A major legislative effort to advance former President Donald Trump’s sweeping tax and spending bill has hit a roadblock in Congress as hardline conservatives demand more aggressive cuts to Medicaid in return for their support. The legislation, intended to extend Trump’s first-term tax cuts and projected to cost $3.72 trillion over a decade, has drawn criticism for potentially increasing the national debt and disproportionately benefiting the wealthy.
Reuters
The House Budget Committee, led by Chairman Jodey Arrington, faces internal divisions that may delay a key procedural vote. At least four Republican hardliners on the committee have threatened to block the bill, which could prevent it from advancing given the party’s narrow 21-16 committee majority.
House Speaker Mike Johnson is attempting to navigate these internal GOP divisions. Hardliners are pushing for deeper Medicaid cuts, including accelerating work requirements from 2029 to as early as fall 2026, cutting off Medicaid access for undocumented immigrants immediately, and hastening the repeal of Biden-era tax credits. These changes could result in tens of billions in savings but also lead to quicker and deeper coverage losses, potentially before the 2028 election.
Moderates seem largely supportive of speeding up Medicaid requirements, with ongoing negotiations over provisions affecting food aid and state-level cost burdens. The legislation, central to former President Donald Trump’s agenda, remains in flux as Johnson engages with both conservative and moderate GOP factions.
The bill, part of Trump’s wider legislative agenda, faces internal Republican division—balancing conservatives seeking deep cuts and moderate members wary of political fallout. Democratic opposition centers on the real-world impact of these policies, pointing to past failures of similar work requirements in states like Arkansas and Georgia. The final outcome depends on intra-party negotiations and Senate dynamics, with opposition growing even among some Republicans like Senator Josh Hawley, who argues against cutting benefits for working-class voters.
The House Energy and Commerce Committee recently passed a budget-reconciliation bill that includes $880 billion in projected savings, with $715 billion coming from Medicaid reductions. The cuts, designed to avoid overt backlash, include mandatory work requirements, eligibility checks, restrictions on provider taxes, and new cost-sharing mandates, all of which are expected to reduce Medicaid coverage, affecting at least 10.3 million people, according to the Congressional Budget Office.
The legislation, known as the “One Big Beautiful Bill Act,” encompasses extensive tax cuts, spending reductions, border security enhancements, and policy changes across numerous sectors. The bill proposes over $5 trillion in tax cuts, including provisions to make permanent the 2017 individual income tax cuts, eliminate taxes on tips and overtime, and increase standard and child deductions. These cuts are partially offset by rolling back clean energy credits and increasing deductions for high-tax states.
The bill also allocates billions to revive Trump’s border wall, increase deportations, and fund a new missile defense system dubbed the “Golden Dome.” It overhauls student loan repayment plans, imposes taxes on university endowments, and expands fossil fuel extraction on public lands. Democrats oppose the bill, citing its extreme measures and potential harm to vulnerable populations.
