The GOP megabill is undergoing some significant changes in the House as conservative hard-liners, moderates and blue-state Republicans all angle to shape the bill to their liking ahead of a potential floor vote this week.
Conservatives are still pushing for controversial changes to the federal share of Medicaid payments, which could lead to major benefit cuts, but House Republican leadership, moderates and the White House are all still resisting that effort, according to two Republicans granted anonymity to describe the private talks. Medicaid work requirements, though, are expected to be phased in two years, addressing the hard-liners’ push to speed up the previously planned 2029 implementation.
The draft bill, however, includes multiple waivers of those provisions that states can pursue, and those waivers are not expected to substantially change, the Republicans said.
Hard-liners also secured a rough agreement from the speaker over the weekend to speed up the phase-out of clean energy tax credits enacted under former President Joe Biden, though the parameters of how quickly that happens are still a major fight inside the GOP conference. One of the biggest battles is over whether so-called shovel-ready projects will be hit, as hard-liners are pushing for.
Some Republicans bristled at the weekend changes the speaker green-lit. Reps. Andrew Garbarino of New York and Mariannette Miller-Meeks of Iowa, who have been defending many of the tax credits, were both at Pope Leo XIV’s inauguration as GOP leaders agreed to some of hard-liners’ demands to scale them back.
Lawmakers are still negotiating over the cap on the state-and-local-tax deduction, or SALT — a major issue for a group of blue-state Republicans. House Speaker Mike Johnson will meet Monday night with moderates concerned about changes to Medicaid, SALT and federal pensions.
On a call with GOP lawmakers Monday morning, Johnson characterized the latest changes as minor and “technical,” according to two people granted anonymity to describe the private call.
Republican leaders have also changed language in the draft bill before the House Rules Committee that would have barred legal immigrants from receiving SNAP food aid, with significant carve-outs for Cuban nationals that some Florida members had requested. Rep. Don Bacon (R-Neb.) and other centrist Republicans pushed leadership to allow more legal immigrants to receive SNAP. Senate Republicans also made clear the ban in the draft bill would not pass muster in their chamber.
That copy of the bill before the Rules panel — which is set to meet at 1 a.m. Wednesday to take it up — also makes other changes to controversial new cost-sharing requirements for some Medicaid beneficiaries. Those would require some beneficiaries in states that have expanded Medicaid under the Affordable Care Act to pay up to $35 per service.
The initial bill did not have explicit carve-outs for certain types of care despite a committee summary saying that the legislation would have exemptions for primary, prenatal, pediatric and emergency room care. The new version exemption applies to primary care, mental health and addiction treatment.
A GOP Energy and Commerce Committee spokesperson said the changes to the language around the exemptions were to clarify what the bill does.
The new version also omits a Government Accountability Office study on how pharmacy benefit managers, pharmacies, and drugmakers get paid in the prescription drug supply chain. It also removes clawbacks of unobligated funds for a slew of Energy Department programs, including more than $400 million for the Office of Energy Efficiency and Renewable Energy and $8 million for the inspector general.
