Trump tells Republicans ‘don’t F with Medicaid’ in final push for tax bill


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Summary

'Big beautiful' tax bill in danger

Republicans are approaching Speaker Mike Johnson’s self-imposed Memorial Day deadline, and there are approximately 15 members who say they are a “no.” 

The three main sticking points

Holdouts are concerned about at least one of three things –– state and local tax deductions, Medicaid reform, and deficit increases.

Trump's final push

President Trump visited Capitol Hill Tuesday for a meeting with Republicans that was described as unifying. He called Republicans who don't support the bill fools.


Full story

President Trump’s “big beautiful” tax and budget bill will not pass the House of Representatives as it’s currently written, putting the future of his agenda at risk. Republicans are approaching Speaker Mike Johnson’s, R-La., self-imposed Memorial Day deadline, and there are approximately 15 members who say they are a “no.” 

“I would say that if the vote were held right now, it dies a painful death,” Rep. Andy Ogles, R-Tenn., told reporters. 

The outstanding issues include state and local tax deductions, Medicaid reform and deficit increases. 

The president met with Republicans on Capitol Hill Tuesday, May 20, to provide encouragement. The meeting was described as very positive. 

“This was a meeting of love,” the president said as he left. “There was great unity in that room.”

What do GOP members want from Medicaid?

According to those in the room, Trump told Republicans who were concerned about cuts to Medicaid exactly what they wanted to hear –– “Don’t F with Medicaid.” Republicans say they took that to mean cut waste, fraud and abuse, not benefits. 

There are some Republicans who want to reduce the federal government’s share of costs for Medicaid expansion recipients, which currently stands at 90%. Some lawmakers believe it should be in line with the traditional Medicaid payment share which stands between 50% and 77%, depending on the state. But making that change could alienate moderate members. 

“We have to defend against it, because they’re in a sense of putting poison pills in that won’t pass,” Rep. Don Bacon, R-Neb., said. 

What SALT reforms are some members fighting for?

Then there’s the state and local tax deduction, or SALT. Blue-state Republicans are working to increase the write-off from the current $10,000 to $30,000. Five members rejected an offer of $30,000. Reports indicate they’re trying to get a deduction of $62,000 for individuals and $120,000 for couples. 

“We hope his remarks today motivate the Speaker to advance a SALT proposal that delivers meaningful relief for our middle-class constituents, as we have worked in good faith with House Leadership for more than a year,” Reps. Mike Lawler, R-N.Y., Nick LaLota, R-N.Y., Andrew Garbarino, R-N.Y., Young Kim, R-Calif., and Tom Kean, R-N.J., said in a joint statement

What would the bill cost over time?

Ryan Ellis, president of the Center for a Free Economy, estimates that a $30,000 cap would be enough to placate 97% of taxpayers who deduct state and local taxes from their federal returns.

In the end, all this negotiating comes down to federal spending and the national debt. The cuts to Medicaid would save the government hundreds of billions of dollars over the next 10 years, but potentially lead to 8.6 million people losing their health insurance. A SALT cap increase would reduce federal revenues and therefore add to the deficit. 

No matter what, the Congressional Budget Office predicts this bill will add approximately $3.8 trillion to the national debt over the next decade, which is enough for Rep. Thomas Massie, R-Ky., to vote no.  “At least three and a half trillion of that is a direct result of the policies in this bill. You can’t tell the American people, you can have all of these free things and not pay taxes,” Massie said.  

Trump was asked what he thought about the holdouts after his meeting ended. 

“Anybody that didn’t support it as a Republican, I would consider to be a fool,” Trump said.  

Democrats are uniformly opposed to the bill. For it to pass the House, 217 of the chamber’s 220 Republican members will need to vote in favor. 

Snorre Wik (Photographer/Editor) contributed to this report.
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Why this story matters

The struggle among House Republicans to pass President Trump's sweeping tax and budget bill highlights divisions within the party and signals challenges for advancing domestic policy changes affecting taxes, social welfare, and the national debt.

Republican party divisions

Disagreements over key provisions such as Medicaid reforms and state and local tax deductions reveal internal conflict within the Republican Party, which could affect the passage of major legislation.

Fiscal policy and national debt

Debates about tax cuts, spending reductions, and the projected addition of trillions to the national debt underscore the complexity and controversy surrounding the government's fiscal priorities.

Social safety net and health care

Proposed changes to Medicaid and other safety net programs have potential consequences for millions of Americans' health care coverage, making the outcome of the bill highly impactful for vulnerable populations.

Get the big picture

Synthesized coverage insights across 26 media outlets

History lesson

Similar major tax cut initiatives were enacted in 2001 and 2017, with both instances leading to partisan splits and concerns regarding the federal deficit. Historical data indicates that expansive tax cuts paired with limited offsetting reductions can significantly increase long-term national debt, while social program reforms often generate political backlash and legal challenges.

Oppo research

Opponents, primarily Democrats and some moderate Republicans, are raising alarms about deep cuts to Medicaid, rollback of clean energy credits, and the overall increase in national debt. Organized advocacy groups and elected officials are voicing concerns about the projected loss of health coverage and arguing that the proposed benefits mostly aid higher-income individuals.

Terms to know

SALT Deduction: Allows taxpayers to deduct state and local taxes from federal taxable income, with the current bill proposing to increase the cap to $30,000 for joint filers. Medicaid: A public health insurance program for low-income individuals, currently at the center of work requirement and funding debates. Work Requirement: A rule that some Medicaid recipients must work or participate in work-related activities to maintain benefits.

Bias comparison

  • Media outlets on the left center on internal GOP discord and the bill’s social costs, emphasizing terms like “grandstander” and “fool” to highlight bitter divisions, while stressing projections that 7.6 million people could lose Medicaid coverage and that the bill would balloon the deficit by $3.3 trillion.
  • Not enough coverage from media outlets in the center to provide a bias comparison.
  • Media outlets on the right spotlight Trump’s leadership and party “unity,” using positively charged language such as “One Big Beautiful Bill” and framing dissent as minor or resolved, even portraying his confrontations with reporters as justified “scorching” retorts.

Media landscape

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36 total sources

Key points from the Left

No summary available because of a lack of coverage.

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Key points from the Center

  • President Donald Trump urged House Republicans on May 20 at the Capitol to unite behind his multitrillion-dollar tax cuts bill titled the "One Big Beautiful Bill Act."
  • Trump’s call followed ongoing negotiations and internal GOP disagreements over the bill’s provisions, including state and local tax deductions and Medicaid cuts.
  • The 1,116-page bill builds on previous tax incentives, introduces additional exemptions such as those for tips and Social Security, and includes proposed reductions in funding for Medicaid, nutritional assistance programs, and renewable energy initiatives.
  • The nonpartisan Congressional Budget Office predicts that changes to Medicaid would result in at least 7.6 million fewer insured individuals, while a fiscal watchdog group estimates the bill could increase the national debt by approximately $3.3 trillion over the next decade.
  • Despite Trump’s assertion of "unbelievable unity," the bill faces significant opposition from GOP holdouts, risking collapse before votes planned this week and signaling challenges in securing a slim Republican majority.

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Key points from the Right

  • President Donald Trump met with House Republicans to gather support for his tax and spending bill, describing the meeting as a "meeting of love."
  • Trump claimed there was "unbelievable unity" among GOP members, downplaying any disagreements after the meeting.
  • He promoted the "One Big Beautiful Bill," which he touted as the largest tax and regulation cut in U.S. history.
  • Trump expressed urgency for all Republicans to support the bill, linking its failure to potential tax increases.

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