Pleading with Republicans to rein any speculation of Medicaid cuts in their megabill, President Trump and key advisers are still haunted by the 2017 blowback to Obamacare repeal attempts.
As the Republican Party works to complete its domestic policy package, some worry that the spotlight on historic coverage losses is making it harder to sell the plan, and that Trump has stronger political instincts about the health program for low-income individuals compared to his colleagues in the House.
“He doesn’t want any political ads saying Republicans are cutting Medicaid benefits,” said Stephen Moore, an independent advisor to Trump. “His finger is definitely on the political pulse, whether you like it or not. Plus, he says, “Let’s not stick our finger in that socket” according to this.
An anonymous Republican who was there during Trump’s Tuesday visit to the Capitol said that the president told House Republicans to “fuck around with Medicaid” many times during the closed-door session. The source wanted to remain anonymous due to the meeting’s private nature. An anonymous White House insider spoke about internal discussions, saying that the president has used a Truth Social post to publicly push conservative hardliners to embrace the plan without further Medicaid cutbacks.
Despite House conservatives meeting with the president on Wednesday to go over the bill, Trump has consistently denied calls for more extensive changes to Medicaid, going against conservative ideology for years in an effort to preserve essential parts of a low-income health program that he now thinks is too popular to cut.
Trump’s tough stance on Medicaid is part of a larger effort to exert control over a megabill that is seen as increasingly important to the realization of his domestic goals and the success of Republicans in retaining control of Congress in the next midterm elections. Also, it’s an attempt by the White House to avoid a high-volume health care battle, which may ruin Trump’s program, in an effort to learn from the previous term’s blunders.
As soon as he took office in 2017, Trump declared it his administration’s top legislative goal to repeal Obamacare, following the example of congressional leaders who had previously pledged to destroy the health legislation. Projection of tens of millions of people losing health insurance caused voter outrage, which ultimately led to the effort’s demise. During Trump’s first year in office, Republicans squandered a lot of energy on the intractable dispute, which drained the party’s energy and public support.
Three anonymous Trump advisors and aides claimed the scandal was a defining moment in the president’s political education. On top of that, it has solidified my belief that his health care instincts are sharper than those of the Republican politicians who are ready to cut even more from the nation’s health system.
Republicans in the House didn’t experience the pushback for the repeal effort in 2017 since less than 40% of them are still in office.
This is really personal for him,” stated the Republican who was informed of Trump’s comments. “Stop talking about Medicaid,” the president has said rather plainly.
The megabill will “implement the tax cuts for working-class Americans and protections for Medicaid that we campaigned on,” according to White House spokesperson Kush Desai, who made the announcement.
It’s probable that Trump will face accusations of benefit reduction regardless of his opposition to further cuts to health care. New job requirements, stricter eligibility checks, and a ban on unauthorized immigrants from Medicaid are among things that the megabill is said to implement.
The impartial Congressional Budget Office projected that, over the following decade, 7.6 million individuals would become newly uninsured due to these provisions. Medicaid expenditure would be slashed by nearly $600 billion due to coverage losses, which would be the worst budget drop in the program’s history.
While testifying before the Rules Committee early Wednesday morning, Rep. Jim McGovern (D-Mass.) cited the CBO report to argue that the plan will have a disproportionately negative impact on the lowest 10% while benefiting the top 10%. “If this becomes law, it will have a devastating effect on middle class families and those who are fighting for a middle class income.”
Studies have demonstrated that provisions like work requirements do little to boost employment and instead create more paperwork for recipients, increasing the odds that qualified recipients will lose coverage. Despite Trump’s efforts to downplay the changes as targeting “waste, fraud and abuse” instead of restructuring Medicaid, the program continues to face problems.
However, White House officials are confident that they can convince senators to support those items as program enhancements rather than the severe cutbacks that some extreme conservatives are demanding. They contend that the public will perceive the new restrictions as a means to streamline Medicaid while protecting funds for individuals with the greatest need.
Moore criticized Trump’s use of the phrase “waste, fraud and abuse” during his Tuesday visit to Capitol Hill, stating that it appeared to be an attempt by the president to counter Democratic commercials. Trump used this phrase in various forms roughly six times. “We are eliminating waste, fraud, and abuse by making it harder to receive benefits, but we are not severing ties with anyone.”
Advisors to Trump have privately observed that the level of opposition to the megabill from Democrats and health care advocates on the left is noticeably lower than what they experienced during the Obamacare fight in 2017. This is believed to be due to the decision to prioritize eligibility rather than implementing more drastic cuts to funding.
In fact, there were occasions when the White House considered on the offensive, praising the bill’s Medicaid provisions as an important way to “strengthen” the program as a whole.
Republican Jim McLaughlin, a veteran political advisor and pollster for Trump, predicted that Democrats would accuse Republicans of slashing Medicaid. “However, according to [Trump officials], this is advantageous from a political and policy standpoint, and it allows them to enhance the program for individuals who earn it.”
But before the White House can put its theory to the test in full, it must overcome significant obstacles with conservative Republicans. Reversing years of progress toward Medicaid reduction has unsettled House holdouts and even some supporters.
Due to the political risk associated with interfering with voters’ benefits, Republicans have already essentially abandoned plans to reform Social Security and Medicare. Turning down the opportunity to reform Medicaid would be like adding a third large program to the “untouchable” list, making it much more difficult for future Republican administrations to significantly reduce government expenditure.
“This should be considered a down payment on future reforms,” commented Roger Severino, conservative Heritage Foundation VP of domestic affairs. There needs to be an open discussion about the sustainability of the budget in the long run, but you must begin by addressing the issues of waste, fraud, and abuse.
Trump, however, is firmly closing the door on that conversation—at least for the time being. According to his supporters, he had previously attempted to take a more conventionally conservative stance on health care during his first term, which had disastrous consequences. He is much more adamant about forging his own path now.
“Trump has never been one who wants to make deep cuts in these sacrosanct programs, so that’s just the reality,” Moore added. We are at that point. It’s all about politics.