While some moderates in recent days said they could support the policy, others have pushed back at what would be a massive cost shift to states.
“I think we’re ruling that out as well, but stay tuned,” Johnson told reporters after the meeting.
Beyond the two hot-button ideas, lawmakers said the contours of the plan are beginning to take shape, including eliminating “waste, fraud and abuse”; instituting federal work requirements; excluding noncitizens from eligibility; and letting states make eligibility checks more frequently, likely every six months instead of once a year — a group of relatively noncontroversial policies for Republicans that were largely already agreed upon.
Still, centrists and swing-district Republicans expressed optimism about the path ahead — even as they acknowledged the thorniest issues have yet to be resolved.
“I think we’re going on a good pathway to make sure that, again, we don’t cut Medicaid to any eligible individual human being or to any facility,” Rep. Jeff Van Drew (R-N.J.) told reporters.
Rep. Dan Newhouse (R-Wash.) said Johnson has a blueprint “that’s workable,” but he noted that “there’s a few wrinkles that need to be worked out.”
“But I think he’s on a good path,” Newhouse added.
But in a sign of the tenuous negotiations, some hard-line Republicans are already sounding off on the emerging proposal.
Rep. Chip Roy (R-Texas), a member of the conservative House Freedom Caucus, said of the FMAP and per-capita caps news: “Well — I haven’t ruled it out.”
“It’s necessary to stop robbing from the vulnerable to fund the able-bodied,” he added in a post on the social platform X.
The movement on potential Medicaid changes comes as House Republicans are looking to move the bill full of President Trump’s legislative priorities through the chamber by Memorial Day, an ambitious timeline that is on thin ice amid a host of key policy disagreements — including those surrounding Medicaid.
The hang-ups prompted the House Energy and Commerce Committee, which has jurisdiction over Medicaid, to delay its plan to hold a meeting to advance its part of the package this week. The panel is now looking to hold the key vote next week.
The legislation calls for the Energy and Commerce Committee to find $880 billion in savings over a decade, with most of it expected to come from health programs.
While some lawmakers touted progress on Tuesday, others pumped the brakes.
“I think this was a listening session for … different menu items. Again, if they had a actual set of proposals, I think you would see them at this point,” Rep. Ryan Mackenzie (R-Pa.) said.
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