The House and Senate still have their different versions of the reconciliation resolutions. To use reconciliation, the House and the Senate must agree on a single approach, and they are negotiating. Republican Leadership will have to walk a line between factions that don’t think the proposed cuts to Medicaid went far enough and those that are concerned about the impact of Medicaid cuts on their constituents and the states they represent. The next step is for the Senate to take up the House-passed budget, likely making amendments, which may happen in late March, after the joint recess.

Republicans are feeling the pressure. Medicaid is popular, among both Trump and Harris voters, and Republicans do not want to admit that they are voting to take health care away from people. We have heard repeatedly that some Republican House staff are telling constituents and advocates that they did not vote to cut Medicaid, but instead merely voted to start the reconciliation process. Make no mistake–the Congressional Budget Office (CBO) recently released a report confirming that the House budget resolution would require deep cuts to Medicaid. 

Meanwhile, over the last two weeks, state and local officials have raised alarm over the impact of proposed Medicaid cuts, driving home that Medicaid is not a red state, purple state, blue state issue, and that federal cuts to Medicaid create huge budget holes that states cannot fill.