Following a marathon markup session, House Energy and Commerce Committee lawmakers passed their portion of the Republican budget reconciliation package, approving many cost-cutting reforms to energy, healthcare, and technology programs.
The committee’s bill fulfills the Republican budget resolution that instructed Energy and Commerce to find savings of at least $880 billion over the next 10 years in programs under its jurisdiction.
“Committee Republicans took an historic step today to unleash American energy, bolster our technological leadership, and prioritize health care for the most vulnerable Americans and U.S. citizens,” Chairman Brett Guthrie, R-Ky., said after the markup. “We make no apologies for putting Americans first, and we will gladly work through a 26 hour markup in order to pursue a more perfect union.”
The energy and environment subtitles of the bill, approved Tuesday night, would rescind tens of billions in not-obligated renewable energy subsidies from the Inflation Reduction Act and would authorize an expedited permitting process for fossil fuel projects.
The communications subtitle, approved in the early morning Wednesday, would authorize a spectrum auction that could bring in $88 billion in federal revenue and applies a 10-year moratorium on state AI regulations.
But most of the markup, continuing well into Wednesday afternoon, centered around the bill’s health subtitle regarding Medicaid reforms, which Democrats categorized as “cruel” and Republicans promised will improve and stabilize the program.
Among other changes, the committee’s Medicaid reforms include changing Medicaid eligibility requirements back to pre-COVID-19 standards; imposing work requirements on most able-bodied adult recipients without dependents; and closing loopholes exploited by states.
According to the Congressional Budget Office, these changes would save $301 billion and reduce the federal deficit by at least $625 billion over the next decade.
They would also mean at least 7.7 million current Medicaid recipients, including 1.4 million people without verified citizenship status, would be ineligible for Medicaid coverage by 2034, per CBO estimates.
“After 26 hours, Republicans failed to justify their draconian Medicaid cuts,” Ranking Member Frank Pallone, D-N.J., said following the markup. “President Trump repeatedly promised Republicans were not going to cut Medicaid, but that was a lie since Republicans just voted for the largest Medicaid cut in history.”
The Biden administration boosted Medicaid spending by 20% and expanded program eligibility beyond low-income seniors; families with children; and pregnant mothers with their infants to able-bodied, childless adults. Given the Biden-era Medicaid spending increase, total Medicaid spending will still grow by at least 3% a year under the committee’s bill.
Rep. John James, R-Mich., accused Democrats of “fear mongering” and said Republicans are “simply prioritizing people Medicaid was originally designed for.”
“If you want to believe that every reform is a cut, that every accountability measure is cruel, and standing up to a failing status quo…we’re not buying it,” James said during the markup Wednesday. “Republicans are going to defend and strengthen Medicaid. We will ensure that Medicaid remains a lifeline for millions of vulnerable Americans, and not a loophole for exploitation.”
Medicaid costs more than $890 billion taxpayer dollars per year, with the federal government shouldering roughly two-thirds of that spending and state governments paying for the rest.
But states will often employ financing gimmicks to take advantage of federal support for Medicaid. As an example, Illinois will overtax Medicaid-participating hospitals and nursing homes but then provide reimbursement, allowing the state to collect matching federal payments for a nonexistent expense.
The bill prevents this practice by limiting how much states can tax hospitals and providers, saving the federal government money in the process. It also axes federal funding to Planned Parenthood and other reproductive clinics, as well as prevents Medicaid and CHIP funding from going to gender transition procedures on children.
The legislation is now on its way to the House Budget Committee to be assimilated into a megabill implementing President Donald Trump’s tax, border, energy, and defense policies, including permanently extending the 2017 Tax Cuts and Jobs Act.
If the House passes the megabill, Senate Republicans may change some of the Energy and Commerce provisions. The final package needs only a majority vote to pass the Senate because the reconciliation process bypasses the filibuster.
