House Republicans have decided to eliminate Medicaid reforms and cut $900 billion in spending during an intense multi-day session aimed at advancing President Trump’s significant bill.
The House Energy and Commerce Committee oversaw the passing of 246 amendments after a lengthy 26-hour debate, resulting in a party-line vote of 30-24 to approve these measures.
The package is now moving to the House Budget Committee for a markup scheduled for Friday, which is intended to integrate other elements of Trump’s flagship legislative effort.
This Energy and Commerce proposal mandates monthly work requirements for able-bodied adults aged 19 to 64 under a federal assistance program aimed at the low-income population.
According to the plan, beneficiaries earning above the federal poverty line ($15,650) must pay up to $35 for each health service, and states will prohibit providers from charging more than Medicare rates. This could have implications for rural hospitals.
These dramatic changes to a program that has been in place for 60 years have raised concerns among some Senate Republicans, notably Senator Josh Hawley (R-Mo.).
“This bill will not pass in its current form, particularly since President Trump won’t sign it,” Hawley stated before the committee vote.
Hawley criticized the cuts in Medicaid, calling them a move away from supporting working-class individuals. He voiced a need for the party’s focus to remain on the workforce.
“I’ve spoken with him multiple times, and what we need are tax cuts for our workers, not cuts in Medicaid benefits,” he added.
The large bill aims to be a noteworthy legislative success for Trump this year, proposing extensions to the Tax Cuts and Jobs Act from 2017, eliminating taxes on tips and overtime wages, as well as increasing border security and defense funding.
Though he expressed support for work requirements, Hawley drew a definitive line at the proposed $35 charge, which he sees as problematic.
“I’m concerned about cutting funds for rural hospitals. The House bill might overreach in that area, and I also dislike these hidden charges for the underprivileged,” he argued, indicating that people would face extra co-payments for healthcare access.
“If we want to implement job requirements, I’m on board with that. Many Americans would likely agree, but this bill feels like it’s going too far in the wrong direction,” Hawley stated.
A Republican from Missouri published an op-ed criticizing the Medicaid cuts, calling the proposal “reverse class warfare.”
Medicaid, which combines federal and state funding, received approximately $618 billion from the federal government in 2024.
If the Republican-backed plan is enacted, around 8.6 million Americans might lose their health insurance, and Medicaid could face reductions amounting to $715 billion over the next decade, according to early estimates from the Congressional Budget Office sought by Democrats.
Republicans in the Energy and Commerce Panel aimed to limit deeper cuts than those proposed by some financial hawks in the party.
For instance, Congressman Andy Harris (R-MD.) from the House Freedom Caucus opposed the working requirements that would kick in as early as 2029.
Others in the Senate, like Senators Rand Paul (R-KY.) and Ron Johnson (R-Wis.), have voiced concerns that the grand plan is insufficient to manage the deficit effectively.
“This grand, beautiful bill will likely increase our deficits and debt,” Johnson expressed, questioning whether it would succeed in the Senate given the current discussions.
According to the Tax Commission’s evaluation, taxes proposed in the bill are estimated to amount to $3.7 trillion over the next decade.
Republicans are striving to finalize details of the plan to achieve a minimum of $1.5 trillion in spending cuts within that time frame.
On another front, moderate Republicans from blue states are opposing their leadership regarding the proposed increase of the state and local tax credit (SALT) cap from $10,000 to $30,000 for individual taxable incomes below $400,000.
These moderate GOP members, especially from New York, are pushing for an even higher SALT cap, complicating the tax section of the bill.
The GOP leadership hopes to present the entire package to Trump by July 4th.
