House Republicans have made slashing hundreds of billions of dollars from Medicaid, the federal-state partnership of public health insurance for lower-income people, a core part of their plan to pay for new tax cuts for the rich — but making such cuts could be much harder than they anticipate, health reporter Joanne Kenen wrote for Politico on Thursday.
The fact is, she wrote, Medicaid "has evolved and expanded significantly over the years — and its constituency has expanded along with it. Some 80 million people now get health care from Medicaid, including many working-class voters in the president’s base."
Indeed, a number of states that backed Trump voted by popular referendum to expand the program, over the objections of their GOP legislators. In these states, Medicaid is often a main driver preventing rural hospitals from closing.
Republicans famously attempted to repeal the Affordable Care Act under Trump's first term, and all of their proposals featured drastic cuts to Medicaid. Public outrage over it at the time played a big role in the Democratic landslide elections in 2018.
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In fact, Kenen continued, Republicans may have gotten an ominous look at just how much blowback they stand to receive for even trying to cut Medicaid.
"Republicans may have just gotten an alarming glimpse of the future," Kenen wrote.
"Amid the chaos of President Donald Trump’s now-rescinded domestic funding freeze, Medicaid portals across the country went offline, which meant states couldn’t get their Medicaid dollars. It was something the administration said was never supposed to happen and which provoked public outrage and a bipartisan outcry," added Kenen.
Trump, for his part, vowed on the campaign trail not to touch Social Security or Medicare, widely considered to be political "third rail" programs too important to ever consider cutting.
Medicaid, which expanded from a very targeted program for distressed families to a broad-based low-income health insurance provider under the Affordable Care Act, may be heading for such status too, wrote Kenen.
"Trump last month remarked he’d 'love and cherish' the program. In recent days, Trump and his aides have said privately that they are worried steep Medicaid cuts would be politically radioactive," Politico reported.
The bottom line, Kenen wrote, is that while "with full GOP control of Washington, the question at the start of the year seemed to be not whether Medicaid would be cut but by how much," this week, House Speaker Mike Johnson (R-LA) "suggested the deepest cuts might not be in the offing" — a clear sign Republicans are aware how fine a line they'll have to walk.
