Republicans hear rage over Medicaid cuts back home

Modern Healthcare – Tuesday, August 19, 2025
By Michael McAuliff

Republicans have their story about the healthcare cuts in the “One Big Beautiful Bill” and they’re sticking to it during the August congressional recess.

At least they are in the relatively rare cases when they’ve faced voters.

Generally, after a party in power enacts landmark legislation like the bill to extend President Donald Trump’s 2017 tax cuts, they are eager to trumpet that success back home.

This year, though, popular tax cuts are being overshadowed by the law’s $1.1 trillion in healthcare cuts. GOP lawmakers who supported them have either avoided public town hall meetings or adhered to talking points provided by party leaders.

The arguments — after touting the tax cuts — include casting negative news about the law as misinformation, focusing on positive aspects such as the law’s $50 billion rural hospital fund, playing up the generally popular idea people should have to work or volunteer to be eligible for Medicaid, and positioning themselves as watchdogs against waste, fraud and abuse who aim to preserve Medicaid for the neediest.

The National Republican Congressional Committee — the House GOP’s campaign apparatus — distributed those talking points to members, and influential healthcare legislators such as House Energy and Commerce Committee Chair Brett Guthrie (R-Ky.) and Senate Finance Committee Chair Mike Crapo (R-Idaho) have echoed those arguments.

For instance, after the Congressional Budget Office released its latest estimates last Tuesday confirming that 10 million people will lose health coverage because of the law, Guthrie cited the data as a selling point.

“Our Republican-led ‘One Big Beautiful Bill Act’ promotes the core mission of protecting our most vulnerable Americans by strengthening, securing and sustaining our crucial federal health programs,” Guthrie said, pointing in particular to the new Medicaid work requirements.

“CBO estimates 10 million individuals enrolled in federal healthcare programs will no longer be covered, with 5.3 million being able-bodied adults refusing to work,” Guthrie said. The CBO estimate does not break down those who are unwilling to work versus people who will lose benefits because of red tape.

A survey of some recent Republican public appearances found similar combinations of sales pitches.

It hasn’t gone over particularly well.

At a town hall in Lincoln on Aug. 4, Rep. Mike Flood (R-Neb.) boasted about $700 million that would come to Nebraska hospitals because of the law. But a boisterous crowd often interrupted him with calls of “liar” and “vote him out.”

Republicans trying to deliver such messages even in safer havens sometimes have run into difficulty.

Rep. Brad Finstad (R-Minn.) attended a meeting of Olmsted County officials in Rochester last Tuesday that they closed to the public after five minutes. The same day, protestors repeatedly interrupted an event Finstad held with the Rochester Chamber of Commerce, according to local media reports.

The hostility evident at public events is at least partially predicted in opinion surveys.

In July, KFF found 63% of the public holds unfavorable opinions about the law. A Pew Research Center survey conducted this month found 46% disapprove of the law while 32% approve.

Some Republicans have found better receptions in more business-friendly environs, such as local chambers of commerce events or political gatherings. Rep. August Pfluger (R-Texas) and House Budget Committee Chair Jodey Arrington (R-Texas) won applause at the West Texas Legislative Summit in San Angelo on July 30.

“There’s a lot of misinformation out there,” Pfluger said during the event. “If you went to a town hall with me yesterday, you would have seen some of that.”

Arrington cast the healthcare cuts as a moral issue.

“Even more than the dollars and cents, it’s about the soul. It’s about how God created us,” Arrington said. “We don’t want to deprive people of the dignity and the blessing of work, right? So that’s what this is about. But it’s going to be demagogued from now into the midterms.”

National Public Radio attempted to count the public town halls held by the GOP this summer and found just three dozen. There are 219 Republicans in the House, all but two of whom voted for the bill. Fifty of 53 Senate Republicans supported the measure.

There is a lesson the healthcare industry can take from the reluctance of the governing party to publicly engage over the unpopular law, said Larry Levitt, executive vice president for health policy at KFF.

The backlash may make some Republicans amenable to proposals to mitigate some of the more painful cuts, especially given the relatively long timeline for implementation of some provisions, Levitt said.

“I expect Republican candidates will be on the defensive for Medicaid and [Affordable Care Act of 2010] cuts in the 2026 campaign, and may be open to delaying or softening some of the cuts before they take effect,” Levitt added.

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