Medicaid fight could come to a head in early May under GOP timeline

One of the most closely watched parts of the GOP’s sprawling domestic policy bill could start coming together in less than a month.

The House Energy and Commerce Committee could meet as soon as the week of May 5 to begin marking up its portion of the party-line package central to President Donald Trump’s agenda, according to nine people with granted anonymity to describe private deliberations.

The panel is tasked with making $880 billion in spending cuts from the programs under its jurisdiction — including Medicaid, the joint federal-state safety net program for health care.

The size and shape of those cuts emerged as a major flash point for Republicans as they haggled over the budget framework for the megabill, which is set to include tax cuts, beefed-up border security, energy policy and more. That blueprint, finalized last week, set a May 9 target for committees to finish their markups, though that is not a binding deadline.

House GOP leaders are also pushing for the Agriculture Committee — which has been ordered to cut $230 billion, likely from the country’s largest food assistance program for low-income Americans — and several other panels to hold their markups the first week of May, according to three other Republicans with direct knowledge of the matter.

Speaker Mike Johnson has said he wants committees to hammer out some details with their Senate counterparts over recess and hold markups when lawmakers return, though some House Republicans are warning that coordinating with the Senate will take more time. The timeline for the tax-writing Ways and Means Committee, for instance, remains in flux.

Senior Republicans are also pressing for the Transportation and Infrastructure Committee to hold its markup April 30, according to a person with direct knowledge of the committee’s schedule. That panel has a relatively modest role in the overall bill.

Energy and Commerce Chair Brett Guthrie told reporters last week he expects between $500 and $600 billion of the committee’s total spending cut target could come from health care programs, including Medicaid, with the rest coming from energy and telecommunications policies.

The Kentucky Republican has insisted those cuts would not result in people losing their current benefits, a claim that Democrats and some experts dispute.

“Hundreds of billions of dollars in Medicaid cuts will terminate health insurance for millions of Americans and shutter hospitals, doctors’ offices and nursing homes,” Sens. Ron Wyden (D-Ore.) and Jeff Merkley (D-Ore.), the ranking members of the Senate Finance and Budget Committees, respectively, wrote in an op-ed in the Portland Tribune Thursday.

Even some Republicans worry Medicaid benefits will take a hit to accommodate demands from GOP fiscal hawks. As Johnson tried to seal his agreement with conservative hard-liners over the budget framework last week, he dashed onto the House floor to reassure a half-dozen moderate Republicans that he would not take away Medicaid benefits.

“We made it very clear once again that we would not vote for anything that takes away benefits from legally eligible recipients,” Rep. Nicole Malliotakis (R-N.Y.) said.

But Guthrie insists $170 billion alone in savings could come from making sure people receiving Medicaid benefits are actually eligible — kicking only those off the rolls who truly do not qualify. Rep. Mike Lawler (R-N.Y.) said during a CNN town hall Thursday night that such policies could include making eligibility checks required every quarter.

More than $200 billion could come from instituting new Medicaid work requirements, according to Guthrie, along with added savings from lowering the share of federal payments for certain beneficiaries in states that have expanded Medicaid.

If the federal government lowers its share of payments, however, states could be forced to cut benefits or raise taxes.

The House on Thursday approved the Senate-adopted budget blueprint, paving the way for a mad dash to complete the megabill. Johnson has been pushing for the bill to be on Trump’s desk by Memorial Day — an ambitious goal given the major issues across all committees that need to be resolved.

Chris Marquette contributed to this report.