In 2018, Democrats regained control of the House by focusing on Republican efforts to overturn the Affordable Care Act. Now, as Republicans propose Medicaid cuts to finance tax reductions, Democrats see a similar opportunity. Senator Ben Ray Luján and Representative Hakeem Jeffries emphasize the public’s discontent over health care issues, recalling past successes. Ads targeting Republicans for potential $880 billion Medicaid cuts are already being launched. While some Republicans, like Senator Lisa Murkowski, warn of similarities to past failures, others stress the need for careful messaging. Discontent regarding Medicaid cuts could prove crucial in upcoming elections, especially for vulnerable representatives.
In 2018, Democrats reclaimed the House by flipping 41 seats, including in traditionally conservative areas like the suburbs of Utah and Oklahoma, by concentrating on a specific issue: Republican attempts to dismantle the widely supported Affordable Care Act.
Currently, as Republicans advance a budget resolution through Congress likely to necessitate cuts to Medicaid to fund a substantial tax reduction, Democrats perceive an opportunity to replicate their previous strategy.
“I’m unsure why Republicans are sticking to the same strategy,” stated Senator Ben Ray Luján from New Mexico, who chaired the House Democrats’ campaign committee in 2018.
“The town halls, the community engagements, the phone lines buzzing in Washington, D.C.,” Mr. Luján added, “I believe you can directly compare this to the outcomes we saw in 2018.”
During the initial weeks of President Trump’s second term, Democrats sought to identify their political targets amidst a relentless stream of executive orders and actions from Elon Musk’s Department of Government Efficiency aimed at weakening federal programs and dismissing government employees. They view potential cuts to Medicaid, which serves over 70 million Americans, as a defining issue that could reignite the enthusiasm that helped them regain power in 2018.
“The American people were outraged in 2005 when Republicans attempted to privatize Social Security. They were similarly frustrated in 2017 over Republican efforts to repeal the Affordable Care Act,” remarked Representative Hakeem Jeffries of New York, the Democratic leader, in an interview. “Now, constituents in my district are also very concerned about the Republican plan to strip away their health care and implement the largest cuts to Medicaid in history.”
He indicated that Democrats would persist in emphasizing the “clear distinction” they previously highlighted for maximum political impact.
They have already begun funding this message. The political action committee of House Democrats announced on Friday that they secured advertising slots in over 20 districts across the nation attacking Republicans for permitting $880 billion in Medicaid cuts.
“They said they’d reduce costs,” the narrator states. “Instead, Trump and Speaker Johnson are about to strip health insurance coverage from millions.”
In 2017, demonstrators flocked to Republican town halls nationwide, urging lawmakers not to vote to repeal the Affordable Care Act.
“When health care is concerned, all politics becomes personal,” said Representative Nancy Pelosi of California, the Democratic leader, the day after her party won back the House in 2018. “We created our own environment. While the G.O.P. sought to distract and divide, our candidates maintained focus on that critical issue.”
Recently, similar scenarios unfolded as lawmakers faced pressure from constituents regarding the extent of Mr. Trump’s proposed budget cuts. Republicans have dismissed these protests as orchestrated by liberal activist organizations, claiming they do not reflect typical voter sentiment.
Nonetheless, some Republicans, having witnessed the backlash firsthand, are advising their colleagues to refine their messaging.
Representative Rich McCormick from Georgia encountered constituents who shouted, jeered, and booed him at a recent town hall focused on the layoffs of federal employees and the Musk team’s access to taxpayer data.
“We have a message centered on preserving Medicaid and Medicare,” Mr. McCormick said, alluding to Mr. Trump’s promises to safeguard those programs. “However, you can undermine that message with a single misstep; we need to be cautious about how we communicate this to avoid appearing indifferent.”
Senator Lisa Murkowski from Alaska, who ultimately opposed the repeal effort in 2017, noted similarities between that push and ongoing attempts to cut Medicaid.
“It feels like we’re reverting to the days of the A.C.A., trying to explain to colleagues how Alaska is disproportionately affected,” Ms. Murkowski remarked.
House Republicans have yet to draft legislation that outlines specific spending cuts and tax reductions required to fulfill their budget plan. Speaker Mike Johnson has recently asserted their intention to seek “efficiencies” within Medicaid—“not cutting benefits for those who genuinely deserve it.”
“We don’t want able-bodied individuals on a program meant for single mothers with two small children just trying to get by,” Mr. Johnson said in a CNN interview. “That’s the purpose of Medicaid. Not for 29-year-old males lounging on their couches playing video games.”
He indicated that Republicans would not fundamentally alter the program’s structure, as some conservative factions have long proposed, nor would they impose a cap on federal Medicaid funding.
While many Republicans are amenable to implementing work requirements for the program, such a change is projected to save only about $100 billion. However, the House Republicans’ budget blueprint necessitates the committee overseeing Medicaid and Medicare to identify over eight times that amount in savings.
Reaching that savings goal, even among Republicans, will be incredibly politically complicated. Moreover, given that numerous states have expanded their Medicaid programs under the Affordable Care Act, such actions are likely to impact a large portion of the populace across various states.
“I won’t support Medicaid cuts,” expressed Senator Josh Hawley, a Republican from Missouri elected in 2018. “While work requirements are acceptable, 21 percent of Missouri residents rely on Medicaid or CHIP,” referring to the program providing health coverage options for children in families that earn too much to qualify for Medicaid.
Representative David Valadao of California, likely to feel pressure during this process, represents a district where nearly two-thirds of residents depend on Medicaid.
Since his election to Congress in 2012, he has successfully won re-election in every cycle except one—2018.
Before casting his vote to support the G.O.P. budget resolution this week, Mr. Valadao took to the House floor to articulate the stakes involved with potential cuts and to caution his party leaders. He stated that achieving $880 billion in budget cuts “is no easy feat.”
“I’ve heard from countless constituents who tell me that the only way they can afford health care is through programs like Medicaid,” Mr. Valadao added, “and I won’t endorse a final reconciliation bill that jeopardizes their access.”
“Cuts to Medicaid,” he concluded, “are exceedingly unpopular among American families who sent us here to act on President Trump’s agenda.”