Congress

How 7 states could thwart GOP plans to overhaul Medicaid

Published

1 year ago

February 28, 2025

Republicans are facing a nationwide backlash over the fate of Medicaid — but the potential program cuts are most threatening in seven conservative-leaning states where voters have cast ballots to expand the entitlement in recent years.

It’s a growing problem as Republicans hunt for enough savings to pay for the White House’s proposed tax cuts.

Republican Sen. Mike Rounds of South Dakota, which has enrolled more than 24,000 people in Medicaid since voters expanded the insurance program for low-income people in 2022, told Blue Light News he’s been arguing against some of his own party’s proposals. One would reduce significantly how much funding for the program comes from the federal government.

“That’s not a cost cutting measure — that’s a cost transfer,” he said. “And when you’ve got partnerships with the states, you shouldn’t be doing that without having them involved in the discussion.”

Republicans face similar skepticism across red and purple swaths of the country where voters have used ballot initiatives to expand Medicaid since Congress last targeted the safety net health insurance program in 2017 – not only in South Dakota, but also in Idaho, Nebraska, Maine, Oklahoma, Missouri and Utah. President Donald Trump won all of those states except Maine. And even there, he won an electoral vote by defeating Kamala Harris in the state’s 2nd Congressional District, where nearly a third of people are enrolled in Medicaid.

The president’s conflicting guidance to Congress about whether and how much to cut from the program suggests he is aware of the political peril.

Additional states could expand Medicaid in the coming years, making future rollbacks even more challenging. There’s currently a campaign underway in Florida to put expansion on the ballot in 2026, underscoring the popularity of Medicaid even in the most MAGA-friendly states.

“Cutting Medicaid seems to be popular with some Republican elites and some right wing think tanks that are getting funded by some right wing billionaires, but they’re unquestionably not popular with the Republican voters,” Joan Alker, the executive director of the Center for Children and Families at Georgetown University’s McCourt School of Public Policy, told reporters at a briefing on Medicaid this week. “We’ve seen many polls recently asking voters to rank what they wanted … and cutting Medicaid was literally the last on the list for voters of all stripes.”

Coalitions on the ground in the seven states that passed Medicaid expansion initiatives — made up of powerful hospital associations, grassroots advocacy groups and other strange bedfellows — are now re-mobilizing to defend them. They’re sending people to town halls. They’re publishing op-eds in local newspapers. They’re flooding the phone lines of their members of Congress. And they’re mulling a revival of some of the more aggressive tactics activists used to protest attempts to repeal the Affordable Care Act in 2017.

“We’re going back to the old playbook,” said Matt Slonaker, the executive director of the Utah Health Policy Project who spearheaded the state’s ballot initiative campaign in 2018. “It’s always hard to get folks to act, but they seem to be really, really ready to do this right now.”

With pressure mounting to find hundreds of billions in savings, lawmakers who are usually on board with slashing government spending remain on high alert about the blowback they could face in their states over Medicaid. And as they struggle to keep their members united behind Trump’s budget plan, GOP leadership is taking notice.

House Speaker Mike Johnson on Wednesday night backed away from some of the most sweeping changes the GOP had been debating, including capping the funds states get for each Medicaid enrollee and rolling back federal support for expansion states, even as he dismissed outrage his members have recently faced over threatened cuts at fiery town halls across the country as the work of “paid protesters.”

“All this attention is being paid to Medicaid because that’s the Democrats’ talking point,” Johnson said. “We’re talking about finding efficiencies in every program, but not cutting benefits for people who rightly deserve them.”

Pro-expansion health care groups in these seven red and purple states mounted expensive and time-consuming ballot initiative campaigns to circumvent conservative state legislatures and governors who refused to expand Medicaid, and some of those same state officials are currently working to roll back the expanded coverage their constituents enacted.

That’s left Republicans on Capitol Hill from Medicaid-expansion states as the loudest — and in some cases the only — effective voices of opposition to the proposed cuts now that Democrats are locked out of power. And while some House Republicans who represent red districts are feeling the heat, senators will have to answer to their entire state.

“I don’t quite think Republicans know the backlash they’re in for,” said Brad Woodhouse, a former Democratic National Committee official who now runs the progressive health care advocacy group Protect Our Care. “And it’s going to be a particularly bitter pill in these states that have used ballot initiatives because in those cases, the voters have really spoken about their preference.”

Republican Sens. Josh Hawley of Missouri and Susan Collins of Maine — both of whom hail from states that expanded Medicaid by ballot measure — crossed the aisle earlier this week to support a Democratic amendment to the Senate budget resolution that would have blocked tax cuts for the wealthy if any Medicaid funding is cut.

