House Speaker Mike Johnson insisted Wednesday night that Republicans are not going to cut Medicaid, Medicare or Social Security as part of their effort to slash trillions in government spending. The budget outline narrowly passed by House Republicans this week directs the Energy and Commerce Committee to come up with savings of at least $880 billion over 10 years — and Medicaid, which provides health coverage to more than 70 million people, is expected to be the main source of those cuts. The numbers don’t really work otherwise.
But in an interview with CNN’s Kaitlan Collins, Johnson said Republican lawmakers and President Donald Trump were on the same page on the issue and would not be seeking massive cuts. “The White House has made a commitment — the president has said over and over and over, we're not going to touch Social Security, Medicare or Medicaid,” Johnson said. "We've made the same commitment. Now, that said, what we are going to do is go into those programs and carve out the fraud, waste and abuse and find efficiencies.”
Earlier in the day, Trump said the three major social safety net programs won’t be cut, except that fraud would be targeted. “I have said it so many times, you shouldn’t be asking me that question. Okay?” he said to a reporter who asked if he can guarantee that Medicare, Medicaid and Social Security won’t be touched. “This will not be ‘read my lips.’ It won’t be ‘read my lips’ anymore: We’re not going to touch it.”
Democrats don’t believe it.
“The Republican budget will set in motion the largest cut to Medicaid in American history,” House Minority Leader Hakeem Jeffries said at a Thursday news conference. “Children will be hurt. Families will be hurt. Seniors will be hurt. Everyday Americans with disabilities will be hurt. Hospitals will be hurt. And nursing homes will be hurt all across America.”
Jeffries said Democrats are prepared to go after waste, fraud and abuse, but he challenged the GOP. “Republicans are lying,” he said. “Prove me wrong. There’s nothing that we as House Democrats would like better than for the Republicans to prove us wrong — that they are not planning to cut Medicaid.”
Some House and Senate Republicans are reportedly also pushing back against the possibility of Medicaid cuts, fearing that such a move could erode their gains with working-class voters and cost them their seats — and cost the party its congressional majorities.
The math leaves Republicans few options if they want to enact all of their tax and spending cuts.
Johnson said that Medicaid loses about $50 billion a year to fraud, and CNN’s Collins noted that Medicare and Medicaid make about $100 billion a year in improper payments. She asked where the other $780 billion in savings would come from. Johnson said that Republicans would be looking across all of government and that the Energy and Commerce Committee has the broadest jurisdiction of any congressional committee. “Everybody just reserve judgement, watch us work, and you’ll like the final product,” he said, later adding, “We’re not going to cut benefits for people who are rightfully deserving.”
Johnson indicated that work requirements for Medicaid would be part of the solution, but he said that per capita caps on federal Medicaid funding or reductions to the federal matching funds to states would not be affected.
That would leave Republicans scrambling for more savings. Estimates by budget analysts suggest that adding work requirements to Medicaid could save about $100 billion, The Washington Post’s Hannah Knowles and Marianna Sotomayor report. They note, as others have, that the Energy and Commerce Committee could slash all the non-healthcare spending it oversees and would still fail to hit its $880 billion target.
The options Johnson ruled out could provide more savings — albeit at a human cost. A new analysis by the Urban Institute finds that imposing per capita caps and eliminating enhanced federal matching funds would cut federal spending by as much as $1.7 trillion over 10 years — and shift those costs to states, which would have to increase their Medicaid spending, perhaps by more than a third. “To offset the lost federal Medicaid revenue,” the report says, “states would have to consider a range of policy options, including increasing taxes, shifting state spending away from education and other priorities, cutting Medicaid provider payment rates, and reducing benefits for Medicaid beneficiaries, including disabled and aged populations.”