The White House is pushing back on concerns that President Donald Trump‘s “one big, beautiful” tax-and-spending bill will make unpopular cuts to Medicaid.
“The president wants to preserve and protect Medicaid for Americans who this program was intended for, the most vulnerable in our society — pregnant women, low income families, seniors, those who truly need these benefits — and it should be going to people who physically cannot work,” White House press secretary Karoline Leavitt told reporters on Monday.
Per Leavitt, Trump would like “to see able-bodied Americans at least working 20 hours per week, whether that’s part-time or full-time.”
“Whether that’s even looking for work or volunteering for 20 hours a week, if they are receiving Medicaid,” she said. “These are common-sense reforms to ensure those that this program was intended for receive those benefits.”
Republican policy regarding Medicaid is one area of disagreement among House GOP lawmakers as the conference continues to negotiate legislation that would enact Trump’s priorities, including tax cuts to immigration programs, into law.
Fiscal conservatives blocked a bill from being approved by the House Budget Committee last Friday before four changed their votes to present on Sunday so that the House Rules Committee could consider the measure on Wednesday. House Speaker Mike Johnson (R-LA) reportedly offered to fast-track new Medicaid work requirements from 2029 to 2026 in exchange for their tentative support.
When asked on Sunday, Johnson wouldn’t provide details on the changes made with fiscal hawks when asked about the 2026 date, but indicated there was broad support to push the date up.
“I think it’s the desire of every Republican, always has been, to make work requirements real and actionable as soon as possible,” Johnson said. “We learned in the process that some of the states needed a longer lag time to add in the implementation of the new policy. So we’re going to … make it happen sooner, as soon as possible. And I think that’s a good change in the policy.”
Republican leadership aides similarly told reporters Monday that they are looking to move the date up “as soon as it is feasible.” However, discussions are still ongoing.
At the same time, more centrist Republicans have concerns about the politics surrounding reforming the entitlement program, as fiscal conservatives encourage Johnson to go even further. For example, they are trying to change Federal Medical Assistance Percentages that determine how much the federal government makes in Medicaid payments to states.
Simultaneously, some more centrist Republicans hope to increase the cap on the state and local government tax deduction, undermining the fiscal conservatives’ overriding goals of decreasing the deficit.
During her opening remarks, Leavitt told GOP members that “it’s essential that every Republican in the House and the Senate unites behind President Trump and passes this popular and essential legislative package.”
“It represents a once-in-a-generation opportunity to deliver on the Make America Great Again agenda responsible for President Trump’s landslide victory on Nov. 5,” she said. “The America First policies in this bill are the reason why Republicans currently have the majority in Congress right now.”
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Regarding Trump’s negotiation strategy, Leavitt added that the president “was in direct conversation and communication with the speaker of the House” last weekend.
“He’s been very involved,” she said. “He always is. He’s willing to pick up the phone when he is asked to, so he’ll continue to be very engaged in this process with both House members and his friends on the Senate side as well.”
Rachel Schilke contributed to this report.