OPINION:
I am all about downsizing government and have spent a great deal of time and energy to that end in my 30-plus years in center-right politics and policy. Americans are staring down significant deficits and a national debt that exceeds $36 trillion. Republican cuts to some programs, however, should not be part of any plan to downsize government and would prove politically catastrophic. President Trump is known for being all over the place on many issues, but he has been rock solid on his refusal to entertain across-the-board Medicaid cuts.
Congress is working on a budget proposal that extends expiring provisions of his 2017 tax cuts and finds spending cuts to offset lost revenue. The cuts can be found, but looking at Medicaid is politically dangerous. Mr. Trump knows it, and all Republicans should know it.
That our soaring national debt is a crisis-level problem needing to be addressed is not debatable. As The Associated Press reported in early April, “the U.S. budget deficit has grown to more than $1.3 trillion in the first half of the 2025 fiscal year — the second highest six-month deficit on record, according to Treasury.” With deficits at record levels, it is understandable that Congress is looking for spending cuts to sell the Trump tax cuts. Voters, egged on by the media and comments by unscrupulous politicians, are beginning to fear that some of the targeted cuts are to programs they desperately need.
As the House Energy and Commerce Committee looks to advance its portion of House Speaker Mike Johnson’s proposed $880 billion spending cuts to Medicaid and Medicare, with markups expected next week, Capitol Hill Republicans are heading for a direct collision with Mr. Trump, who has repeatedly pledged to protect Medicaid from cuts. Last month, the president told Time magazine that he would veto such reductions. This confrontation highlights the increasingly precarious politics of Medicaid for the Republican Party.
Recent polling from Republican-aligned firms reveals a potential electoral time bomb associated with talk of Medicaid cuts that could threaten House Republicans’ majority in the 2026 midterm elections. These high-profile pollsters, whose key clients include Mr. Trump, would never release such consequential data if they were worried about offending the president. As such, the data’s release and promotion could indicate that Mr. Trump is looking to gently move House Republicans away from crazy talk.
To wit: A McLaughlin & Associates poll found that 88% of likely voters in 12 battleground congressional districts support Medicaid. Seventy-five percent had a favorable opinion of the program, and 62% said they were less likely to vote for a congressional candidate who supported cuts of up to $880 billion from Medicaid that would impact hospitals and all patients. A poll by Trump’s personal pollster, Tony Fabrizio’s firm, found that 61% of the president’s voters had a favorable view of Medicaid and 40% had a personal or family connection to Medicaid. This is strong evidence that Medicaid cuts are qualitatively politically insane.
Trump-friendly political analysts seem to have put out the word that Medicaid is off limits. Axios quoted a “key MAGA-world adviser” arguing that “if you talk to MAGA Republicans, no MAGA Republican wants to touch it. The only people who want to touch it are part of the old guard [Republican] establishment, who are becoming extinct.” This is strong evidence that if Congress rolls out these cuts, instead of focusing on memorializing key cuts related to the Department of Government Efficiency, they may well cut themselves out of their majority.
Seniors, who would be hardest hit by nursing home coverage reductions, vote at disproportionately higher rates in midterms. Last month, Rep. Mike Lawler, who represents New York’s Hudson Valley, became the 13th vulnerable House Republican to sign a letter opposing Medicaid cuts. The electoral danger signs are everywhere, and the smart Republicans are scrambling to avoid the baggage.
Democrats can take control of the House of Representatives by flipping just a handful of seats. The Senate may also be in danger if the midterm elections sweep Republicans out of power. The Trump agenda would be stalled for the latter two years of his presidency, and the Trump administration would be spending all its time dealing with subpoenas and investigations under Democratic rule. See what I’m getting at here, Republicans? Follow your leader here, heed the data and find your offsets somewhere other than Medicaid.
• Christian Josi is a veteran public affairs and media relations professional and a globe-trotting singer. He writes often for a variety of publications.
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