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House Republicans on Sunday night offered the first glimpse of their Medicaid overhaul plan, which is expected to cut billions of dollars to help finance President Donald Trump’s sweeping tax and spending cuts agenda. Details of the plan, unveiled by House Energy and Commerce Chairman Brett Guthrie, show major new rules designed to cut spending. That includes work requirements for adults who are physically “capable” of working and more frequent eligibility checks for those relying on the program, which provides health insurance to low-income Americans. But it does not appear to be the radical restructuring sought by many House GOP hardliners. Instead, it represents a compromise that the party’s more centrist members — and perhaps those across the Capitol in the Senate — may be more willing to support. Full legislative text of the plan was released Sunday night, though it could see further changes before a key committee vote midweek. Still, the plan signals some of the biggest decisions made by House Speaker Mike Johnson and his leadership team so far as they work to strike a deal on Trump’s big domestic policy bill. It remains to be seen, however, whether the powerful Energy and Commerce Committee can meet its goal of cutting $880 billion over a decade in funding from programs in its jurisdiction — which will be critical to winning conservative support for the overall package. In a Wall Street Journal op-ed earlier Sunday, Guthrie described the committee’s Medicaid plan as a “common sense” proposal to rein in spending on one of the government’s most expensive health care programs. “Without Republican solutions, Washington risks a complete collapse of Medicaid. Even with these simple steps to eliminate waste and abuse, Medicaid spending will continue to rise every year for the foreseeable future,” the Kentucky Republican said. Since Medicaid is a joint federal-state program, many conservatives wanted to cut federal costs by requiring states to pay more. But that idea — which would have involved what’s called the Federal Medical Assistance Percentage, or FMAP — was too contentious among GOP centrists. The GOP panel’s plan does make one proposed change to FMAP, however: The bill would penalize states that provide a state health care program, such as Medicaid, to “illegal immigrants” by cutting their federal contribution to Medicaid by 10% — an apparent targeting of some blue states like California. Guthrie, in his op-ed, also signaled that Republicans would repeal at least some parts of former President Joe Biden’s signature climate policy bill — though it’s not yet clear whether GOP moderates will support this move, as some had lobbied publicly and privately to keep certain tax credits. “The legislation would reverse the most reckless parts of the engorged climate spending in the misnamed Inflation Reduction Act, returning $6.5 billion in unspent funds,” Guthrie wrote. The House Ways and Means Committee, the GOP’s powerful tax-writing panel, earlier announced it will mark up its portion of the legislative package Tuesday. Republicans on the panel released a bare-bones version of their tax bill, but that initial release did not include a series of contentious issues the committee is still hammering out, including the state and local tax deduction known as SALT. A group of House Republicans fighting over that provision will huddle Monday with the Ways and Means Committee to try to find a path, a source told CNN. This story has been updated with additional information. CNN’s Haley Talbot contributed to this report.
