House Republicans to vote on spending deal that could slash Medicaid funding

House Republicans are planning to vote on Tuesday on a spending blueprint central to Donald Trump’s agenda, but the package faces potential derailment over nearly $1tn in Medicaid cuts that could fracture their slim majority.

The fiscal year 2025 proposal includes approximately $4.5tn in tax cuts alongside increased spending for defense and border security. To offset these costs, the plan tasks congressional committees with finding about $2tn in spending reductions over the next decade.

But some lawmakers are warning that the budget could include an estimated $800bn in potential cuts from Medicaid, a federal program providing healthcare coverage to more than 72 million Americans. Though the resolution doesn’t explicitly target Medicaid, skeptical lawmakers warn there are few alternatives to achieve the $880bn in cuts assigned to the energy and commerce committee.

If the budget measure doesn’t pass by the 14 March deadline, the government faces a shutdown – and Democrats are committed to not voting it through.

“Let me be clear, House Democrats will not provide a single vote to this reckless Republican budget,” said the House minority leader, Hakeem Jeffries, from the steps of the US Capitol on Tuesday surrounded by Democratic lawmakers and advocates protesting the vote. “Not one, not one, not one.”

With Democrats united in opposition, House speaker Mike Johnson’s slim Republican majority cannot afford more than one defection. Several moderate Republicans from vulnerable districts have expressed concerns, particularly those with constituents heavily reliant on Medicaid.

Eight House Republicans, including the California representative David Valadao and the New York representative Nicole Malliotakis, warned in a letter to Johnson last week that “slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities”.

The Nebraska Republican Don Bacon, representing a district that backed Kamala Harris as the Democratic presidential candidate in November, has demanded leadership to prove the proposal “won’t overly cut Medicaid”.

Opposition to the House budget resolution has been steadily building over the last few weeks. During last week’s recess, constituent anger over Republicans’ proposed cuts to Medicaid and other social safety net programs as well as Elon Musk’s efforts to dismantle the federal government boiled over at town halls and congressional offices across the country.

At an earlier Capitol Hill rally on Tuesday, Senator Chris Murphy assailed the Republican budget bill as the “most massive transfer of wealth and resources from poor people and the middle class to the billionaires and corporations in the history of this country”.

He continued: “You’re talking about $880bn of cuts to Medicaid … That means that sick kids die in this country. That means that hospitals in depressed communities and rural communities close their doors, right? That means that drug and addiction treatment centers disappear all across this country.”

The vote comes after the Senate passed its own budget bill last week – a less contentious one that Trump does not support as much as the House’s. House leadership must now navigate competing demands within their caucus: some members want deeper tax cuts while others seek steeper spending reductions or protection for social programs.

“There may be more than one [defector], but we’ll get there,” Johnson said on Monday. “We’re going to get everybody there. This is a prayer request. Just pray this through for us because it is very high stakes, and everybody knows that.”