Congress
Energy and Commerce Committee’s Medicaid problem just got tougher
It was always going to be tough for House Energy and Commerce Chair Brett Guthrie to rally his members around cuts to Medicaid; his job could soon get even harder.
The House GOP budget blueprint unveiled Wednesday would direct several congressional committees to achieve at least $1.5 trillion in spending cuts across programs under their panels’ purviews — necessary to offset a party-line, budget reconciliation bill to enact President Donald Trump’s domestic agenda.
The Energy and Commerce Committee has been told to find at least $880 billion in savings, or more than half of that total amount, to pay for a massive package that would extend expiring tax cuts, beef up border security and expand American energy production. It’s a far larger number than many House Republicans had originally anticipated.
The bulk of those savings will have to come from making changes to Medicaid, which currently insures more than 70 million Americans. And, in an interview Wednesday, Guthrie acknowledged that one major savings option probably won’t have the support to pass the House.
That’s per-capita caps, under which the Medicaid would be paid for based on population instead of being an open-ended entitlement. It could lead to hundreds of billions of dollars in cuts, and has been raised in the past as one of the biggest possible cost-saving measures on the table.
“I’d personally love per-capita allotments for Medicaid,” said Guthrie, a Kentucky Republican. “I’m not sure we’re going to be able to get 218 votes for that.”
The House Budget Committee still needs to mark up, and approve, the budget resolution, which it intends to do on Thursday; then, the full GOP-led House needs to advance it, with just two votes to spare. But assuming all goes as planned, it could present an even steeper challenge for Guthrie, who was already preparing for a struggle to get committee members to make cuts to the popular health safety-net program — even at more modest levels.
The task could also expose moderate Republicans, many of whom have been working behind the scenes to avert significant cuts to Medicaid among other social safety-net programs, to Democratic attacks.
“This is a heartless and cruel proposal that will ruin people’s lives so the rich can get richer,” Energy and Commerce ranking member Frank Pallone (D-N.J.) said in a statement Wednesday. “It’s a Republican Rip-Off and Democrats will do everything we can to defeat it.”
Guthrie said Wednesday his members need more time to discuss specifics of what policies could be targeted to reach the $880 billion savings goal, but suggested that changes to Medicaid could be in store for states that have opted to expand the program — including many GOP-led states.
The Energy and Commerce Committee is also weighing repeals of programs in the Inflation Reduction Act and other Biden administration climate spending, though Medicaid cuts will have to make up the lion’s share of the savings.
Options previously floated have included work requirements in Medicaid, which would be among the most politically feasible choices for Republicans, said Rep. Gary Palmer (R-Ala.), who chairs the Energy and Commerce Committee’s oversight subcommittee, in an interview. The nonpartisan Congressional Budget Office has estimated work requirements could save more than $100 billion over a decade.
Palmer said ending enhanced federal subsidies for Medicaid expansion states would need to occur on a “glide path, not all at one time,” but that it could lead to $500 billion in savings. He added that the overall spending cut floor is attainable if measures to take on Medicaid fraud are enacted.
“I don’t think it’s a big lift at all when you take into account improper payments,” Palmer said of the committee’s work ahead. “Just requiring states to do regular eligibility checks would address some of the improper payment problems.”
Sen. Susan Collins said Tuesday she will vote against Todd Blanche’s confirmation as attorney general.
The Maine Republican, who is facing a difficult race for reelection, said in a statement she would oppose Blanche, citing “several actions that have further eroded the Department’s independence.” She specifically mentioned his role in a controversial IRS settlement with President Donald Trump and over having “promised an anti-abortion organization that he would seek to prohibit the mailing of abortion medication to women nationwide.”
Two other Republicans — Bill Cassidy of Louisiana and Lisa Murkowski of Alaska — are known to still be undecided; Blanche needs one of their votes to secure confirmation.
Rep. Ayanna Pressley (D-Mass.) has once again broken ranks with House Democratic leadership over endorsements, this time to support former Missouri Rep. Cori Bush over incumbent Rep. Wesley Bell.
In a post to social media Tuesday, Pressley called on voters to elect “champions” like Bush, who is in a heated primary rematch Tuesday in a contest that lays bare the party’s divide over Israel.
“Whether in Massachusetts, Michigan or Missouri, we all need politicians who fight for us, not corporations,” Pressley said. Her endorsement comes as voters head to the polls for primaries in both Michigan and Missouri, where progressive challengers are taking on moderate incumbents.
It marks the second time this primary cycle Pressley has endorsed against candidates backed by Minority Leader Hakeem Jeffries (D-N.Y.). Last month, she joined a handful of other Congressional Black Caucus members to support Michigan state Rep. Donavan McKinney in his bid to unseat Democratic Rep. Shri Thanedar.
A spokesperson for Jeffries did not immediately respond to a request for comment.
Pressley’s endorsement also sets her squarely against the establishment wing of the party: both Bush and McKinney have been endorsed by their local Democratic Socialists of America chapters.
But the endorsement is unsurprising: she and Bush served as members of the progressive “Squad” in the last Congress and often worked together on legislation. In a previous interview with POLITICO, Bush said she and Pressley continued to talk regularly, even after Bell unseated her in 2024.
Todd Blanche picked up an important GOP vote Tuesday for his nomination as attorney general — Sen. John Curtis of Utah — likely leaving him just one vote shy of securing confirmation.
Curtis said in a statement he plans to “support” Blanche and was pleased with the nominee’s “receptivity and understanding” of issues raised, including ending the “Anti-Weaponization Fund” created under a May settlement Blanche brokered between the IRS and President Donald Trump.
The announcement came moments after the Senate Judiciary Committee voted on party lines to advance Blanche’s nomination to the full Senate.
Crucial to that vote was Blanche agreeing in writing that the $1.8 billion payout fund was nullified and that another aspect of the settlement — an IRS audit immunity agreement — was scaled back. That gave GOP Sens. John Cornyn of Texas and Thom Tillis of North Carolina enough comfort to vote for Blanche.
The remaining undecided Republican senators are Sen. Bill Cassidy of Louisiana, Sen. Susan Collins of Maine and Sen. Lisa Murkowski of Alaska. All three said Tuesday they are still grappling with their decisions.
“I’m still considering everything,” Collins said. “I watched part of the markup this morning to hear some of the statements, but I don’t have any decision to share with you right now.”
Murkowski declined to say how she would vote, and Cassidy told reporters that he had “nothing about Todd Blanche” to say.
Cornyn said he has already spoken with Collins and Murkowski and that additional conversations are expected.
“Senator Collins, she’s one of the most diligent individuals I know, certainly here in the United States Senate, and we had a good conversation.” Cornyn said. “She’ll have to speak for herself as to her ultimate conclusion. And I’ve also been exchanging messages with Senator Murkowski, and I know we’ll have further conversations about this.”
Jordain Carney and Calen Razor contributed to this report.
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