In a strategic move, Speaker Mike Johnson, R-La., is actively seeking to reconcile two opposing factions within the House that are proving to be significant obstacles to advancing a substantial bill aligned with President Donald Trump's agenda. These factions consist of blue-state Republicans advocating for increased tax breaks for their constituents and conservatives pushing for expedited cuts to Medicaid. During a press conference on Wednesday, Johnson hinted at the possibility of incorporating provisions for a higher state and local tax (SALT) deduction and implementing new Medicaid work requirements sooner than planned, as he faces a self-imposed deadline of Memorial Day weekend for passage of the bill.
“I am convinced that we’ll be able to adjust the dial, so to speak, so that we can come to an agreement that will meet the criteria that everybody has and that we can move this thing forward,” Johnson stated after discussions with both pro-SALT Republicans and members of the hard-right Freedom Caucus. He emphasized the importance of balancing the interests of both factions, stating, “If you do more on SALT, you have to find more savings. So these are the dials, the metaphorical dials, that I’m talking about.” Johnson reaffirmed the commitment to a deficit-neutral approach, a core promise made by Republican leadership.
When queried about the possibility of accelerating the Medicaid work requirements to achieve larger savings in a revised plan, Johnson responded, “Everything is on the table.” This approach may appeal to conservative hard-liners who are insisting that new work requirements for Medicaid recipients begin sooner than the initially proposed 2029 timeline. Rep. Tim Burchett, R-Tenn., remarked, “That is the compromise that could work,” indicating a potential path forward.
Despite lingering uncertainties, Republicans have made steady progress on the legislation this week. Currently, eleven House committees have successfully passed their sections of the bill, which are now being compiled by the Budget Committee into a cohesive package. Given the narrow margins in the House, Johnson can only afford three Republican defections on the final vote. This reality amplifies the influence of smaller factions like the SALT Caucus, whose members often represent critical battleground districts that could determine the outcome of the next election.
However, the strategy of accelerating Medicaid cuts poses risks. Politically vulnerable Republicans may resist such measures, especially in light of the backlash surrounding existing spending reductions and limits to the healthcare program. As negotiations continue, Johnson anticipates that discussions will extend into the weekend, even as he remains committed to meeting the Memorial Day deadline for passing the comprehensive tax cuts, energy, and border package through the House.
Throughout the week, tensions within the House GOP have escalated over the SALT issue, with some pro-SALT members expressing hesitance about accepting a proposal to raise the current $10,000 cap to $30,000. Nevertheless, moderates and conservatives emerged from Johnson’s office following a two-hour meeting, reporting a positive atmosphere with no red lines established by either side. Rep. Mike Lawler, R-N.Y., a SALT Caucus member, commented, “The bottom line is, a higher SALT cap is going to be in the bill, and we’re going to work through it.”
Conversely, Rep. Byron Donalds, R-Fla., a member of the Freedom Caucus, cautioned that while increasing the SALT cap may be favorable for some, it necessitates finding additional funding elsewhere. This dilemma creates a complex situation for House Republicans. While deeper Medicaid cuts and a higher SALT deduction might satisfy certain hard-liners and blue-state members, they could also alienate other politically vulnerable members who fear the repercussions of such decisions.
Despite avoiding the most severe potential cuts to the healthcare program, the current proposal is projected to result in 8.6 million individuals losing their insurance coverage, as per an early estimate by the nonpartisan Congressional Budget Office. It remains uncertain whether Johnson has the necessary votes to pass the existing Medicaid cuts, which encompass new work requirements and stricter eligibility checks that critics argue will impose undue burdens on deserving recipients.
Reps. David Valadao, R-Calif., Rob Bresnahan, R-Pa., and Don Bacon, R-Neb., represent some of the most vulnerable GOP-held districts and are closely evaluating the impact of the Medicaid provisions. Valadao, who has the highest percentage of Medicaid recipients in any GOP district, stated he has yet to review the details, saying, “We’re still getting through it and seeing the actual impact.” Meanwhile, Bacon indicated he would be “amenable” to adjusting the timeline for when Medicaid provisions take effect.
Democrats are closely monitoring the situation, with Justin Chermol, a spokesperson for the Democratic Congressional Campaign Committee, criticizing Republican moderates for their previous assurances against cuts to Medicaid. Chermol stated, “The self-described moderates spent months falsely promising the American people they would draw a red line on cuts to Medicaid. Now they want to trigger these cuts before the midterms? Good riddance.”
On the conservative side, some members express hesitance about increasing SALT relief for residents in high-tax blue states. Rep. Beth Van Duyne, R-Texas, a fiscal hawk, conveyed skepticism regarding the feasibility of raising the SALT cap. In contrast, Rep. Anna Paulina Luna, R-Fla., who was not present at the meetings, suggested that achieving a resolution would largely depend on former President Trump’s influence in the negotiations, stating, “If we do land the plane, it’ll be because” of Trump.