Hawley, who represents about 326,000 people who became eligible for Medicaid under the state’s 2021 expansion, has said he wouldn’t support “severe” cuts to Medicaid — specifically cuts that would lead to reduced benefits — calling it a “red line” for securing his vote.

The politics are especially tricky for representatives of more rural states where Medicaid has been a lifeline for hospitals struggling to keep the lights on — hospitals that in some instances are among the state’s biggest employers.

In Idaho, for example, voters approved expanding Medicaid in 2018 with 61 percent support, extending coverage to about 90,000 more residents. But if federal funding for Medicaid decreases as a result of the current negotiations in Washington, the state legislature has the power to intervene and potentially repeal the expansion. Idaho House Minority Leader Ilana Rubel, a Democrat, is among those warning that such an outcome would threaten the state’s remaining rural hospitals.

“That’s a disaster, not only for the people on Medicaid, but for the people on private insurance,” Rubel said. “Because when you live in these rural areas, you know you can have the best insurance in the world, but if the hospital in your area has gone out of business and you fall off a ladder or have a heart attack, there will be nobody to help you.”

Yet not every Republican from an expansion state is worried about the sweeping reforms hardliners in their caucus are pushing for.

Sen. James Lankford of Oklahoma, where more than 245,000 people became eligible for coverage after the state voted to expand Medicaid in 2020, echoed Speaker Johnson’s argument that the final budget would not impact individuals’ health care benefits and said he hadn’t heard from concerned citizens about it.

“I have not heard anyone talking about cutting off Medicaid to people,” he said. “It has been dealing with formulas. It’s been dealing with fraud.”

Utah Sen. John Curtis told Blue Light News this week that after discussing the matter with Republican Gov. Spencer Cox, he’s not sweating the political implications.

He said he’s “not near as concerned” about cuts to the safety net program as he is “about the fiscal irresponsibility that we’re facing,” adding that he’s “in total harmony with our state leaders on this.”

Medicaid enrollment in Utah grew nearly 60 percent after a ballot measure expanding the program passed in 2018. But Utah is among the nine states that has a “trigger” law in place to automatically end Medicaid expansion or require major changes to the program if federal funds decline, threatening coverage for millions of people.

For Curtis, that’s a feature rather than a bug.

“Our state is one of more fiscally responsible states, in my opinion, and they saw this coming,” he said.

Congress

Trump escalates his war on Senate Republicans — and senators are striking back

Published

1 hour ago

June 17, 2026

Blue Light Newsroom

President Donald Trump is making life almost impossible for Senate Republicans — and these days fewer of them are willing to just let it slide.

Some lawmakers that were once happy to brush off impulsive and disruptive behavior by saying they hadn’t seen the president’s social media posts or that it was just “Trump being Trump” are increasingly willing to speak out against what they view as bad decisions that undermine their ability to deliver legislative wins as the midterms approach.

The latest irritation was the early-morning Truth Social post Wednesday that upended GOP hopes of quickly confirming a new director of national intelligence and reviving a surveillance bill that Trump already derailed earlier this month.

The chaos that followed Trump’s sudden U-turn on Jay Clayton’s nomination, just hours before a scheduled confirmation hearing, further loosened tongues in the Capitol hallways — even from lawmakers who tend to be reliable allies.

“The president’s timing and communication needs improvement,” Sen. Shelley Moore Capito (R-W.Va.) said. “I think it’s unfortunate. It throws a kicker into the system when we get going and then we have to readjust.”

Asked about frustration within the conference about the recent lack of coordination, Sen. John Kennedy (R-La.) added, “Well, duh.”

Kennedy added, “No, I don’t,” when asked if Trump takes senators into consideration: “He wants what he wants, and until he gets it, he just keeps pushing.”

The public frustrations are bubbling up at a crucial moment for Trump and Republicans more broadly. The president sent his wee-hours missive from France, where he was meeting with global leaders at the annual G7 conference and seeking to sell an Iran peace deal that many in his party despise.

Trump has faced recent pushback on several fronts in the Senate, with Republicans foiling plans to fund part of his White House ballroom project in a recent immigration funding deal and forcing the Justice Department to abandon plans for a $1.8 billion “Anti-Weaponization Fund” that could compensate Trump allies.

The president’s frequent demands that the Senate abandon its longstanding filibuster rule to pass more legislation along party lines, including a controversial elections overhaul, have also gone unheeded — adding to Trump’s obvious frustration.

He has now responded on several occasions by simply infuriating GOP senators who believe they are on the precipice of delivering a legislative win — only for Trump to suddenly pull the rug out from under them.

His announcement of the DOJ payout fund, for instance, delayed and nearly killed a critical immigration funding bill. And his decision to tap Bill Pulte, a close political ally who heads a housing agency, as acting director of national intelligence blew up a brewing three-year deal on reauthorizing a key piece of Foreign Intelligence Surveillance Act.

