House punts on budget, deep healthcare cuts

Modern Healthcare – Wednesday, April 9, 2025
By Michael McAuliff

The House abandoned a vote on the budget resolution Wednesday, leaving President Donald Trump’s tax cuts and massive reductions to federal healthcare spending in limbo.

House Speaker Mike Johnson (R-La.) pulled the measure, which the Senate approved Monday, from the floor just before it was set for a vote. A handful of conservative Republicans rebelled because they believed the budget would not bring about sufficiently deep cuts.

In consultation with Trump, Johnson said House GOP leaders would strive to mollify upstart Republicans with new language he said would ensure conservatives get the huge spending cuts they demand, and try hold a vote Thursday. Congress is scheduled to begin a two-week recess Thursday evening.

“We want to ensure and have commitments amongst ourselves that we’re going to find a requisite number of savings while also protecting essential programs,” Johnson said. “House and the Senate Republicans are working together as one team. There’s a mutual commitment that we’re going to find real savings in federal spending, because we have to do that.”

The GOP opponents expressed particular displeasure about how the Senate amended the budget resolution the House initially passed in February.

While the budget calls for the House to cut at least $1.5 trillion in spending over 10 years, the Senate would only have to cut as little as $4 billion, setting up a clash between the majority-Republican chambers over the eventual tax and spending cuts bill.

Prior to Johnson canceling the vote, insurgent House Republicans said they did not trust their chamber would win out.

“The Senate sent over a joke, and we’re going to capitulate to the Senate knowing full well that the Senate instructions carry the day,” Rep. Chip Roy (R-Texas) said “We’re going to be sitting there in a reconciliation debate where we’re going to end up on the short end of the stick.”

The Senate’s portion of the budget resolution is “not serious,” said Rep. Lloyd Smucker (R-Pa.). The House approved the first draft of the budget resolution in February.

Johnson’s stumble doesn’t necessarily signal that Trump won’t get the tax cuts he covets, most of which originated in the Tax Cuts and Jobs Act of 2017, the signature accomplishment of his first term. The House could modify the budget resolution and renew negotiations with the Senate over the measure, which provides the framework for legislation lawmakers intend to draft over the next month.

But coming to terms with the Senate would be no mean feat, as several Republicans in the upper chamber have raised concerns about the House’s plan to slash healthcare spending by $880 billion, almost all of which would likely come from Medicaid.

The margin for error is narrow on both sides of Congress. The GOP has a 220-213 majority in the House and a 53-47 edge over Democrats and allied independents in the Senate.

Senate Majority Leader John Thune (R-S.D.) acknowledged the split within his party and between the two chambers of Congress at a news conference Tuesday. But it would be best to move ahead, and work out the differences later, he said.

“What this does is it unlocks budget reconciliation and unleashes all the things that we want to accomplish for the American people,” Thune said.

When the Senate passed the budget resolution, GOP Sens. Susan Collins (Maine), Lisa Murkowski (Alaska) and Josh Hawley (Mo.) joined Democrats in an unsuccessful bid to strip the $880 billion provision from the resolution.

Hawley stood firm on his resistance to the House-backed healthcare cuts and said he didn’t believe the Energy and Commerce Committee, which would have to make the cuts, could meet its target without harming Medicaid enrollees.

“Twenty-one percent of Missourians get either Medicaid or [the Children’s Health Insurance Program],” Hawley said Tuesday. “I’m not willing to cut benefits to children — poor children — or adults who can’t otherwise afford health insurance and are working a job and doing the best they can.”

Trump has pressured his party to come together. On Tuesday, the president harshly criticized Republican holdouts.

“Close your eyes and get there. It’s a phenomenal bill. Stop grandstanding,” Trump said at a fundraiser for the National Republican Congressional Committee, the House GOP’s campaign arm. “If we don’t get it done because of stupidity or a couple of people who want to show how great they are, you just have to laugh at them or smile at them or cry right in their face.”

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