House Budget Bill Could Slash Medicaid: How PA Delegation Voted

PENNSYLVANIA — The Pennsylvania delegation in the U.S. House backed a GOP budget blueprint Tuesday evening that calls for deep spending cuts, potentially including $880 billion to Medicaid, which 55 percent of their constituents rely on for health coverage.

The resolution was a crucial step toward delivering President Donald Trump’s “big, beautiful bill” with $4.5 trillion in tax breaks and $2 trillion in spending cuts. It narrowly passed on almost exact partisan lines, 217-215, overcoming a wall of opposition from Democrats and discomfort among Republicans. All Democrats and a single Republican — Congressman Tom Massie of Kentucky — voted against it.

The Pennsylvania delegation, which is comprised of 10 Republicans and 7 Democrats, voted 10-7 in favor of it.

• Brendan Boyle (D, 2nd) - No
• Robert P. Bresnahan, Jr. (R, 8th) - Yes
• Madeleine Dean (D, 4th) - No
• Christopher R. Deluzio (D, 17th) - No
• Dwight Evans (D, 3rd) - No
• Brian K. Fitzpatrick (R, 1st) - Yes
• Chrissy Houlahan (D, 6th) - No
• John Joyce (R, 13th) - Yes
• Mike Kelly (R, 16th) - Yes
• Summer Lee (D, 12th) - No
• Ryan Mackenzie (R, 7th) - Yes
• Daniel Meuser (R, 9th) - Yes
• Scott Perry (R, 10th) - Yes
• Guy Reschenthaler (R, 15th) - Yes
• Mary Gay Scanlon (D, 5th) - No
• Lloyd Smucker (R, 11th) - Yes
• Glenn Thompson (R, 15th) - Yes

Some Republicans downplayed the potential harms of the budget and noted that there will likely be several iterations of the bill that go back and forth between the House and Senate before a final version is passed.

"The word Medicaid is not mentioned or addressed anywhere in this procedural bill," Bucks County's Rep. Fitzpatrick, one of the more moderate Republicans in the Pennsylvania delegation, said in a statement after the vote. "We will continue to keep a close eye on these deliberations as they continue, to ensure that the interests of our PA-1 community are protected."

Montgomery County's Rep. Dean said the budget placed many of Pennsylvania's residents at risk.

"(The budget) prioritizes the wealthiest and hurts our most vulnerable," she said.

The potentially largest cut to Medicaid in U.S. history could be a sticking point for some moderate Republicans in the long, cumbersome process ahead to pass the budget. That includes weeks of committee hearings to draft the details and send the House version to the Senate, where Republicans passed their own scaled-back version.

"The House Republican budget resolution will set in motion the largest Medicaid cut in American history,” House Minority Leader Hakeem Jeffries, D-N.Y, said after the vote.

Medicaid is the primary comprehensive health and long-term care program used by 1 in 5 Americans, and accounts for nearly $1 out of every $5 spent on health care, according to KFF (Kaiser Family Foundation), an independent provider of health policy research, polling and news.

Even as they press ahead, Republicans are running into a familiar problem: Slashing federal spending is typically easier said than done. With cuts to the Pentagon and other programs largely off limits, much of the other government outlays go for health care, food stamps, student loans and programs relied on by their constituents.

Several Republican lawmakers worry that scope of the cuts being eyed — particularly some $880 billion over the decade to the committee that handles health care spending, including Medicaid, for example, or $230 billion to the agriculture committee that funds food stamps — will be too harmful to their constituents back home.

GOP leaders insist Medicaid is not specifically listed in the initial 60-page budget framework, which is true; the proposal directs the House Energy and Commerce Committee, which oversees Medicaid, to cut $880 billion in spending over the next decade.

Medicaid is a valued safety net program, according to a recent KFF poll that showed 77 percent of Americans and 84 percent of Medicaid recipients view it favorably. Nearly half (46 percent) and two-thirds of Medicaid enrollees believe the federal government isn’t spending enough on the program, according to the poll.

According to data from KFF, Medicaid and CHIP (Children’s Health Insurance Program), of Medicaid recipients nationwide:

• 82 percent have children living below the poverty level;
• 62 percent are people living in nursing homes;
• 41 percent are pregnant women giving birth;
• 39 percent are children;
• 31 percent are non-elderly adults with disabilities;
• 19 percent are Medicare recipients.

More big votes are ahead, including an unrelated deal to prevent a government shutdown when federal funding expires March 14. Those talks are also underway.

It’s all unfolding amid emerging backlash to what’s happening elsewhere as billionaire Trump adviser Elon Musk is tearing through federal agencies with his Department of Government Efficiency firing thousands of workers nationwide, and angry voters are starting to confront lawmakers at town hall meetings back home.

During debate Tuesday, Democrats decried the package as a “betrayal” to Americans, a “blueprint for American decline” and simply a “Republican rip-off.”

“Our very way of life as a country is under assault,” House Democratic Leader Hakeem Jeffries said Tuesday. But as the minority party, they don’t have the votes to stop it.

Although the blueprint ultimately passed, some Republicans said they want assurance that Medicaid will be protected as the House version takes shape and is merged with the Senate proposal. Rep. Mike Lawler (R-New York) said Trump has promised he would not allow Medicaid to be cut.

“The president was clear about that. I was clear about that,” Lawler said. “We will work through this, but the objective today is to begin the process.”

“While we fully support efforts to rein in wasteful spending and deliver on President Trump’s agenda, it is imperative that we do not slash programs that support American communities across our nation,” Rep. Tony Gonzales (R-Texas) wrote in a letter signed by several other GOP lawmakers from the Hispanic Conference. Another member of the Hispanic Caucus, Rep. Juan Ciscomani (R-Arizona), also raised concerns about protecting Medicaid, food stamps and Pell grants for college.

Some GOP deficit hawks withheld support until they were convinced the $4.5 trillion in tax cuts for wealthy Americans wouldn’t add to the nation's $36 trillion debt load. Massie, the lone Republican voting against the blueprint, wrote on X that it “extends the 5 yr. tax holiday we've been enjoying, but because it doesn’t cut spending much, it increases the deficit by over $300 billion/yr. compared to letting tax cuts expire. Over 10 years, this budget will add $20 trillion to US debt.”

The Associated Press contributed reporting.