More than a dozen House Republicans have privately informed congressional leaders they will not support the Senate’s version of the tax and spending legislation unless changes are made to preserve Medicaid funding. The group, led by Rep. David Valadao of California, expressed concern that the Medicaid cuts outlined in the Senate Finance Committee’s proposal go too far and would harm vulnerable constituents.
In a letter addressed to Senate Majority Leader John Thune and House Speaker Mike Johnson, the lawmakers made clear they are aligned with the more measured Medicaid reforms included in the House version. They warned that the Senate’s more aggressive approach could destabilize access to health coverage and undercut hospital systems, particularly in rural communities.
They emphasized their position by writing that safeguarding Medicaid is a responsibility they owe to those who rely on the program. They urged that the more balanced and compassionate provisions from the House be preserved in the final legislation.
At the center of the dispute are two cost-cutting mechanisms targeted in the Senate proposal: state-directed payments and Medicaid provider taxes. These tactics allow states to secure additional federal Medicaid funding and redirect it to hospitals. Rural healthcare providers, in particular, depend heavily on these mechanisms to maintain financial stability.
The Senate Finance Committee’s plan calls for sharp limits on the taxes states can charge medical providers an effort to curtail practices that some argue inflate Medicaid reimbursements. While supporters of the move say it’s about fiscal responsibility, critics, including many hospital systems, argue it would result in severe funding shortfalls.
Despite having supported the House version of the bill, which includes substantial Medicaid cuts amounting to $700 billion over the next ten years the lawmakers behind the letter are drawing a red line on what they see as excessive changes introduced in the Senate draft. Their objections signal that key issues remain unresolved, and that bipartisan consensus will be necessary to move the bill forward.
Republicans have set a goal of passing the legislation by July 4 and sending it to President Trump for his signature. But with growing pushback from moderate Republicans over Medicaid provisions, negotiations are expected to intensify in the coming weeks.