Trump warns GOP hardliners: ‘Don’t f*** around with Medicaid’

Modern Healthcare – Tuesday, May 20, 2025
By Michael McAuliff

President Donald Trump warned holdout House Republicans not to tank his top legislative priority by demanding deeper Medicaid cuts during a private session with GOP lawmakers Tuesday.

According to Republicans who attended the meeting in the Capitol basement, Trump offered a simple message to hard-line conservatives threatening to vote against the bill: “Don’t f*** around with Medicaid.”

Trump remains supportive of cutting Medicaid by $625 billion, imposing work requirements and curbing provider taxes states use to finance their share of Medicaid expenses.

But political figures central to Trump’s “Make America Great Again” movement such as Laura Loomer and Steve Bannon have publicly cautioned the president and congressional Republicans that many of their supporters are Medicaid recipients. Trump previously pledged to veto legislation that diminishes the program for low-income people and people with disabilities more than he prefers.

House Republican leaders hope to vote on a bill this week that would extend tax cuts from Trump’s first term, and the Rules Committee is scheduled to meet at 1 a.m. EDT to incorporate revisions to the measure in preparation for a final debate in the House. The Senate has not begun public work on counterpart legislation.

Medicaid remains a key sticking point in the House for both far-right conservatives seeking steeper funding reductions and swing-district Republicans anxious about the political consequences of rescinding benefits for millions of people.

According to a Congressional Budget Office analysis, the bill the House Budget Committee advanced Sunday would add around $4 trillion to the national debt over 10 years because the lost revenue is only partially offset. The largest spending cuts, totaling $625 billion, would apply to Medicaid, leading to 7.6 million people losing benefits, the CBO projects.

Trump’s salty admonishment seemed aimed at reassuring GOP moderates that while he supports shrinking Medicaid, he would only accept cuts that could be described as targeting waste, fraud and abuse.

“If you find waste or fraud or abuse, we want to strengthen Medicaid, we want to strengthen Medicare,” Trump told reporters after the meeting with GOP legislators.

Exactly what qualifies as waste, fraud and abuse, however, has not been decided, said Budget Committee Chair Jodey Arrington (R-Texas).

“I think he is deferring to our conference, because there’s a healthy debate in our own conference about where the waste and fraud is, versus just restructuring the program to make it work better,” Arrington said. “These are issues that are being vetted right now.”

The legislation nearly got stuck in Arrington’s committee over the weekend, but four hard-right members allowed it to move ahead by voting “present” after GOP leaders promised to dial up the Medicaid cuts, possibly by imposing work requirements and tighter eligibility reviews in 2027 instead of 2029. Revising the tax-and-spending cuts bill in that manner likely would boost the Medicaid spending reductions to more than $700 billion.

“There’ll be some changes,” Trump said.

Rep. Dr. Andy Harris (R-Md.), who chairs the conservative Freedom Caucus, said he still opposes the bill. Harris said Congress should move more quickly to limit enrollment and do more to curtail provider taxes and other mechanisms states use to cover Medicaid costs.

Rep. Ralph Norman (R-S.C.), who favors bigger Medicaid cuts and sits on the Rules Committee, said only that he wants to see what GOP leaders devise.

Other conservatives, such as Rep. Dr. Greg Murphy (R-N.C.), said they prefer deeper cuts, perhaps by converting federal Medicaid funding to block grants, but see advancing the bill as more important than holding the line. Murphy also said that while he backs implementing work requirements more quickly, that policy would pose logistical problems for regulators.

“It would create a bureaucracy of enforcement,” Murphy said. “In theory, yes, it’s a good idea. But in reality, we deal in the real world.”

Blue state Republicans are particularly on the lookout against deeper cuts. Rep. Nick Langworthy (R-N.Y.) said any drastic amendments could imperil the bill.

“Hopefully, they’re not significant to the point where it divides the conference,” said Langworthy, who serves on the Rules Committee. “We have to come together. I think the president’s message today is: Just get it done.”

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