Trump Blindsides Staff, Congress With Conflicting Medicaid Messages
Republicans are getting worried about how much they’ll have to cut from the popular health safety-net program, and whether the president will protect them from political blowback.
By Ben Leonard, Adam Cancryn and Robert King Politico February 19, 2025
President Donald Trump surprised some of his own staff Wednesday when he endorsed a House budget that would gut Medicaid, hours after pledging that the safety net program “isn’t going to be touched.”
The comments sent aides scrambling to figure out what Trump meant and which Medicaid cuts he would be willing to accept, according to three people granted anonymity to discuss the action happening behind closed doors. The potential Medicaid reductions — an option to help pay for Trump’s wide-ranging tax, energy and border agenda — are triggering a backlash from Republican lawmakers whose constituents rely on the program.
Trump’s seemingly contradictory comments — shared in a Fox News interview Tuesday evening and then Truth Social Wednesday morning — are also fueling confusion and concern among Republicans on Capitol Hill, who are looking to him for political cover as they contemplate a potentially risky vote
“You’ve got to look at if it is worth the political struggle to do it,” Republican Sen. Chuck Grassley of Iowa said in an interview. “Entitlements are difficult to deal with.”
Sen. Josh Hawley, a Missouri Republican, said he has “concerns” about “the House’s proposal for very deep cuts to Medicaid.”
As Medicaid has expanded in more red states under the Affordable Care Act and the Republican Party has become more populist, its voter base is increasingly reliant on the program, which provides health care to lower-income Americans of all ages.
On Wednesday, the White House appeared to add a new wrinkle by indicating Trump may also be open to altering elements of Medicare — the popular health care program for older Americans he’s repeatedly promised to preserve.
“The Trump administration is committed to protecting Medicare and Medicaid while slashing the waste, fraud, and abuse within those programs — reforms that will increase efficiency and improve care for beneficiaries,” White House spokesperson Kush Desai said in an initial statement to POLITICO.
But after this article was published, Desai sent an updated statement that omitted the mention of Medicare, instead saying only that the administration sought to protect Medicaid “while slashing the waste, fraud and abuse within the program.”
The flurry of pronouncements threatens to further complicate a major legislative push meant to serve as the centerpiece of Trump’s agenda in his first 100 days in office.