Senate Majority Leader Faces ‘Medicaid Moderates’ in Megabill Clash/ Newslooks/ WASHINGTON/ J. Mansour/ Morning Edition/ Senate Republicans face internal opposition over deep Medicaid cuts in the House-passed megabill. GOP moderates and fiscal hawks threaten to derail leadership plans ahead of July 4. Senate Majority Leader John Thune must balance competing demands to keep the package alive.
Medicaid Bill Showdown Quick Looks
- Senate GOP “Medicaid moderates” resist House-approved benefit cuts
- John Thune can only afford three GOP defections
- Provider tax freeze and work requirements spark internal rift
- Senators Josh Hawley, Lisa Murkowski, Susan Collins raise objections
- Rand Paul, deficit hawks demand deeper spending cuts
- Senate Finance Chair Crapo tries to manage growing discord
- Trump pressures GOP to stay united on budget and Medicaid
- Democrats plan procedural challenges to parts of the megabill
- Hearings begin this week for Trump’s fiscal 2026 budget
Deep Look: Senate Republicans Divided as Medicaid Cuts Trigger Backlash
WASHINGTON — June 2, 2025 — As Senate Republicans try to shepherd a massive budget and tax overhaul package to President Donald Trump’s desk before the July 4 recess, a growing number of GOP lawmakers are resisting one of its most controversial provisions: deep Medicaid cuts.
Senate Majority Leader John Thune (R-S.D.) is now confronting a bloc of influential “Medicaid moderates” — centrist Republicans uneasy with the House-passed version’s reductions to Medicaid funding and benefits. With a narrow GOP majority, Thune can afford to lose no more than three senators.
Key members of this moderate faction include Sens. Josh Hawley (Mo.), Lisa Murkowski (Alaska), and Susan Collins (Maine) — a diverse trio united in their concerns over the impact of proposed provider tax freezes and work requirements tied to Medicaid eligibility.
Medicaid Flashpoints Expose GOP Divide
Senate Finance Chair Mike Crapo (R-Idaho) is walking a political tightrope, managing a wide-ranging package that covers everything from tax reform to health policy. Crapo has expressed support for Medicaid work requirements, a feature championed by the House, but he has declined to publicly commit to the more aggressive structural cuts under fire from moderates.
One major point of contention is the House-approved freeze on provider taxes — a financial mechanism states rely on to fund their share of Medicaid costs. Former West Virginia Governor and now-Senator Jim Justice called it “a real issue,” while Sen. Kevin Cramer (N.D.) has gone even further, advocating for a complete rollback of the tax structure.
Deficit Hawks Demand Deeper Cuts
On the opposite end of the spectrum, fiscal hardliners like Sens. Rand Paul (Ky.), Mike Lee (Utah), Rick Scott (Fla.), and Ron Johnson (Wis.) are pushing for steeper spending reductions, despite Trump’s demands for party unity. Paul warned Sunday that the bill in its current form is unacceptable due to the debt limit hike it includes, threatening to derail it unless significant revisions are made.
“I would be very surprised if the bill at least is not modified in a good direction,” Paul said on CBS’ “Face the Nation,” hinting at the influence hardliners could wield in a narrowly divided Senate.
Political Landmines at Home
The political blowback over Medicaid is already surfacing back home. At a town hall last week, Sen. Joni Ernst (R-Iowa) faced fierce public criticism over the cuts. Her defiant “we’re all going to die” retort — and subsequent refusal to walk it back — sparked headlines and viral backlash, giving Democrats potent campaign material.
Trump Administration Pushes Forward
Despite the resistance, the Trump administration continues to back the bill. Centers for Medicare and Medicaid Services Director Mehmet Oz argued that the Medicaid changes would “future-proof” the program during a podcast interview with POLITICO’s Dasha Burns.
Trump, meanwhile, personally urged Sen. Paul to back the bill and reaffirmed his push for fiscal restraint, while signaling a willingness to impose party discipline if needed.
Democrats Prepare to Fight Back
Senate Democrats, led by Minority Leader Chuck Schumer, are preparing to challenge portions of the bill through procedural means. In a Sunday “Dear Colleague” letter, Schumer identified a controversial provision that would restrict judicial enforcement of contempt orders — a move critics say undermines judicial authority.
Democrats are expected to use the Senate parliamentarian to block several measures they argue violate legislative rules or constitutional norms.
Also on the Capitol Calendar This Week:
- Trump’s Fiscal 2026 Budget Faces Scrutiny
- The House Appropriations Committee begins marking up Trump’s fiscal 2026 proposal Thursday, starting with Military Construction, Veterans Affairs, and Agriculture. Trump’s budget seeks a 22% cut in non-defense spending, which Democrats have vowed to fight.
- Trump Officials Testify on Budget Plans
- Education Secretary Linda McMahon will appear Tuesday
- Acting FAA Administrator Chris Rocheleau testifies Wednesday
- Commerce Secretary Howard Lutnick is set for two days of testimony Wednesday and Thursday
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