On Episode 20 of the Progress Pondcast, we talked to Mark Stier, the Executive Director of the Pennsylvania Policy Center, who has been working diligently to fight against the Medicaid cuts the Republicans want to use to pay for the tax, energy and immigration policies in Donald Trump’s “Big, Beautiful” reconciliation bill. It was a very informative and prescient discussion about the congressional GOP’s coming attempt and why we have a chance to stop them.

Stier told us that 65 percent of Americans will be on Medicaid at some point in their lives, often not for very long, and they generally love it. It’s a very popular program, and polling has consistently showed that the public is vociferously opposed to major cuts to the program.

I’ve also written several pieces on this issue this year, including Day 23: The Fascist Regime and House Budget Committee are Coming for Medicaid on February 13 and The GOP is Waddling Toward a Medicaid Buzzsaw on April 27th.

With all that predication, hopefully you won’t be surprised by the Wednesday’s reporting from Roll Call. It appears the congressional Republicans hit a brick wall.

The reconciliation process is mind-numbingly complicated and writing about it is correspondingly laborious. I hate having to explain the basic difficulties in every piece I write about it, so I’m going to speed through this and ask that you use some of the above links to answer any additional questions you might have.

What you need to know is that the Republicans passed a budget outline in both the House and Senate that specifies how much money needs to be cut from the budget to pay for Trump’s priorities, which includes an extension of his 2017 tax cuts that heavily favored the rich. Responsibility for finding the cuts is delegated to congressional committees which are given minimum targets they must reach. For the House Agriculture Committee this is $230 billion over ten years. For the House Energy & Commerce Committee this is a whopping $880 billion over ten years.

That’s a lot of money and these (and other) committees can only cut from programs that are within their jurisdiction. The Agriculture Committee has jurisdiction over the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps. The Energy & Commerce Committee has jurisdiction over Medicaid. Both programs have therefore been under attack.

As Stier explained on our podcast, the Energy & Commerce Committee was inevitably going to come after the Federal Medical Assistance Percentage, or FMAP, which is “the portion of state Medicaid costs borne by the federal government for the Medicaid expansion population, which is currently 90 percent.” The so-called “Medicaid expansion” is a key component of the Affordable Care Act. It incentivizes the states to participate in Obamacare, and it worked. Forty states plus the District of Columbia adopted Obamacare and receive the 90 percent federal cost sharing. Ten heavily Republican states do not.

Several states put a caveat in their agreement to participate which was that they would opt out or make other adjustments if the federal government ever reduced the 90 percent rate. So any reduction would immediately and directly cost countless people their health insurance. Countless more would see their insurance come under threat, and states that continued to participate would be forced to find hundreds of billions of dollars in the budgets to fill the hole, which would come primarily from higher taxes and/or cuts to education.

Repealing Obamacare might sound good to some people in the abstract, but it isn’t an easy or popular thing to do. The same can be said for kicking people off food stamps. But to reach the $230 and $880 billion targets, respectively, the Agriculture and Energy & Commerce committees had little choice but to seek these cuts.

But they’ve given up.

On the Medicaid front, they now realize that they don’t have the votes to mess with FMAP. They also can’t find the votes for another idea they had which would have punished just the states that participate in Obamacare.

Republicans will have to come up with alternative savings to make up for hundreds of billions of dollars in potential Medicaid cuts that GOP leaders appeared to rule out after meeting with moderates in Speaker Mike Johnson’s office Tuesday evening.

Johnson, R-La., said leadership had ruled out two Medicaid policies that could go a long way toward meeting the Energy and Commerce Committee’s $880 billion, 10-year savings target but faced strong pushback from blue-state GOP centrists.

First, Johnson said the emerging package wouldn’t touch the Federal Medical Assistance Percentage, or FMAP, rate — the portion of state Medicaid costs borne by the federal government — for the Medicaid expansion population, which is currently 90 percent.

Johnson also poured cold water over a provision that would implement per capita caps on Medicaid benefits for enrollees in expansion states, though he wasn’t quite as definitive on that front.

“I think we’re ruling that out as well, but stay tuned,” he said.

