Sen. Josh Hawley, R-Mo., is positioning himself as his party’s primary defender of Medicaid after the House passed President Donald Trump’s “big, beautiful” budget bill last week containing nearly $800 billion in cuts to the program.
Missouri’s senior senator has long warned the GOP against Medicaid cuts and has clearly indicated that he will not support legislation that slashes healthcare for the country’s working poor.
In a New York Times opinion piece earlier this month, Hawley argued that cutting Medicaid benefits “is both morally wrong and politically suicidal.”
“Republicans need to open their eyes: Our voters support social insurance programs,” Hawley wrote. “More than that, our voters depend on those programs.”
Following the passage of the budget reconciliation bill in the House, Hawley said Republicans “ought to just do what the president says” and focus on cutting “waste, fraud, and abuse” instead of Medicaid.
Hawley told reporters he raised the issue with Trump, who reiterated his desire that Congress leave Medicaid alone.
“His exact words were ‘Don’t touch it, Josh.’ I said ‘Hey, we’re on the same page,'” Hawley said, according to The Hill.
He also expressed concern about the impact the Medicaid provisions contained in the House bill would have on rural hospitals, especially the freeze on provider taxes.
In a recent CNN interview, Hawley took aim at a provision that requires increased beneficiary co-pays, calling it “basically a hidden tax on working poor people who are trying to get healthcare.”
According to outside observers, Hawley’s decision to take up the Medicaid cause is a reflection of the changing demographics within the GOP base. The working-class people enrolled in the low-income health care program now make up a substantial part of the Republican Party, which has struck a more populist tone in the age of Trump.
While voters in Missouri overwhelmingly elected to return Trump to the White House in 2024, they also voted to expand Medicaid via a ballot measure in 2020.
“All the research shows that there are more people in rural areas on Medicaid than in urban areas and I think [Hawley’s] picked up on that,” Timothy McBride, a health economist and professor at Washington University’s School of Public Health, told The Hill. “These are his voters, and he seems to be speaking out of a populist position.”
The “One Big Beautiful Bill Act,” which passed the House late last week, would use a number of provisions to cut nearly $800 billion from Medicaid, including work requirements for “able-bodied adults” through age 64 without dependents, a provider tax freeze, more frequent eligibility checks, and slashing federal Medicaid payments to states that cover illegal migrants.
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