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GOP leaders snubbed the hard right on Medicaid. They’re vowing to fight back.

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House Republican leaders appear to have won support from key moderates by backing off the most controversial proposals to overhaul Medicaid — but it has created new risks for the GOP’s domestic policy megabill.

Fierce pressure is now building from hospitals and clinics to the Medicaid cuts that have survived while conservative hard-liners are threatening to withhold their votes if they don’t get deeper trims to the safety-net program.

It adds up to a bumpy road ahead for the House Energy and Commerce Committee as it prepares for a marathon meeting to advance the legislation Tuesday afternoon.

The proposal unveiled by Chair Brett Guthrie (R-Ky.) would not slash federal reimbursement rates in most cases or impose per-capita caps on payments to states, but it would likely force states to revamp how they finance their programs or cut benefits. A preliminary Congressional Budget Office estimate requested by Democrats found that more than 8.6 million people would go uninsured if the health portions of the GOP’s party-line package become law.

While such significant changes to Medicaid could face significant resistance in the Senate — Sen. Josh Hawley (R-Mo.), for example, wrote in a New York Times op-ed Monday that big Medicaid cuts are “morally wrong and politically suicidal” — Guthrie appears to have the votes he needs to make progress this week.

Rep. Nick Langworthy (R-N.Y.), an Energy and Commerce member who had been wary of deep cuts to Medicaid, praised the “bold” proposal in a social media post Monday, saying it “achieves our top priorities: protecting Medicaid for those who genuinely need it.”

So did Rep. Gabe Evans (R-Colo.), another panel member who said the legislation, “follows through on Republicans’ promises to cut waste, fraud, and abuse while protecting coverage for Colorado’s most vulnerable populations.”

“The critics will spread fear about cuts for political purposes, so let me clear: this bill allows Medicaid spending to increase year-over-year for the next ten years,” he added.

Once past the committee, however, the legislation faces a whirlwind of threats on the House floor, where opposition from any three Republican members could sink the entire sweeping package of tax cuts, border security enhancements, defense plus-ups and more.

A key leader of the hard-right bloc, Rep. Chip Roy (R-Texas), said in social media posts Monday that Guthrie’s proposal doesn’t offer “ANY transformative changes” to Medicaid, “among MANY [other] problems.“

“We will need SIGNIFICANT additional changes to garner my support,” Roy added.

And it remains to be seen if a broader group of swing-district Republicans would be swayed by the proposal. Guthrie has made the case that the legislation would preserve Medicaid for the most vulnerable instead of “capable adults who choose not to work,” but Democrats are prepared to weaponize coverage-loss predictions and potentially major impacts on state budgets to pressure potential GOP holdouts.

“The Republicans are trying to say this is a moderate bill,” ranking member Frank Pallone (D-N.J.) told reporters Monday, referring to the proposals GOP leaders opted not to include. “Nothing could be further from the truth.”

A mounting pressure campaign from health care facilities could be especially influential; many Republicans have cited the potential for hospital and clinic closures in expressing wariness about deeper cuts. While worst-case scenarios did not come to fruition, providers are arguing the proposed policies would still have devastating impacts.

The National Association of Community Health Centers is blanketing Capitol Hill for a fly-in Tuesday, and hospital groups are issuing blistering statements. Hospitals are major employers in many members’ districts and can have significant sway over members’ votes.

“Congressional Republicans and President Trump rightly pledged to protect Medicaid benefits and coverage — this bill fails that test,” said Chip Kahn, president of the Federation for American Hospitals, in a statement. “It is imperative Republicans go back to the drawing board; too many lives depend on it.”

“Congress has a moral obligation to consider the harm that such disastrous cuts would have on America’s health safety net,” added Sister Mary Haddad, the Catholic Health Association CEO.

Some blue state governments also warned about coverage losses and crushing fiscal impacts. Sarah Adelman, commissioner of New Jersey’s Medicaid agency, said the proposal “would cut people off from coverage and take vital funding away from New Jersey” by curtailing provider taxes, a common practice states use to finance their Medicaid programs.

She also said that punishing states for using their own funding to offer coverage regardless of immigration status is “cruel and short-sighted.”

The Greater New York Hospital Association also slammed the bill, arguing in a statement that work requirements could lead to 1.6 million people to lose coverage in the state. The group also projected New York would lose $1.6 billion in federal funds from the cut to expansion funding for coverage of undocumented immigrants. New York is one of 14 states that use state funds to cover undocumented children.

Republicans, meanwhile, are accusing Democrats and their allies of fear-mongering about the impacts. They are feuding, for instance, over one CBO estimate Democrats used to claim the legislation would lead to 13.7 million more people going uninsured — an estimate that included coverage losses attributable to the potential expiration of enhanced subsidies for Affordable Care Act, something Republicans never meant to address in the party-line megabill, even if they are skeptical about extending them.

