03-07-2025
Why Republicans can't quit Medicaid cuts
Republicans also largely see the two programs as earned entitlements because they are funded with payroll taxes, whereas Medicaid is still viewed by many in the party as a handout, even though most recipients work, policy experts said.
'Social Security and Medicare also clearly have a beneficiary group of elderly who are politically active, but Medicaid is politically easier to go after because you're talking about kids and poor people and people with disabilities,' said Chris Howard, a professor of government and public policy at William & Mary in Virginia.
With Social Security and Medicare off the table, Medicaid became one of the only targets for Republicans to find cuts of the size they needed to pay for Trump's policy priorities.
'When you have to pay for stuff in the federal budget, there are only a couple of programs they can look at,' said GOP health strategist Joel White, president and CEO of the consulting firm Horizon Government Affairs. 'The money lined up.'
Messaging war
Trump's remaking of the Republican Party aside, the rhetoric around the Medicaid debate was familiar to anyone who's paid attention to politics over the last several decades.
Republicans said the Medicaid expansion had exploded the welfare state by allowing 'video-game-playing young men' too lazy to work to enjoy taxpayer-funded health care. Democrats said Republicans were shredding the social safety net to pay for tax cuts for billionaires.
The nonpartisan Congressional Budget Office estimated an earlier version of the bill would lead to a $1.1 trillion cut to health spending over the next decade and 11.8 million people tossed off coverage. The CBO does not have an updated score yet on the version of the bill that narrowly passed the House on Thursday after several health provisions were dropped, such as a penalty on states for coverage of undocumented immigrants.
Recent polling shows that Democrats appear to be winning the messaging war. A poll released June 26 from Quinnipiac University found 55 percent of U.S. voters were opposed to the bill compared with 29 percent in support and 16 percent didn't have an opinion. Another poll from health research group KFF found 64 percent of U.S. adults opposed the bill and 35 percent were in favor.
'The combination of these deep cuts to food and health care, which most people strongly believe are important kinds of benefits, and the tax cuts for the rich — it's going to be very easy for Democrats to portray Republicans as the sort of heartless friends of the rich,' said Howard.
White said Republicans have long had problems talking about health care, and lawmakers must keep to their message that the policy changes go after abuses.
'There are simple things they can say: 'If you are an able-bodied adult, you need to work or volunteer in your community and get educated,'' he said.
White added that Republicans need to explain more clearly why the cuts are necessary to shore up the program for those truly in need and that those kicked off can obtain insurance through an employer or an Obamacare exchange.
'All members of Congress need to say what is at stake, which is the integrity and long-term stability of the Medicaid program,' he said.
