WASHINGTON (States Newsroom) — The U.S. House committee tasked with overhauling energy policy and Medicaid to achieve $880 billion in spending cuts on Tuesday began what was expected to be a long, grueling session with debate on dozens of amendments.
Republicans on the panel argued during opening statements the proposed changes are necessary to realign several programs with President Donald Trump’s campaign promises and some long-standing GOP policy goals, primarily an extension of the 2017 tax cuts.
Democrats contend the legislation, one of 11 measures that will make up the GOP’s “big, beautiful bill,” would kick millions of people out of Medicaid, the state-federal program for lower income Americans, some people with disabilities and a considerable number of nursing home patients.
Energy and Commerce Committee Chairman Brett Guthrie, R-Ky., said the GOP bill is aimed at reducing waste, fraud and abuse within Medicaid “by beginning to rein in the loopholes, by ensuring states have the flexibility to remove ineligible recipients from their roles and removing beneficiaries who enrolled in multiple states.”
“We make no apologies for prioritizing Americans in need over illegal immigrants and those who are capable but choose not to work,” Guthrie said. “Our priority remains the same: strengthen and sustain Medicaid for those whom the program was intended to serve — expectant mothers, children, people with disabilities and the elderly.”
Democratic New Jersey Rep. Frank Pallone, ranking member on the panel, rejected comments that the GOP bill was “moderate” and said it clearly was not aimed at addressing waste, fraud and abuse.
“Medicaid is a life-saving program that 80 million Americans count on every day,” Pallone said. “It provides health care to 1 in 3 Americans and nearly half of all children in the United States. It covers close to half of all births. And it’s the largest source of funding for long-term care for seniors and people living with disabilities. With this bill, Republicans are essentially telling millions of Americans, ‘Gotcha, no more health care for you.’”
Pallone added that Republican lawmakers were “intentionally taking health care away from millions of Americans, so they can give giant tax breaks to the ultra-rich, who frankly don’t need them.”
Just before Pallone spoke, several protesters in the room, including at least three people in wheelchairs, began chanting “No cuts to Medicaid” and were led out by U.S. Capitol Police, who charged 25 people with illegally demonstrating in the Rayburn House Office Building.
Photos of constituents
Democrats gave numerous opening statements at the start of the markup, each holding up a large photograph of one of their constituents on Medicaid and sharing stories of how the program helped them get or keep access to health care after complex diagnoses, like congestive heart failure, leukemia and cerebral palsy.
Democratic lawmakers expressed concern those people would lose access to the health care program if the GOP bill becomes law.
“You don’t just gut the largest insurer of low income Americans without real harm,” said Illinois Democratic Rep. Robin Kelly. “Call it what it is — abandonment, disinvestment and pure disregard for human life.”
Florida Republican Rep. Kat Cammack rebuked some of the Democrats’ comments, which she said sought to fearmonger and lie to people about what was in the GOP bill.
“The posters that our colleagues on the left have held up are touching. The stories, they’re very emotional. And I agree that we want to protect those most vulnerable,” Cammack said. “As a pregnant woman, I want to make sure that pregnant women, expectant mothers have access to resources around the country.”
Cammack added that “not a single person in those posters is going to be impacted by this legislation.”
Floor action as soon as next week
Republicans have already approved eight of the reconciliation bills in committee and are scheduled to wrap up work on the remaining three measures this week. The Ways and Means Committee began debating the tax bill shortly after Energy and Commerce began its markup, and the Agriculture panel was scheduled to begin its debate Tuesday evening.
Later this week, the House Budget Committee plans to bundle all 11 bills together and send the full package to the floor. The entire House is set to vote on the legislation before Memorial Day.
GOP leaders cannot afford much disagreement over the entire package, given their paper-thin majority in the House. If all of the current members are present at the vote, just three Republicans can oppose the package and still have it pass.
The same margin exists in the Senate, which is expected to make substantial changes to the package should the House approve the measure and send it across the Capitol.
$880 billion cut
The Energy and Commerce Committee’s bill up for debate Tuesday met the panel’s goal of cutting at least $880 billion in federal spending during the next decade, according to a letter from the nonpartisan Congressional Budget Office.
Congress’ official scorekeepers, however, hadn’t released their full analysis of the panel’s bill before the start of the debate and amendment process, known in Congress as a markup.
Once those details are made public, lawmakers and the voters who elected them will have a much more detailed look at how each of the proposed changes will affect federal revenue, spending and the number of people who could lose access to Medicaid.