“Democrats are pedaling incorrect reports that include policies that aren’t even in the bill,” Guthrie said in a statement. “It is reckless that my colleagues on the other side of the aisle claimed an artificially high number in alleged coverage loss just so they can fear monger and score political points.”

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GOP hard-liners threaten to tank FISA vote

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House GOP hardliners are threatening to tank the FISA rule shortly on the House floor as Speaker Mike Johnson tries to force through a five year extension, according to four people granted anonymity to speak about plans not yet public.

They’re livid over the “inexplicable 5 year extension, the fake warrant requirement, and the walk back of the promise from this afternoon to include CBDC,” according to one of the people, referring negotiations to prohibit a central bank digital currency.

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‘The original sin:’ Hill Republicans blame White House for slow-walking FISA sales pitch

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A messy GOP battle over a key government spy authority boiled over in the House this week — but the crisis was months in the making.

White House officials and Republican Hill leaders have tried to pressure GOP hard-liners into approving a clean, 18-month extension of Section 702 of the Foreign Intelligence Surveillance Act that President Donald Trump demanded. But amid a GOP rebellion on Capitol Hill, Speaker Mike Johnson Thursday afternoon punted a vote on the measure for the second day in a row.

The program expires Monday night. Senators went home for the weekend as Johnson continued to pursue a compromise with the holdouts for an extension as long as three years with reforms, and raced to hold a vote.

Now, the finger-pointing among Republicans is rampant and temperatures are running high.

A band of House ultraconservatives — who have long been concerned that warrantless government surveillance of foreign individuals could sweep up data on Americans — shot down Trump and GOP leaders’ long-held plans for the 18-month extension with no reforms earlier this week.

“A clean extension ain’t going to move on the floor,” Rep. Chip Roy of Texas, one of the head House GOP holdouts, warned earlier this week.

In interviews with more than two dozen Republican lawmakers and aides on Capitol Hill involved in the talks, many of whom were granted anonymity to speak freely about the contentious policy debate, the consensus is that the White House is largely responsible for the current breakdown as GOP factions snipe and assign blame.

“This is why we shouldn’t wait until the last minute on these things,” one House Republican fumed Thursday. A congressional GOP aide added, “The White House was too late to come to a decision. That was the original sin.”

A senior White House official disputed the characterization from some Hill Republicans that the administration had taken too long to plead their case. They pointed to a briefing in the Situation Room months ago with Republican lawmakers, during which “the president heard arguments on both sides of the issue.”

The official added, “We’ve had multiple briefings from senior officials, both on the House and Senate side, about the desirability of this program. Again, going back months ago.”

Trump told House Intelligence Chair Rick Crawford (R-Ark.) and House Judiciary Chair Jim Jordan (R-Ohio) that he wanted a clean extension, without reforms, in February. The president arrived at this position, a second White House official said, after “the administration completed a policy process through the interagency and advised POTUS that a clean extension was the best course and solicited views on length from Blue Light News.”

There was also coordination between the White House and Capitol Hill, according to three people familiar and the senior White House official: Johnson requested the reauthorization run for 18 months, and Trump agreed.

The administration succeeded in convincing Jordan, who had previously pushed for changes to Section 702, to publicly support a clean extension following a White House meeting on the subject.

But ultraconservatives on Capitol Hill were harder to convince, with some House Republicans correctly predicting two months ago they were going to have issues as the vote drew nearer. Trump has forced those hard-liners to cave in recent months on other fights, but the spy powers legislation was one area where members have not been as willing to relent.

While Trump officials made outreach to members at least two months ago, Hill engagement ramped up in the days leading up to the scheduled vote. That has included appeals to lawmakers from CIA Director John Ratcliffe, Deputy CIA Director Michael Ellis and Joint Chiefs Chair Gen. Dan Caine, according to five people. Ellis has made personal phone calls to members, according to two people familiar with the pressure campaign.

White House deputy chief of staff James Blair, White House Legislative Affairs chief James Braid and other legislative affairs officials have also been calling individual House Republicans and working through negotiation details, according to six other people with direct knowledge of the conversations.

Noticeably absent from this outreach is Director of National Intelligence Tulsi Gabbard. Her office plays a statutory role in overseeing Section 702 and has historically been a key proponent of the powerful spy powers.

Gabbard in early February expressed concerns to Trump about reauthorizing the statute without additional privacy guardrails, as Blue Light News reported earlier Thursday, though her appeal appears to have been unsuccessful.

And while the administration’s position on Section 702 came into focus in February, there were signs earlier in the month that its position had not fully crystallized. Officials meeting with the Senate Intelligence Committee at that time refused to divulge the White House’s stance on extending the surveillance power and adding reforms, according to five people with knowledge of the meeting. The exchange frustrated Republicans and Democrats on the panel, who are generally supportive of the surveillance program.

