House Passes Trump's Reconciliation Bill After Shoving In Larger Medicaid Cuts At Last Minute

Yahoo

22-05-2025

After weeks of intraparty fighting, House Republicans passed the reconciliation package that addresses President Donald Trump's fiscal agenda in a largely party line 215-214 vote early Thursday morning.
Reps. Thomas Massie (R-KY) and Warren Davidson (R-OH) voted against the bill, joining all Democrats in opposing the package.
House Freedom Caucus Chair Andy Harris (R-MD) voted 'present,' a decision that lowered the threshold for the 'yes' votes needed by Republicans in order to pass it out of the lower chamber.
'I voted to move the bill forward along the process,' Harris said, according to Punchbowl. 'I don't think it was completely where I would need it to be. But it was a vote to move along. Obviously if I voted no, it would've gone nowhere today.'
Meanwhile, Reps. David Schweikert (R-AZ) and Andrew Garbarino (R-NY) did not vote. Garbarino reportedly fell asleep and missed the vote after sitting through proceedings all night.
The massive reconciliation package — which already included massive cuts to Medicaid and the popular food assistance program SNAP, as well as tax cuts that will largely benefit wealthy Americans — got a makeover on Wednesday largely to appease the far-right members who were threatening to sink the bill.
Notably, leadership made substantial changes to the Medicaid portion of the bill overnight.
The new text moves up the start date of Medicaid work requirements from Jan. 1, 2029 to Dec. 31, 2026. That was one of the demands members of the Freedom Caucus had been pushing since last week.
The bill already included a provision that banned coverage of gender-affirming care for minors. The new text extends that ban to adults under the program as well. Republicans also expanded the criteria for a provision that could cause states to lose a portion of the funds they receive through the federal matching rate if they offer coverage to undocumented immigrants.
Another notable change is expected to incentivize states not to expand their programs under the Affordable Care Act. A newly added measure would give states a financial incentive not to expand coverage outside of the traditional enrollees, making higher payments to providers, like hospitals, for uncompensated care.
The passage of the One Big Beautiful Bill Act comes after two obstinate factions of the House GOP caucus spent the past several weeks refusing to come together and support the package without assurances their competing demands would be met.
A group, largely made up of members of the House Freedom Caucus, had been pushing for steeper spending cuts and calling for leadership to move up the date for when Medicaid work requirements outlined in the legislation would kick in. Simultaneously, another group of largely blue-state Republicans have been unhappy with leadership's state and local tax (SALT) offer, as well as provisions of the bill that would slash Medicaid.
House Republican leadership had been working with both sides to get everyone in line ahead of their self-imposed deadline: passing the bill out of the lower chamber by Memorial Day.
But they had to call in the real leader of the House Republican conference this week to ultimately pull that off.
On Tuesday morning, Trump attended a closed-door House Republican conference meeting in an attempt to strongarm both groups into accepting the offers they have received from leadership. He even called out a handful of Republicans by name during the meeting, telling them to get in line or else.
A handful of members came out of that meeting signaling to TPM and other reporters outside the room that the President had made significant progress with holdouts on both sides of the spectrum. But others also acknowledged more time was likely needed for negotiations.
That same night, House Speaker Mike Johnson (R-LA) and the blue-state Republicans reached a tentative deal on SALT as the Speaker agreed to boost the cap on state and local tax deductions to $40,000 for taxpayers making below $500,000 in the reconciliation package.
That agreement, which was endorsed by Trump, triggered a rebellion from far-right members who had been calling for steeper cuts to lower the deficit.
Johnson and House Freedom Caucus members went to the White House on Wednesday afternoon to work through their issues with Trump. That meeting and continued negotiations led to some of the major last minute revisions.
The bill will head to the Senate next where it is expected to face its own challenges.
Sen. Ron Johnson (R-WI) has already said he is a 'no' on the bill in its current form, as it does not do enough to address the deficit. And Senate Republican leadership is considering taking the House's package and chopping it up into pieces to make it easier to pass.
Johnson reportedly warned Senate Republicans against making major changes to the bill, as he barely whipped the votes he needed to pass it in the lower chamber. Any major changes might not withstand a second House floor vote.