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TRUMP SENDS CONFLICTING MEDICAID CUT MESSAGES  
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Ben Leonard, Adam Cancryn and Robert King
February 19, 2025
Politico
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_ Republicans are getting worried about how much they’ll have to
cut from the popular health safety-net program, and whether the
president will protect them from political blowback. _

President Donald Trump speaks with reporters as he signs executive
orders in the Oval Office at the White House, Feb. 13, 2025., Francis
Chung/POLITICO

 

President Donald Trump surprised some of his own staff Wednesday when
he endorsed a House budget that would gut Medicaid, hours after
pledging that the safety net program “isn’t going to be
touched.”

The comments sent aides scrambling to figure out what Trump meant and
which Medicaid cuts he would be willing to accept, according to three
people granted anonymity to discuss the action happening behind closed
doors. The potential Medicaid reductions — an option to help pay for
Trump’s wide-ranging tax, energy and border agenda — are
triggering a backlash from Republican lawmakers whose constituents
rely on the program.

Trump’s seemingly contradictory comments — shared in a Fox News
interview Tuesday evening and then Truth Social on Wednesday morning
— are also fueling confusion and concern among Republicans on
Capitol Hill, who are looking to him for political cover as they
contemplate a potentially risky vote.

“You’ve got to look at if it is worth the political struggle to do
it,” Republican Sen. Chuck Grassley of Iowa said in an interview.
“Entitlements are difficult to deal with.”

Sen. Josh Hawley, a Missouri Republican, said he has “concerns”
about “the House’s proposal for very deep cuts to Medicaid.”

As Medicaid has expanded in more red states under the Affordable Care
Act and the Republican Party has become more populist, its voter base
is increasingly reliant on the program, which provides health care to
lower-income Americans of all ages.

On Wednesday, the White House appeared to add a new wrinkle by
indicating Trump may also be open to altering elements of Medicare —
the popular health care program for older Americans he’s repeatedly
promised to preserve.

“The Trump administration is committed to protecting Medicare and
Medicaid while slashing the waste, fraud, and abuse within those
programs — reforms that will increase efficiency and improve care
for beneficiaries,” White House spokesperson Kush Desai said in an
initial statement to POLITICO.

But after this article was published, Desai sent an updated statement
that omitted the mention of Medicare, instead saying only that the
administration sought to protect Medicaid “while slashing the waste,
fraud and abuse within the program.”

The flurry of pronouncements threatens to further complicate a major
legislative push meant to serve as the centerpiece of Trump’s agenda
in his first 100 days in office.

The White House has kept in close contact with congressional leaders
constructing their budget resolutions, which will provide the
instructions for where lawmakers should find savings to pay for tax
cuts and other Trump priorities in their budget reconciliation bill.
The Senate is moving forward with its blueprint this week, with the
House on track to advance its proposal the next.

But throughout this process, Trump officials have remained vague on
how exactly Republican lawmakers should use Medicaid to achieve
offsets, wary of getting out ahead of a president closely attuned to
the political peril of touching entitlement programs who has also
shown a willingness to blow up weeks of careful negotiations at a
moment’s notice.

They kept quiet even as the House budget would instruct the House
Energy and Commerce Committee to slash $880 billion from programs
under their purview, with Medicaid making up the lion’s share —
ceding to demands from fiscal hard-liners.

But Trump’s support for the House plan, and lack of clarity about
what he means by it, has effectively left Republicans without guidance
on how far the White House will go in providing political cover for
potential cuts, the three people involved in the discussions conceded.

Sen. John Kennedy (R-La.), in an interview, acknowledged the need for
more guidance from the administration at this juncture: “We’ll sit
down and talk with the president about our specific cuts if we decide
to make them, and we’ll work it out.”

Moderates in both chambers are speaking out against the proposal —
including, on Wednesday evening, eight House Republicans representing
large Hispanic populations in a direct plea to Speaker Mike Johnson.

Still, the reality is sinking in that Republicans aren’t going to be
able to pay for their reconciliation bill at the levels deficit hawks
require without targeting a popular safety net program that insures
nearly 70 million Americans. While Republicans in recent days have
floated cutting spending from elsewhere to find savings under the
Energy and Commerce Committee’s jurisdiction, including energy
programs and telecom policies, most lawmakers agree that won’t be
enough.

Some Republicans are interpreting Trump’s comments as favoring cuts
if they can be sold as making Medicaid more efficient in the long
term, highlighting the president’s insistence on going after alleged
fraud, waste and abuse within the system.

“Most of the proposals for cost savings are making sure the states
pay their fair share of Medicaid,” said GOP Sen. Rand Paul of
Kentucky in an interview.

Sen. Roger Marshall, a Kansas Republican and a physician, asserted
that at least 25 percent of Medicaid spending, or even “closer to 50
percent,” is “fraud, waste and incompetence.”

He continued, in an interview, “Medicaid is probably the most broken
federal government. It’s something I’ve dealt with on a daily
basis as a physician and running a hospital. We can certainly make it
more efficient.”

Marshall and others did not cite evidence to support their high
estimates and most studies have estimated the level of waste, fraud
and abuse in the system at a much smaller level. A White House
official declined to specify any policies that would fit Trump’s
mandate to target waste, fraud or abuse in Medicaid.

It’s not clear, however, whether this message will resonate as
Republicans break the news to voters that they’re slashing access to
a widely used and in many cases life-saving program. And now Trump may
not even be there to back these members up when the political blowback
hits.

Democrats see an opportunity for a political win.

“In 2017, it was very clear that Republicans were doing everything
they could to … essentially eliminate Medicaid across America. In
the same breath, my Republican colleagues would say they were not
eliminating Medicaid,” said Sen. Ben Ray Luján, a New Mexico
Democrat who was a member of the House during the GOP’s Obamacare
repeal bid, which would have reversed an expansion of the program in
many states.

“This is the playbook,” said Luján. “It’s coming.”

_Connor O’Brien contributed to this report._

 

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