Democrats released a CBO analysis last week showing the impact of various proposals, though Energy and Commerce GOP staff cautioned Monday during a background briefing that what they proposed in the actual bill didn’t completely align with those scenarios.
The bill would make considerable changes to Medicaid if the House and Senate approve the legislation as written, which seems highly unlikely, given objections from several GOP senators, including Missouri’s Josh Hawley.
The House legislation would require able-bodied people between the ages of 19 and 65 to work, participate in community service, or attend an education program for at least 80 hours a month. There would be exceptions for pregnant people, Medicaid enrollees with dependent children and people with complex medical issues, among other exclusions.
That provision would take effect on Jan. 1, 2029, according to an explainer on the bill from nonpartisan health research organization KFF.
States would be required to check eligibility for all Medicaid patients every six months, lowering the threshold from one year for people eligible for the program under the expansion in the 2010 Affordable Care Act. That would need to begin by Oct. 1, 2027.
Republicans are seeking to get the 12 states that allow immigrants without legal status into their Medicaid programs to change course by lowering the percent the federal government pays for those states’ expansion population enrollees from 90% to 80%. That would take effect Oct. 1, 2027.
The legislation seeks to block Medicaid funding for a narrow subset of health care providers who offer abortion services, which appeared to target Planned Parenthood.
The prohibition would apply to “providers that are nonprofit organizations, that are essential community providers that are primarily engaged in family planning services or reproductive services, provide for abortions other than for Hyde Amendment exceptions, and which received $1,000,000 or more (to either the provider or the provider’s affiliates) in payments from Medicaid payments in 2024,” according to a summary of the GOP bill. It would take effect as soon as the bill becomes law and last for a decade.
The Hyde Amendment allows federal funding for abortions that are the result of rape, or incest, or that endanger the life of the pregnant patient.
Planned Parenthood, SBA Pro-Life react
Planned Parenthood Action Fund President and CEO Alexis McGill wrote in a statement that defunding the organization and overhauling Medicaid would mean that “cancers will go undetected; it will be harder than ever to get birth control; the nation’s (sexually transmitted infection) crisis will worsen; Planned Parenthood health centers will close, making it significantly harder to get abortion care; and people across the country will suffer — all so the supremely wealthy can become even richer.”
SBA Pro-Life America President Marjorie Dannenfelser applauded the potential change to federal funding.
“It’s time to stop forcing taxpayers to fund the Big Abortion industry. Thanks to Speaker (Mike) Johnson and Energy and Commerce Committee Chairman Brett Guthrie, this year’s budget reconciliation bill contains the commonsense language to make that happen,” Dannenfelser wrote. “Taxpayers should never be mandated to prop up an industry that profits from ending lives and harming women and girls.”
More than 80 organizations, including the National Women’s Law Center and the Center for Reproductive Rights, wrote in a letter to congressional leaders that cutting off Medicaid funding for Planned Parenthood “would be catastrophic, shutting down health centers and stripping millions of patients across the country of access to essential and affordable health care.”
“In many communities, Planned Parenthood health centers are the only affordable provider with expertise in sexual and reproductive health,” the organizations wrote. “For those communities, the gap left by Planned Parenthood health centers would mean that many patients would have nowhere to turn for care.”
President of the American College of Obstetricians and Gynecologists Stella Dantas wrote in a statement the GOP’s changes to Medicaid might create challenges for pregnant patients seeking to access care and that some states may roll back their expansion of postpartum coverage from a full year.
“Pregnant patients who keep their coverage under Medicaid will still face challenges accessing care as labor and delivery unit closures escalate as a result of Medicaid cuts, leaving patients to travel longer distances to give birth,” Dantas wrote. “Ob-gyns are also concerned that the cuts will threaten the 12 months of postpartum coverage that we have fought so hard to achieve, and which will leave so many without access to medical care during the year after delivery when two-thirds of maternal deaths occur.
“Backsliding on our recent progress in increasing access to postpartum coverage puts lives at risk.”
American Public Health Association Executive Director Georges Benjamin wrote in a statement that House Republicans’ planned overhaul of Medicaid “does nothing to improve public health.”
“Instead, it would undermine much of the progress we have made to expand access to affordable, quality health insurance and implement other evidence-based measures to protect the public’s health,” Benjamin wrote. “We urge the House to reject this bill and instead work in a bipartisan manner on legislation to improve public health and expand access to health care for all Americans.”
