LEILA FADEL, HOST:
House Republicans will vote this week on a couple of President Trump's biggest campaign promises. A budget resolution will advance border security funding and extend Trump's first term tax cuts. It also calls for up to $2 trillion in spending cuts over 10 years.
A MARTÍNEZ, HOST:
And GOP leaders plan to take a significant amount from Medicaid, the health care program for low-income elderly and disabled Americans. Almost 80 million Americans are enrolled in Medicaid or related programs. Not all Republican lawmakers, though, are on board. NPR congressional correspondent Deirdre Walsh reports on the split.
DEIRDRE WALSH, BYLINE: President Trump insisted recently on Fox News a budget bill should not touch Medicaid.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: Medicare, Medicaid, none of that stuff is going to be touched.
SEAN HANNITY: Nothing...
WALSH: But the next day, the president embraced the House Republicans proposal that is expected to include more than $800 billion in cuts over a decade to the largest health insurance program in America. House Speaker Mike Johnson says cutting benefits is not on the table, but he says reforms are needed.
MIKE JOHNSON: Medicaid is infamous for fraud, waste and abuse.
WALSH: And a White House spokesman opened the door to changes, telling NPR in a statement, the administration is committed to protecting Medicaid while slashing waste and improving efficiency. Conservatives like House Freedom Caucus chair Andy Harris say Medicaid should limit how much the federal government pays to each state for each beneficiary. He supports attaching work requirements for adults not caring for small children.
(SOUNDBITE OF ARCHIVED RECORDING)
ANDY HARRIS: I think the American people do believe that able-bodied people who get welfare benefits in this country actually should be asked to work, train for work, go to school.
WALSH: But some Republicans are warning they may oppose the budget if it impacts programs like Medicaid. Pennsylvania freshman Rob Bresnahan released a statement after the House Budget panel adopted its resolution warning, quote, "if a bill is put in front of me that guts the benefits my neighbors rely on, I will not vote for it." And he added, "these benefits are promises that were made to the people of Northeastern Pennsylvania, and where I come from, people keep their word."
One left-leaning nonprofit called Protect Our Care unveiled ads targeting Bresnahan and other swing district Republicans. Their ad says how many people in Bresnahan's district could be impacted.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED NARRATOR: Over 229,000 of us in our community can have our health care ripped away. We're talking veterans, seniors, kids with disabilities, everyday working people.
WALSH: One pollster who worked for Trump's campaign released a survey last week in swing House districts, showing both Trump and swing voters back tax policies that keep tax credits to help pay for health care.
In a red district in suburban Atlanta, Georgia Republican Rich McCormick encountered pushback in a town hall where he argued entitlement programs needed reforms to reduce the deficit. A reporter from the Atlanta Journal-Constitution posted an exchange on social media.
(SOUNDBITE OF ARCHIVED RECORDING)
RICH MCCORMICK: If you don't do something with Social Security, Medicare or Medicaid, which is 75% of our budget is mandatory spending...
(CROSSTALK)
MCCORMICK: Seventy-five percent.
UNIDENTIFIED PERSON: No, it isn't.
MCCORMICK: Google it right now.
WALSH: Earlier this week, a group of Republican Hispanic lawmakers and those with large numbers of Latino constituents, sent a letter to the speaker, warning Medicaid cuts would have serious consequences.
Liam Donovan, a GOP strategist who worked for the Senate Republican Campaign Committee, notes Trump created his own lane when he ran for president, breaking with others in his party who argued these federal programs needed to be reformed.
LIAM DONOVAN: He understood that there is a popular market among your average voters, and even your average Republicans, that doesn't want to touch those things.
WALSH: The House is slated to vote on the budget this week, and Speaker Johnson can only afford to lose one vote. And how Republicans address Medicaid could be the deciding factor on whether the president's border security funding and tax cuts move forward.
Deirdre Walsh, NPR News, the Capitol.
(SOUNDBITE OF TORTOISE'S "TNT") Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
