Key GOP votes withhold support from House plan despite Trump's backing

Three key House moderates told The Hill on Wednesday that they are still not on board with the chamber’s budget resolution, even after President Trump endorsed it earlier in the day.

Reps. David Valadao (R-Calif.), Nicole Malliotakis (R-N.Y.) and Don Bacon (R-Neb.) said they still have concerns about potential cuts to Medicaid, which some GOP lawmakers are eyeing to pay for the cost of tax cuts and other provisions in the massive package.

It’s a concerning sign for GOP leaders as they try to corral the conference around the measure ahead of next week’s vote. Republicans can only afford to lose one vote if all members are present and the entire Democratic caucus votes “no,” which is expected.

“I’m leaning no on the resolution as-is, minus getting clarity on my concerns,” Malliotakis said shortly after Trump endorsed the House GOP’s single-bill plan over a rival Senate GOP two-bill plan.

“I’m glad to hear that he agrees with me that we need to protect Social Security, Medicare, Medicaid, but it doesn’t eliminate my concerns with the specific resolution put forward by the House or my need for clarity before next week’s vote,” Malliotakis said.

Valadao, who represents a purple battleground district, said “there’s probably 10 [Republicans] that are really nervous about the situation,” signaling that the concerns are not confined to the three Republicans speaking out.

“Until I know exactly what’s going to be in, or what this is going to look like, or at least have some pretty good idea, I’m really concerned with this,” he added. “But it sounds like the president and myself and others are on the same page, we don’t want to touch Medicaid. We want to make sure that we’re all on the same page. If he’s on the same page as me, that makes me feel a little bit better about it.”

The Republicans were referring to comments made by Trump on Tuesday night during an interview with Fox News’s Sean Hannity, where he said he would not significantly impact Social Security, Medicare and Medicaid, aligning with the position of many moderate GOP lawmakers.

“Social Security won’t be touched — other than if there’s fraud or something — we’re going to find it; it’s going to be strengthened — but won’t be touched,” Trump said. “Medicare, Medicaid, none of that stuff is going to be touched.”

That statement runs counter to remarks from some House Republicans, who believe that cuts to Medicaid will be needed to achieve the minimum spending cut levels that were outlined in the conference’s budget resolution.

The measure — which advanced out of the Budget Committee last week and is on track for a House floor vote next week — lays out a $1.5 trillion floor for spending cuts across committees with a target of $2 trillion. It puts a $4.5 trillion ceiling on the deficit impact of any GOP plan to extend Trump’s 2017 tax cuts, and includes $300 billion in additional spending for the border and defense and a $4 trillion debt limit increase.

The resolution directs the Energy and Commerce Committee — which has jurisdiction over Medicaid — to make $880 billion in cuts, the largest chunk any panel is tasked with finding. Some Republicans say the only way to reach that figure is by slashing Medicaid.

“There’s only one place you can go, and that’s Medicaid. That’s where the money is,” Rep. Russ Fulcher (R-Idaho), who sits on the Energy and Commerce Committee, said last week. “There’s others, don’t get me wrong, but if you’re going to get to $900 billion, something has to be reformed on the Medicaid front.”

Comments like those are sparking concerns among the moderate Republicans, many of whom represent districts with large numbers of people who get Medicaid benefits.

In 2023, 48.7 percent of Valadao’s constituents in California’s 22nd District were covered by Medicaid, as were 26.8 percent of Malliotakis’s constituents in New York’s 11th District and 13.9 percent of Bacon’s constituents in his Nebraska district, according to Georgetown University’s McCourt School of Public Policy.

“I appreciate the president’s comments on Hannity last night reaffirming his commitment to not cut Social Security, Medicare and Medicaid, but I still need some clarity from my colleagues in the House on how we’re gonna get to the numbers mandated in the resolution without cutting Medicaid in a way that it impacts beneficiaries or my hospitals,” Malliotakis said.

Johnson told reporters last week “Medicaid has never been on the chopping block,” noting that the conference is interested in rooting out “fraud, waste and abuse” from the program and instituting work requirements, two ideas Republicans broadly support.

Several lawmakers, however, are doubtful that those two efforts will generate enough money to reach the needed cuts. According to the Congressional Budget Office, work requirements for Medicaid would decrease federal spending by $109 billion over 10 years.

“I don’t know how they move it forward without touching Medicaid, but it’s one of those situations where we won’t know until it’s passed and the committees start to do their work and we see their final packages, and that’s something that we’re concerned about,” Valadao said.

Bacon is asking for assurances that the conference will not go after more parts of the program.

“My ask of leadership is, show me how you can cut $880 billion in [Energy and Commerce Committee] without it having significant cuts to Medicaid, and I’m not interested in voting for something that's gonna lead to big cuts in [the committee] when even the president says he’s opposed to it,” Bacon echoed. “That’s my position.”

If the committees do not achieve the tax cuts laid out in the budget resolution, the total amount that the tax portion of the package is allowed to add to the deficit may decrease, putting pressure on panels to find cuts. House Republicans on the Budget Committee added that language to the resolution in the form of an amendment last week, which was key to securing support among hard-line Republicans.

The amendment, however, is exacerbating the worries among some lawmakers as they look to get a number of Trump’s costly tax wish list items in the package. The budget resolution currently allows for a $4.5 trillion cap on the deficit impact of the Republicans’ plan to extend Trump’s 2017 tax cuts, which some top Republicans say is not enough on its own to achieve the president’s agenda.

“That’s the other piece to this, and that’s why that last-minute amendment that they put in there is troublesome to me,” Malliotakis said.

“It should be troublesome to the president if he wants to achieve his agenda of the no tax on tips, tax relief for seniors, [state and local tax (SALT)] relief and the 15 percent made in America, which are all my priorities, those are all priorities of mine. And it makes it difficult to achieve with the existing instructions and top lines given to us by the Budget Committee.”

The debate over Medicaid comes as Republicans are looking to pass a budget resolution, which would unlock the budget reconciliation process — a procedure the party is looking to utilize so they can circumvent Democratic opposition in the Senate. The budget resolution lays out instructions for committees to use to craft the ultimate reconciliation package.

While the trio of moderate Republicans voiced concerns with the current budget resolution plan, there does appear to be a path to securing their support, which would allow the process to proceed. Historically, moderates have been easier to get on board compared to conservatives.

“Just that we’ll be a part of this process and it moves forward,” Valadao said when asked what he needs to hear from top lawmakers to support the measure. “Talk to leadership about making sure that we're sticking to the president's word, my word and others, that Medicaid was going to be left, at least for those who need it most, still be there and not affect those folks.”

The California Republican, however, was clear-eyed that even beyond the Medicaid conversation, the path forward could get messy.

“It’s a tough spot to be in because we all want to see the tax bill continue in this current policy, but then the SALT, all that stuff adds to the cost, and we’re already struggling with the numbers as-is,” Valadao said, citing another thorny issue Republicans will have to grapple with down the road. “It’s just, we’re gonna have some tough times ahead.”