President Trump issued a strong warning to congressional Republicans on Tuesday, telling them not to interfere with Medicaid as they continue to negotiate the details of his sweeping legislative package, commonly referred to as “one big, beautiful bill.” His blunt message was aimed at conservative lawmakers pushing for deeper cuts to the program.
In the meeting, Trump made it clear that he is already considering political consequences for Republicans who don’t support the legislation. He singled out Rep. Thomas Massie of Kentucky, a vocal opponent of the bill, calling him a “grandstander” and suggesting he should be voted out of office.
Trump also cautioned moderate Republicans from high-tax states not to press too aggressively on lifting the cap on state and local tax (SALT) deductions, signaling his frustration with multiple factions within his party.
He emphasized that any reductions to Medicaid should focus strictly on addressing waste, fraud, and abuse not on gutting the program. After the meeting, some conservative members echoed this stance. Rep. Andy Biggs of Arizona, for example, said cuts should be focused in those areas.
Despite that, some conservatives are still pushing for more significant cuts, arguing that deeper Medicaid reductions are needed to balance out the costs of the bill’s tax provisions. At the same time, members of the SALT caucus remain firm in their demands for greater deductions, making consensus elusive.
One of the key remaining disputes involves Medicaid provider taxes. Rep. Andy Harris of Maryland, chair of the House Freedom Caucus and a holdout on the legislation, called for stricter limits on the taxes states use to fund their share of Medicaid. He pointed out that even Democrats have criticized the provider tax system, yet the bill leaves most of it intact.
That position clashes with moderates like Rep. Rob Bresnahan of Pennsylvania, who said any such limits are a “non-starter” for him and his allies.
If the bill moves forward in its current form, millions of Americans could face the loss of health coverage due to the proposed Medicaid changes.
The White House responded by framing the administration’s approach as focused and protective. Spokesperson Kush Desai said that Trump and Republicans are committed to preserving Medicaid for the groups it was originally designed to help including pregnant women, children, disabled individuals, and seniors. Notably absent from that list are low-income working-age adults without children, many of whom gained access to coverage under the Affordable Care Act’s Medicaid expansion.