Could Medicaid Cuts Lead Republicans to Break With Trump?
$880 billion in proposed cuts are making some GOP members of Congress very nervous.

At least one Republican is thinking about the millions of Americans that depend on Medicaid.
Representative David Valadao, a California dairy farmer, represents more Medicaid recipients in his district than anyone else in his party. He also appears to be one of the few Republicans working overtime to keep the fallout of his party’s Medicaid slashing spree to a minimum.
Valadao has spent weeks coordinating group chats with other concerned conservatives and lobbying leadership over the proposed cuts. He also led a letter protest signed by a dozen vulnerable Republicans opposing the bill, all in hope of steering the party’s cart in a different direction from the steep cuts.
“He’s got a very good sense of what Americans need out of their health care. I appreciate his leadership,” New York Representative Nick LaLota, another vulnerable Republican, told Politico Friday. The two, according to LaLota, are in constant communication. “He’s been clear in his communications: We shouldn’t be throwing people off Medicaid who are designed to be on the program.”
Pennsylvania Representative Rob Bresnahan, who similarly has a lot of Medicaid recipients in his district, described Valadao as a “total pillar” of the internal Medicaid debate. “He’s someone I immediately gravitated to,” Bresnahan told Politico. “Just a great sounding board.”
Republicans have spent months attempting to pencil out a $880 billion cut to the program in order to extend Trump’s 2017 tax cuts for corporations and billionaires in an effort to make the tax cut’s estimated $6.8 trillion deficit hike more palatable to their base.
But Valadao, for his part, knows that his political future depends on keeping his constituents happy. The lawmaker was one of many House Republicans to lose his job in 2018 after he voted to repeal the Affordable Care Act—a failed effort that would have stripped health insurance from millions of Americans.
By 2020, Valadao was back in office with a better grip on the stakes of the job. But this time around, Valadao and his cohort are already facing aggressive counter campaigns, featuring provocative TV ads and town hills that oppose the Republican-led cuts.
“We’re going through this partisan exercise to do what is supposed to be a tax bill, and it’s becoming a health care bill, which is what we’re trying to avoid, on an issue that desperately needs reform to make it better,” Valadao told Politico.
One much-discussed solution to square the Medicaid cuts is to make the program more exclusive by way of adding returning work requirements, which House Speaker Mike Johnson said in April would encourage young men to “be at work instead of playing video games all day.”
Republican proposals to introduce a work requirement to Medicaid have thus far asked recipients to navigate work-reporting and verification systems on a monthly basis—a detail that would require significant federal funding. The plans would also negate coverage for individuals who find themselves temporarily unemployed, such as those who were recently fired or laid off.
A February report by the Center on Budget and Policy Priorities found that introducing work requirements to the insurance program could strip upwards of 36 million Americans of their health coverage—half of Medicaid’s 72 million enrollees.