Trump's budget: Gutting Medicaid to pass tax cuts?

Republicans like House Speaker Mike Johnson are at war over how to 'slash the trillions in taxes and spending that Trump is demanding'

(Image credit: Anna Moneymaker / Getty Images)

By The Week US

published 22 April 2025

Republicans are at war over how to "slash the trillions in taxes and spending that Trump is demanding," said Russell Berman in The Atlantic. House Speaker Mike Johnson secured a win last week when the Republicans' budget framework squeaked through the lower chamber, setting up a final vote in coming weeks. But the "big, beautiful bill" that President Trump has asked for hangs on the support of the GOP's House hard-liners. They are demanding $1.5 trillion in spending cuts that "they believe they are on the verge of achieving." The Senate, which already passed its blueprint, set a minimum of just $4 billion in cuts, but Johnson promised a dozen House holdouts that the Senate would fall in line. One thing all the Republicans agree on is that they need to come up with a bill, or "Trump's 2017 tax cuts will expire, resulting in an across-the-board hike at the end of the year."

A central squabble is over Medicaid, said Ben Leonard and Meredith Lee Hill in Politico. The House Energy and Commerce Committee is tasked with finding $880 billion in cuts, and the healthcare safety net program falls under its jurisdiction. Additionally, GOP leaders are pushing the Agriculture Committee to cut $230 billion, potentially from SNAP, the largest food assistance program for low-income Americans. Fiscal hawk Chip Roy (R-Texas) said he reluctantly backed the framework after private promises of entitlement cuts. But other lawmakers, including heavy-hitting Trump allies like Sen. Josh Hawley, don't want to touch Medicaid. GOP hard-liners have been public about wanting to "gut the low-income insurance program," said Ellie Quinlan Houghtaling in The New Republic. But Johnson isn't ready to admit the "reality" that taking a chainsaw to Medicaid is the most plausible path to the cuts they want.

Some Republicans have floated "a tax increase on the rich," said Andrew Duehren in The New York Times. Extending Trump's 2017 tax cuts would cost a shiver-inducing $4 trillion. Bringing the top tax rate back to 39.6 percent from its current 37 percent would save $366 billion. Just don't count on Republicans suddenly rediscovering fiscal responsibility, said Andrew Egger in The Bulwark. In Biden's presidency, they repeatedly took "the nation to the brink of government shutdown or debt default, supposedly over its deep concern about deficit spending." Now they want to "blow a brand-new hole in the federal budget" by renewing the 2017 tax cuts, all the while "lying" to claim the tax cuts are free.