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Republicans are coming off of their best presidential election performance with low-income voters in recent memory. According to the (imperfect) 2024 exit polls, President Donald Trump won voters earning $50,000 or less, something he didn’t do in either his 2020 or 2016 campaigns. This is a landmark measure of the Trump era realignment, with lower-income, noncollege voters of all races moving toward the Republican Party, while college-educated, higher-income white voters migrate to the Democrats.
Republican governance, however, has not kept up with these changes.
After a chaotic, grinding effort Tuesday to corral the necessary votes, House Republicans barely passed a blueprint for their “one big, beautiful bill” containing much of Trump’s legislative agenda. It tees up their ability to use the filibuster-proof reconciliation process to enact a sweeping bill, along party lines, down the road.
The blueprint creates space for a mishmash of Republican priorities, like beefing up border security and boosting defense spending. But its core is the same old, same old: Cutting spending for programs that poor people rely on, and cutting taxes. It is, in other words, roughly the same agenda that Republicans sought in 2017, when Trump entered the White House for the first time, even though the party’s composition has changed significantly since then.
(To clarify: This process is a separate negotiation from the other major ongoing legislative effort—funding the government beyond March 14—that will require Democratic cooperation. It has its own problems.)
What House Republicans passed Tuesday is not the final bill achieving all of Trump’s big, beautiful successes. Instead, this measure gives various committees their marching orders: The Armed Services Committee has put together a plan for $100 billion in new defense spending; the Homeland Security and Judiciary committees, which have immigration and border jurisdiction, get $200 billion to play with; the Education and Workforce Committee has to find $330 billion in savings; and so on. Once the House and Senate pass an identical blueprint, then the committees set about writing the final bill itself, and try to pass that.
All in all, the blueprint allows for $4.8 trillion in tax cuts and spending on other GOP priorities, while requiring at least $1.5 trillion in spending cuts elsewhere. It also has a mechanism, at the conservative Freedom Caucus’ request, that if Republicans don’t reach $2 trillion in mandatory spending cuts over the next decade, then there’s less money allowed for tax cuts.
The most controversial element for Republicans is that the blueprint tasks the Energy and Commerce Committee with finding $880 billion in cuts. This powerful committee, once described as having jurisdiction over “anything that moves, burns, or is sold,” also oversees Medicaid. Since Trump has ruled out cuts to Medicare, it’s Medicaid, a program that spends nearly a trillion dollars per year, that’s the obvious pot to raid for cash. Indeed, House Republicans earlier this year put out a menu of spending cuts they could choose from, and the bulk of the Energy and Commerce options relate to Medicaid. Republicans have some other big targets, for other committees, in mind, whether that’s rolling back food stamps or student loans. But the members have cornered themselves into targeting Medicaid for the bulk of the savings they want to achieve in order to finance tax cuts.
It has at least begun to dawn on some Republicans that the party now describing itself as the tribune of the American poor might be acting counterintuitively here.
A group of eight GOP members of Congress representing significant Hispanic American populations—a demographic sprinting to the Republican side of the aisle—wrote a letter to House Speaker Mike Johnson last week warning that “slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open.” Missouri Sen. Josh Hawley, who fancies himself a New Right populist, warned the House against “severe cuts to Medicaid.” So, too, has MAGA whisperer Steve Bannon.
“Medicaid, you gotta be careful,” Bannon recently said on his podcast. “Because a lot of MAGAs are on Medicaid, I’m telling you. If you don’t think so, you are dead wrong.”
Trump, himself, seems to understand the damage Medicaid cuts could do to his coalition. But he’s given mixed and conflicting views on the House GOP’s targeting of Medicaid, as is his wont.
Moderates’ concerns about Medicaid were not Speaker Johnson’s only worry as he tried to bring the plan to a vote at the beginning of the week. Certain conservatives with a flair for independence had their own gripes about the package’s debt impact.
It was a few of the conservative members holding out who stalled the action into Tuesday night. Those most concerned about Medicaid were placated earlier in the day to at least go along with this step. Two talking points were key to bringing them around.
The first was the technically correct assertion that the blueprint does not mention the word “Medicaid” once.
“Can you specify one thing today that identifies a single cut?” New York Rep. Mike Lawler told reporters Tuesday morning. The blueprint, as he said, is where “you start the process, and then you negotiate what the final terms of the agreement are going to be.” This, again, is correct. But the blueprint does dig an $880 billion hole that it’s difficult, if not impossible, to fill without major cuts to Medicaid—and not just “waste, fraud, and abuse.” For now, though, Republicans can say with a straight face that they’re simply beginning a process.
Secondly, these members are also hoping that this will all be changed when the process moves to the Senate.
“Ultimately, the question is, what is the Senate going to come back with?” Lawler said. “We have to pass the same resolution, right?” In other words, House Republicans expect the version of the blueprint that comes out of the Senate—which doesn’t have to contend with a hard-ass Freedom Caucus—won’t put such a target on Medicaid.
And so the process moves along. The bill that passed Tuesday night doesn’t actually enact any cuts, and thus, it allows everyone to save face. Eventually, though, this will all come to a head. The historically narrow House Republican majority, depending on any given day’s attendance, can only afford one or two defections on a vote. On one end are moderates and vulnerable members, or members representing ascendant, working-class elements of the new Republican coalition, for whom cutting the social safety net makes no political sense whatsoever. On the other end are Freedom Caucus members who believe with divine passion that the United States will soon collapse under the weight of its debt, and that meaningfully reducing that debt is their single biggest priority while they hold power. One side will eventually have to give.
The GOP is only training its sights on Medicaid for cuts because Trump had ruled out changes to Medicare and Social Security, both commonly understood to be third rails. But it might be dated thinking for the GOP, given the changes in its coalitional composition, to not consider Medicaid a third rail of its own. They’ll either back off, or risk finding out the hard way.