Sen. Thom Tillis of North Carolina, who announced his retirement last year after breaking with Trump on policy legislation, said the dynamic is “undermining our ability to produce the very results he wants.”

“Look, we are not the manufacturing department of the Article II branch — we are the board of directors for the Article II branch,” he said. “You start treating us like that, coordinating with us like that, we won’t have these embarrassing setbacks.”

Trump’s decision to call off Clayton’s appearance before the Senate Intelligence Committee came as Republicans believed he was on track to be confirmed as soon as Thursday. That, they believed, would allow for an extension of the spy law — something administration officials had previously argued is crucial to protect Americans amid the World Cup and ongoing America 250 celebrations.

Instead, Clayton and the FISA reauthorization have become the latest tension point between Trump and the Senate, with the president again hammering Republicans for not passing the partisan elections bill known as the SAVE America Act, while also needling them about refusing to blow up the filibuster and the internal rules granting home-state senators deference on some presidential nominees.

Senate Majority Leader John Thune has expressed his own frustrations in a more understated way than others in the GOP ranks.

Normally chatty with reporters, Thune was unusually tight-lipped Wednesday, saying that Senate Republicans would have to figure out the path forward on Clayton and the surveillance law “one day at a time” and that his relationship with Trump was “fine” amid the public turmoil.

“The president has his own mind, makes his own decisions, so do we,” Thune said.

He later explained in an interview that the White House and Senate Republicans do a “fair amount of coordination.” “But sometimes you get surprised,” he added. “It’s a business model the White House employs, and we’ve had to figure out how to be adaptable.”

The White House said in a statement that Trump has worked closely with Senate Republicans on the party’s agenda over the past year, including last year’s $4.5 trillion tax cut and the immigration enforcement bill passed earlier this year.

“We look forward to continuing these close relationships and fulfilling President Trump’s priorities that Americans elected him to enact,” Abigail Jackson, a White House spokesperson, said in the statement.

Thune and Trump developed a good working relationship at the outset of the president’s second term, a turnaround from tensions that emerged in the period after Trump’s 2020 election loss that included him calling for a primary challenge to Thune in 2022. Several Senate Republicans praised Thune Wednesday for trying to keep the conference focused and said they didn’t believe Trump’s salvos were personal.

“Hating Thune would be like hating golden retrievers. You can’t dislike Thune. I don’t think the president dislikes him,” Kennedy said, while adding that Trump is fixated on the elections bill: “I just think he wants what he wants, and he continues to push. I just don’t think in this instance he’s likely to get it.”

Several other members identified the SAVE America Act as a persistent friction point despite GOP senators showing over and over again that the bill doesn’t have the votes to pass in the Senate. They are eager for Trump, and some of their own colleagues, to turn their focus from infighting to hammering Democrats heading into November.

Senate Republicans, according to two people granted anonymity to describe a private meeting, directly criticized Sen. Mike Lee (R-Utah) during a closed-door lunch Wednesday over setting unrealistic expectations about passing the bill.

Without naming Lee, Sen. John Cornyn (R-Texas) took a jab afterward at those “making unrealistic promises and then when they’re not obtained, criticizing one another.”

Cornyn, who lost his bid for renomination to a fifth term this month after Trump endorsed his opponent, also acknowledged the president was the source of “some frustration” inside the Senate GOP around “basically being able to function.”

Congress

Pence-backed think tank joins push to keep kids’ safety bills out of AI package

Published

4 hours ago

June 17, 2026

Blue Light Newsroom

More than a dozen groups including former Vice President Mike Pence’s Advancing American Freedom are urging Senate Commerce Committee leaders to reject efforts to attach kids’ online safety measures to a national artificial intelligence framework, according to a letter shared exclusively with Blue Light News.

The groups argue that the proposed measures could undermine users’ free speech rights while creating new risk to privacy and data security. Their push comes as lawmakers weigh broader AI legislation, and follows reports last week that Sen. Marsha Blackburn (R-Tenn.) is working with the White House to shore up support for a kids’ safety package that could ultimately preempt some state laws on AI.

The Blackburn-led measure is expected to include the Senate version of the Kids Online Safety Act, which includes a “duty of care” requiring companies to design their products with an eye toward preventing harm to children, the NO FAKES Act and the App Store Accountability Act. It’s not yet clear how aggressively it would preempt state action on narrow issues such as verifying users’ ages on social media.

Think tanks including the libertarian R Street Institute, the Taxpayers Protection Alliance, and industry group NetChoice, are among the 13 total signatories. They take issue primarily with ASAA, which would require app store platforms such as Google and Apple to verify users’ ages, and KOSA.

