Trump, House GOP Meet to Discuss Whether to Cut Medicaid for Millions of Americans

US House Speaker Mike Johnson, a Republican from Louisiana, center, arrives for a House Republican caucus meeting at the US Capitol in Washington, DC, US, on Tuesday, April 8, 2025. House Republicans are anticipating a tense meeting this morning when Johnson pitches frustrated conservatives on a Senate-adopted framework for a tax and spending bill. Photo by Kent Nishimura /Bloomberg

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(Bloomberg) — President Donald Trump and House Republicans are slated to meet to wrangle over one of the thorniest issues dividing the party: whether to cut Medicaid benefits for millions of low-income Americans.

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House Speaker Mike Johnson and Representative Brett Guthrie, who chairs the committee that oversees Medicaid, are scheduled to meet with the president at the White House Thursday morning to discuss potential cuts to the health coverage program, a person familiar with the plan said.

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Tax issues are also on the agenda for the meeting, which will include Representative Jason Smith, chairman of the House panel that handles tax legislation, the person said.

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Republicans face wide divisions over whether — or how — to scale back Medicaid benefits in a tax cut bill being crafted in Congress. 

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Ultra-conservative Republicans have demanded Guthrie’s House Energy and Commerce Committee find $880 billion worth of savings in the legislation, a goal they can only meet if they cut federal medical coverage for low-income people. 

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Proposals to cut the program include shifting costs to the states either by instituting per capita spending caps, reducing federal matching support and limiting eligibility through work requirements that experts say will cause dis-enrollment of millions of recipients.

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Trump has said he would veto a bill that calls for benefit cuts in Medicaid, Medicare or Social Security, though suggested he would be open to measures that reduce “waste, fraud, and abuse” in the programs.

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House Majority Leader Steve Scalise said Trump is on board with work requirements for Medicaid recipients. 

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House Republican leaders also plan to confer with Trump on further cuts through per capita caps on federal dollars to state Medicaid programs and lowering the federal cost share, Scalise said. When asked if Trump is on board, he said that is a matter of discussion.

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Scalise said $880 billion will be achieved but it won’t be all from Medicaid. Some will come from spectrum sales and other regulatory changes, he said.

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The debate over Medicaid cuts pits hardline conservatives — who seek big spending reductions — against some House moderates and several Republican senators who have said they won’t support a bill that cuts critical programs for their constituents.

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The lack of consensus has the potential to slow down the passage of the bill that will extend Trump’s 2017 tax cuts and increase the debt ceiling. Republicans also have punted on a series of other difficult decisions including which of the president’s campaign pledges to enact in the bill and how much to increase the state and local tax deduction.

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Johnson has set a target of the end of May to pass the tax bill, while Senate Republicans have talked of being able to complete the process by August. The 2017 tax cuts don’t expire until the end of the year.

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