Congress
GOP leaders snubbed the hard right on Medicaid. They’re vowing to fight back.
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.”
Congress
Republicans just took ICE spending fights off the table. It won’t end shutdown threats.
Republicans just solved an immediate crisis with a party-line vote to fund immigration enforcement agencies into 2029. But that hardly improves the chances of avoiding a shutdown for the rest of the government.
Lawmakers in both parties say the odds of another federal funding lapse are unimproved, if not heightened, by the GOP’s move to fund President Donald Trump’s immigration and border security efforts for three years through the party-line budget reconciliation process.
The Sept. 30 government shutdown deadline, less than four months away, hits just weeks before the November elections that will determine which party controls the House and Senate next year. This electoral uncertainty was already complicating cross-party negotiations to fund federal agencies.
“It’s not helpful for sure,” Washington Sen. Patty Murray, the Senate’s top Democratic appropriator, told reporters this week of the GOP’s party-line gambit. “It makes it very difficult for us moving forward.”
The Senate’s top appropriators, who are typically chummy, are at loggerheads over totals for the military and nondefense programs — prompting the cancellation this week of committee markups for the second week in a row.
Republicans’ move to stiff-arm Democrats has further soured negotiations to fund the government and raised concerns of more my-way-or-the-highway ultimatums from members on both sides.
“Does it mean that we avoid a shutdown in that area? Takes care of that,” Sen. Lisa Murkowski (R-Alaska), a senior appropriator, said about removing the need to fund Immigration and Customs Enforcement and Border Patrol past the end of President Donald Trump’s term.
“But how many other accounts do we have that we could have another kerfuffle?” she continued. “And all of a sudden we now have leverage, because we tried it once — and we pulled the trigger.”
Murkowski voted against the reconciliation bill last week — the only Senate Republican to do so.
It’s widely accepted on Capitol Hill that Congress will pass a stopgap funding bill to keep cash flowing for federal agencies past the midterms.
Rep. Steve Womack (R-Ark.), who oversees annual transportation and housing spending, predicted this week that Congress will be crafting a funding patch come September. “I just hope we’re not seriously talking about a potential shutdown again,” he added. “We touched that stove once. It was pretty hot.”
Yet some are predicting Senate Minority Leader Chuck Schumer will direct his members to band together to oppose a funding patch, as Democrats did last September in triggering a 43-day government shutdown.
“They do not want appropriation bills. They do want to shut down government,” Sen. John Kennedy (R-La.) told reporters about Democrats. “And they think they’re going to take the House and maybe the Senate and can get a better deal then.”
Senate Appropriations Chair Susan Collins said Democrats “have made clear they are not willing to work with us” to pass government funding bills. But the Maine Republican also said she doesn’t think her party’s move to fund immigration enforcement through reconciliation “has an effect one way or another” on funding the rest of the government beyond September.
Though ICE and Border Patrol are now funded through September 2029, some Democrats say they are planning to use the dozen annual government funding bills as leverage to demand policy changes and funding cuts at those two agencies.
“I can tell you this: We’re going to try every which way to unfund these agencies,” Rep. Lois Frankel (D-Fla.), a member of the Appropriations Committee. “We have 12 bills that we have to pass. We have so many battles — this piece is one of them.”
Democrats had for months been demanding guardrails on Trump’s immigration enforcement activities as a condition of supporting enforcement funding after federal agents shot and killed two U.S. citizens in Minnesota in January. When talks broke down, Republicans made the decision to act alone.
It’s not just ICE and Border Patrol that control immigration enforcement policy, though. Congress still has to fund the broader operations of DHS each year, including the office of Secretary Markwayne Mullin, who recently told lawmakers he couldn’t commit to following court orders.
“You still have to ultimately deal with the Homeland Security bills, and they’ve refused to rein in a lawless ICE operation,” Maryland Sen. Chris Van Hollen, a top Democratic appropriator, said in an interview. “That’s not changed.”
Some appropriators are holding out hope that collegiality on the House and Senate funding panels will ultimately prevail, if for no other reason than the margins of the Republican majorities in both chambers depend on it.
“You don’t have to have a master’s in logic to figure out that, at the end of the process, the bills in today’s Congress are going to have a bipartisan flavor,” Womack said, “because the numbers dictate that anybody that thinks otherwise is just simply not being intellectually honest about the situation that we happen to be in.”
After Rep. Andy Harris (R-Md.) proposed the idea this week of funding other controversial agencies through party-line reconciliation bills, House Appropriations Chair Tom Cole immediately rejected the idea floated by one of his subcommittee chairs.
“We’re not doing that. I will just tell you flat out, that will not happen,” the Oklahoma Republican told reporters.
He also refuted the idea that the $70 billion party-line immigration enforcement package could be attractive for his colleagues to replicate going forward.
“I don’t think it’s a precedent,” Cole said. “But if it became a regular practice, I certainly wouldn’t be supporting it.”
Congress
Trump-backed Marty O’Donnell wins primary for battleground Nevada House seat
Trump-endorsed Marty O’Donnell won the GOP primary Tuesday to take on Democratic Rep. Susie Lee in Nevada’s battleground 3rd District.
The seat, which touches parts of Las Vegas, is one of Republicans’ targeted pickups this November since President Donald Trump carried it by less than 1 percentage point in 2024 after losing it by nearly seven points in 2020.
But O’Donnell — who also has the backing of the National Republican Congressional Committee — will face an uphill battle. He recently came under fire for hosting a neo-Nazi influencer on his podcast. Trump’s tariffs have hit the district hard, with Canadian tourism to Sin City down by 17 percent, leaving Democrats confident they can hold the seat.
O’Donnell is best known for his role as the audio composer for the “Halo” video game series. It’s his second run in the district after placing fourth in the 2024 Republican primary.
O’Donnell bested several candidates Tuesday, with businessperson Tera Anderson and former Ambassador to Iceland Jeff Gunter — who ran for Senate in 2024 — putting up the most significant challenges.
Congress
Sen. Lindsey Graham wins primary over ‘America First’ challenger
South Carolina Sen. Lindsey Graham is on his way to clinching his fifth term in the Senate.
Graham won the Republican primary for Senate on Tuesday, vanquishing five opponents that included businessperson Mark Lynch — who challenged the senator over his staunch support for the war in Iran and long history in Washington. Lynch also drew support from some of the president’s most prominent MAGA Republican critics.
But Graham won more than half the primary vote, allowing him to avoid an embarrassing two-week runoff sprint. He is expected to cruise to victory in November; a Democrat has not represented the state in the Senate since 2005, when longtime Sen. Fritz Hollings chose not to seek reelection.
The four-term senator spent big in the final weeks of the campaign to make sure he won, combining with his allies to spend over $18 million in television and digital ads touting his record and endorsement from President Donald Trump. That spending proved to be decisive in staving off Lynch’s challenge from the right.
He even called in the big guns for a last minute bump, bringing in Trump, who reaffirmed his support for his occasional frenemy in a telerally on the eve of the primary election.
Graham’s success is a loss for the strict “America First” wing of the GOP that has criticized the president’s new interventionist foreign policy streak, including former Rep. Marjorie Taylor Greene, former Trump White House chief strategist Steve Bannon and former counterterrorism official Joe Kent. They came out in support of Lynch during the final stretch of the campaign, though that was not enough to upset Graham, a fixture of Columbia and Washington politics.
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