The coalition is alarmed by age verification requirements that could require users to submit personal information to digital databases vulnerable to data breaches and hacks. It also takes issue with parental consent provisions, which would “inevitably require even more intrusive data gathering to prove both the identity of the parent and his or her status as the child’s legal guardian,” the letter reads.

KOSA is also problematic, according to the coalition, because of its duty of care provision. It argues this would infringe on users’ First Amendment speech rights by “requiring online platforms to suppress certain kinds of content.”

Meta helped kill KOSA two years ago after raising similar free speech concerns with the bill to Speaker Mike Johnson, though it has since dropped its opposition because Blackburn’s package is expected to include language preempting state AI laws, as POLITICO exclusively reported Tuesday.

Congress

‘Un-American’: Democrats attack Trump’s uneven disaster response

Published

6 hours ago

June 17, 2026

Blue Light Newsroom

Democratic senators Wednesday attacked President Donald Trump’s approach to disseminating disaster aid as “unconscionable,” “shameful” and “un-American.”

At a confirmation hearing for Trump’s nominee to run the Federal Emergency Management Agency, three Democrats cited an article by POLITICO showing that the president had approved 89 percent of disaster requests from Republican-led states compared to 23 percent of requests from states led by Democrats. No president has distributed disaster aid at such uneven levels going back to at least 1981, when Ronald Reagan took office.

“Denying over 75 percent of requests from states that are led by representatives of another party is unconscionable,” said Sen. Gary Peters of Michigan, the top Democrat on the Senate Homeland Security and Governmental Affairs Committee, displaying a large poster of a chart included in the news article.

“Given this stark data, what other conclusions can one draw other than that the president is using federal disaster assistance to punish states that elect Democrats?” Peters asked Cameron Hamilton, who would be the first permanent FEMA administrator in Trump’s current term. The committee did not vote Wednesday on Hamilton’s nomination.

“The idea that Americans who need help in the wake of a tornado or a flood or a hurricane should be treated differently based upon politics is shameful. It is un-American,” Sen. Maggie Hassan (D-N.H.) told Hamilton.

Hamilton avoided answering questions about the discrepancy as he tried to assure senators.

“If confirmed, my focus will be to ensure that FEMA is objective, is fair and reasonable, follows the law, and is consistent in the approach to how we adjudicate claims and requests for disasters,” Hamilton told Peters.

“You still can’t answer questions about what happened while you were there,” Peters shot back, noting that Hamilton was FEMA’s acting administrator for part of 2025. “I don’t trust that that’s what you’re going to do because it didn’t seem like you did it when you were there before.”

The sharp comments came the day after 16 Democratic senators along with Sen. Bernie Sanders (I-Vt.) sent a letter to White House budget director Russ Vought citing the Blue Light News article to ask for details about every disaster request Trump has handled, including internal FEMA documents.

“There is no politicization to the President’s decisions on disaster relief,” White House spokesperson Abigail Jackson said in a statement to Blue Light News’s E&E News.

Hamilton ran FEMA from the start of Trump’s term until he was fired on May 9, 2025, after contradicting the administration by testifying that FEMA provides essential services to the country. Trump and then-Homeland Security Secretary Kristi Noem had said they were considering eliminating the agency.

During Hamilton’s 15 weeks at FEMA last year, Trump denied a disaster request for Washington state that had been submitted by Gov. Jay Inslee (D) in late 2024, shortly before he left office.

FEMA’s own analysis of Inslee’s request found that storms and flooding had caused $34 million in damage, which is more than double the agency’s financial threshold to qualify for disaster aid. Trump and Inslee had harshly criticized each other during Trump’s first term.

Hassan asked Hamilton what he would do if Trump rejected a request for disaster aid to punish Democrats.

“Well, that’s a very odd hypothetical. I don’t believe the president would do that. But I will tell you that my oath of office requires that I follow and obey the law,” Hamilton replied.

“You all are going to have to think about what you will do when he reverses your decision, completely based on politics, which as I said would be immoral and un-American,” Hassan replied.

Federal law gives presidents exclusive authority to approve or deny requests for disaster aid. FEMA recommends whether aid should be approved or denied based on an estimated cost of repairs.

Michigan Sen. Elissa Slotkin (D) recalled what she described as an unusual action by Trump after Gov. Gretchen Whitmer (D) sought disaster aid last year following an ice storm that demolished electricity infrastructure in northern Michigan. Trump approved some disaster aid but denied Whitmer’s request for aid to repair the damaged equipment. Trump eventually reversed his denial and approved the infrastructure aid after heavy lobbying from Michigan officials.

“It’s just hard to rationalize how many disasters have been approved for aid in Republican states versus Democratic states,” Slotkin said. “Republicans would be screaming bloody murder if the stats were reversed.”