Due to a quirk in the law, the administration will still be able to operate the program for nearly a year even if it is not renewed, and privacy advocates have argued that Monday is a false deadline. But without the law on the books, communications providers like Google and AT&T, which the government tasks to surveil foreign messages, could stop complying with those orders.

But White House officials want an extension codified now, all the same. They have been arguing in conversations with lawmakers that the country is at war and national security is paramount amid threats from Iran. Therefore, they say, hardliners should fall in line to back the clean extension without delay, according to five people involved in the conversations.

“The program is critical for the United States military to listen to the conversations of foreign terrorists abroad while we are engaged in a military operation in Iran. That’s what we’ve been telling individuals, as well as the elevated threat levels around the world, as well as the threat from Mexican drug cartels,” the senior White House official said.

Two groups of House GOP hard-liners, after being summoned by Trump Tuesday night, met with officials at the White House. But some of the Republicans declined the invitation.“I’ve heard everything that the executive has to say on FISA,” Freedom Caucus Chair Andy Harris (R-Md.) said in an interview that evening. That meeting, however, marked a shift: Those House Republicans who went to the White House alongside GOP leaders — among them Roy and Reps. Keith Self of Texas, Byron Donalds of Florida, Clay Higgins of Louisiana, Morgan Griffith of Virginia and Warren Davidson of Ohio — took the opportunity to begin negotiations about a framework for a possible agreement around the use of warrants to access certain information.

The discussions included how the White House and GOP leadership needed to make good on a months-old promise to advance legislation that would ban a central bank digital currency. Enough House GOP holdouts late Thursday evening were threatening to still tank the procedural vote to advance the extension if the White House didn’t address the digital currency matter, according to four people with direct knowledge of the matter. “Unless it’s included, there’s enough votes to kill the rule,” Rep. Ralph Norman (R-S.C.) said in an interview Thursday afternoon. But other Republicans, White House officials and Senate GOP leadership are warning that attaching the measure directly would tank the FISA bill.

In exchange for making these concessions, GOP leaders and the White House have been pushing for a Section 702 extension that’s longer than 18 months and closer to three years.

The senior White House official also said Thursday the administration has “focused in on potentially having conversations about reforms to the program that we think would strengthen protections for American civil liberties … those conversations are ongoing.”

Jordan, meanwhile, has been helping build support for a clean extension by privately telling some Republicans that, if they can pass this 18-month clean extension now, they could potentially work on warrant reforms later, according to three people with direct knowledge of the discussions. That’s raised some eyebrows internally among House Republicans.

The House delays are leaving barely any time for the Senate to act. Majority Leader John Thune said in an interview Thursday that he’s already started having conversations with his own members about what they would need to clear a FISA extension Monday.

Ultimately, even if GOP leaders strike a deal on changes to the current proposed extension, it could risk support for reauthorization among key Democrats, who Republicans will need to pass the final legislation in a narrowly-divided House. While some House Democrats are expected to help Republicans get the final bill across the finish line — including top Democrat on the House Intelligence Committee, Rep. Jim Himes of Connecticut — Democratic leaders have so far declined to shore up the votes for any fast-tracked process.

“I am deeply skeptical of a straightforward extension,” House Minority Leader Hakeem Jeffries said Thursday, adding he told Johnson a few days ago there was “great Democratic skepticism” on a clean extension.

One Democratic Hill aide said Johnson and Trump did far too little to coordinate their pitch with Democrats, who carried a razor-thin vote to re-up the law in 2024.

“They never came to us,” the aide said.

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GOP, Democrats blast Vought for holding back cash: ‘You don’t have the authority to impound’

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Senators from both parties chided the Trump administration Thursday for continuing to withhold funding Congress has approved, more than a year after the White House first froze billions of dollars for temporary “review.”

During White House budget director Russ Vought’s testimony before the Senate Budget Committee, Sen. Chuck Grassley (R-Iowa) scolded the OMB chief for not sending hundreds of millions of dollars the Trump administration is supposed to give states throughout the year to support community services aimed at reducing poverty.

“Congress has appropriated money, and you don’t have the authority to impound it,” Grassley said about the more than $810 million Congress appropriated this year for the Community Services Block Grant program.

That program helps states fund anti-poverty services such as transportation, education and nutrition assistance that serve more than 9 million people each year.

Grassley told Vought that lawmakers “are not getting any answers” as to why the Trump administration hasn’t sent states their quarterly funding from the program. “I want those quarterly allotments released,” Grassley said.

While Vought did not directly address Grassley’s comments, he said at a different point during the hearing that “we have not impounded a single thing.”

Other senators, including Sen. Mark Warner (D-Va.), lamented federal dollars being withheld for the fund that provides capital to small banks and credit unions in underserved areas. For months lawmakers from both parties have pushed back against Trump’s plans to eliminate that program, the Treasury Department’s Community Development Financial Institutions Fund.

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