On the SNAP front, the Agriculture Committee discovered its plan to target overpayment errors is inoperable:

Meanwhile, the House Agriculture Committee, which is tasked with finding $230 billion in 10-year savings, is having its own problems coming up with the money.

Republicans on that panel met Tuesday morning to hash out SNAP cuts, particularly a controversial proposal to introduce a state-match requirement similar to how Medicaid operates. [Rep. Derrick] Van Orden [of Wisconsin] has been a vocal opponent of the idea, which he says would force states like Wisconsin to subsidize other states with much higher overpayment error rates.

“I want to be explicitly clear, I will not vote to have the citizens of the state of Wisconsin pay 10 percent cost share to make up for other people’s just blatantly horrible management,” Van Orden said. “The only thing that’s acceptable to me is to tie it directly to the state error rate. Period.”

To make matters even clearer, opposition to the Medicaid cuts, in particular, are coming not just from moderate or endangered Republicans but also from the MAGA base. Laura Loomer, for example, is arguing that the proposals are “a shocking betrayal of President Donald Trump’s unwavering commitment to America’s working-class families, and his promise to protect Medicaid.”

And Loomer is correct that Trump is opposed to making cuts to traditional “non-expansion” Medicaid benefits. But if the Republicans cannot attack the Medicaid expansion and they can’t attack traditional Medicaid, they have a problem, as I explained in my buzzsaw piece.

According to the Congressional Budget Office (CBO), the House Energy and Commerce Committee doesn’t have much choice in where they look for cuts in mandatory spending if cuts to Medicare are off the table. Non-Medicare spending under the committee’s jurisdiction is made up almost entirely of Medicaid spending. The 10-year projection is that “Medicaid comprises $8.2 trillion out of the $8.6 trillion in mandatory spending that E&C must use to come up with spending reductions.” Put another way, “over the next 10 years, 93% of non-Medicare spending in the E&C jurisdiction is from the federal share of Medicaid spending.”

This looks like the Energy & Commerce Committee has reached a dead end. The same may be true for the Agriculture Committee. So, what happens next?

According to the Center on Budget and Policy Priorities, “committees usually meet their reconciliation targets, but if a committee falls short of its target or fails to act at all, there are procedures for offering amendments to fill the gap when the bill goes to the full House or Senate.” It doesn’t specify what those procedures are, but I suppose we will soon find out. In the end, they’ll need to patch a hole that may exceed a trillion dollars.

Bloomberg News is reporting that the Republicans are now looking to offset some of the costs of Trump’s tax cuts by selling public land in Utah and Nevada.  That could be a start, but it’s currently a proposal from the House Natural Resources Committee and would raise only a fraction of the committee’s estimated $18 billion target for savings.

The House is trying to produce and pass a bill before Memorial Day which will then be taken up by the Senate with the goal of passing the final bill before the Fourth of July and the beginning of the summer recess. But what they’re working with now is a mess. With Speaker Johnson taking the bulk of the Medicaid cuts off the table, the budget hawks are very unhappy, and it’s far from clear that Johnson will ever be able to satisfy them by finding cuts elsewhere.

With all these budgetary problems, there’s been some talk, including from people like Steve Bannon, of reducing the tax cuts for millionaires. It’s consistent with Loomer’s populist opposition to cuts to Medicaid. But Trump shot down the idea two weeks ago, saying, “I think it would be very disruptive because a lot of millionaires would leave the country.”

He may be forced to revisit the idea because something has to give.

Eventually there will be a moment of truth. It’s quite possible now that the attempt to pass a budget reconciliation bill will not succeed. And if it doesn’t succeed, that will mean that the Republicans cannot avoid the Democratic filibuster in the Senate and will have to negotiate to pass an extension of the Trump tax cuts or to pass energy and immigration legislation.

Giving the Democrats any kind of leverage at all will completely change how Trump can operate in almost every imaginable way, which is why the Republicans still have a chance to succeed. At some point, the Republican members of Congress may face a choice of voting for a big, beautiful bill that almost every one of them has good reasons to avoid like the plague or watching Trump’s whole mode of operation crash and burn.

Another possibility is that they never get to the point of even having a hope of passing the thing and decide not to make matters worse by forcing a vote at all.

They put all their eggs in one basket and it looks like that basket might be about to tip over.