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U.S. House GOP mandates Medicaid work requirements in giant bill slashing spending

The U.S. House will begin debate in committee this week on a bill that would cut Medicaid spending. (Getty Images)

The U.S. House will begin debate in committee this week on a bill that would cut Medicaid spending. (Getty Images)

WASHINGTON — U.S. House Republicans plan to debate and approve the three final pieces of their “big, beautiful bill” in committee this week, including the tax measure, major spending cuts to Medicaid that will change how states run the program and an agriculture bill.

At least $880 billion over the next 10 years would be slashed under the piece of the bill that covers energy and health care, including from Medicaid. Republicans would add new Medicaid work requirements for some able-bodied adults; seek to penalize the dozen states that allow immigrants living in the U.S. without legal status in the program; and require states to more frequently check Medicaid enrollees’ eligibility, among other changes.

An estimate was not yet available for exactly how much that would save in Medicaid spending or how many people enrolled might lose coverage. Earlier projections of various other scenarios by the Congressional Budget Office had placed the numbers of displaced enrollees in the millions, and Democrats predicted the same effect from the newest plan.

House panels have already signed off on eight of the 11 bills that will make up the sweeping reconciliation legislation. And if all goes according to plan, that chamber should approve the entire package before the end of the month.

Debate is expected to begin Tuesday in each of the panels and last hours, possibly into Wednesday. Democrats will offer dozens of amendments seeking to change the bills and highlighting their disagreement with GOP policy goals.

Internal Republican disputes between centrists and far-right lawmakers over numerous tax proposals and funding changes to Medicaid will also likely lead to debate on GOP amendments.

With paper-thin majorities in the House and Senate, nearly every Republican needs to support the overall package for it to move through both chambers and to President Donald Trump.

If Republicans fail to reach agreement during the next couple months, it would put nearly every aspect of their agenda in jeopardy. GOP leaders would also need to negotiate a bipartisan debt limit agreement before the August recess, should the reconciliation package fall apart, since they plan to include debt limit language as well.

GOP divided over Medicaid cuts

Kentucky Republican Rep. Brett Guthrie, chairman of the committee that oversees energy and Medicaid, wrote in a statement last week announcing the markup that his panel’s measure would “end wasteful government spending, unleash American energy and innovation, and strengthen Medicaid for mothers, children, individuals with disabilities, and the elderly.”

But the bill released this weekend might not have support from far-right members in the House and seems to be running into opposition from some GOP senators as well. 

Texas Republican Rep. Chip Roy, of the hard right, wrote on social media that he hoped “House & Senate leadership are coming up with a backup plan…. ….. because I’m not here to rack up an additional $20 trillion in debt over 10 years or to subsidize healthy, able-bodied adults, corrupt blue states, and monopoly hospital ceos…”

Missouri Republican Sen. Josh Hawley, who has voiced concern for months about potential cuts to Medicaid, wrote an op-ed published in The New York Times on Monday highly critical of a “contingent of corporatist Republicans” who support lower federal spending on the program.”

“This wing of the party wants Republicans to build our big, beautiful bill around slashing health insurance for the working poor,” Hawley wrote. “But that argument is both morally wrong and politically suicidal.”

The entire House package will be open to amendment if the legislation makes it to the Senate, where several GOP lawmakers are expected to rework or even eliminate entire sections.

Work requirements

The Energy and Commerce Committee’s bill is the one that would cut federal spending by at least $880 billion during the next decade including on Medicaid, the state-federal health program for lower income people.

The legislation would institute work requirements nationwide for able-bodied adults between the ages of 19 and 65, with several exceptions, including for pregnant people, enrollees with certain disabilities or serious medical conditions, and parents of dependent children.

People not exempted from the requirements would need to work, engage in community service, or enroll in an education program for at least 80 hours a month.

A staffer on the panel told reporters during a background briefing Monday that Republicans tried to learn from challenges certain states had in the past when they implemented work requirements.

After discussions with current and former state Medicaid directors, the staffer said the committee wrote a bill that they are confident “states will be able to implement effectively.”

The work requirements take into account various unexpected circumstances, like if someone were to be hit by a bus and unable to complete the 80-hours-per-month requirement on time because they were hospitalized, the staffer said.

“We did try to be very thoughtful about any kind of circumstance that could happen,” they said.

Immigrant coverage, eligibility checks

The Medicaid legislation also seeks to encourage states who include undocumented immigrants in their program to stop doing so or lose some federal funding.

The federal government currently pays 90% of the cost of covering enrollees who are eligible for Medicaid under the 2010 Affordable Care Act expansion. That would decrease to 80% for the expanded population if states choose to keep covering undocumented immigrants.

The committee staffer said this would impact California, Colorado, Connecticut, the District of Columbia, Illinois, Maine, Massachusetts, New Jersey, New York, Oregon, Utah, Vermont and Washington states if they don’t change their policies regarding undocumented immigrants.

Additionally, states would need to check eligibility for all of their Medicaid enrollees every six months, instead of once a year for the expanded population. This likely would lead to some people being kicked out of the program.

Committee staff members were unable to share exactly how each of the Medicaid provisions would affect the federal budget or how many people could lose access to the program if Congress were to implement the legislation as written.

But the nonpartisan Congressional Budget Office wrote in a letter Monday that it estimates the Energy and Commerce Committee met its target of cutting at least $880 billion in spending “over the 2025-2034 period and would not increase on-budget deficits in any year after 2034.”

Staff on the committee said they don’t expect to have the full CBO score before the markup begins Tuesday and didn’t have an estimate for when that information will be out.

Energy and Commerce Committee Ranking Member Frank Pallone, D-N.J., wrote in a statement the GOP bill would lead to millions of people losing access to Medicaid.

“This is not trimming fat from around the edges, it’s cutting to the bone,” Pallone wrote. “The overwhelming majority of the savings in this bill will come from taking health care away from millions of Americans. No where in the bill are they cutting ‘waste, fraud, and abuse’—they’re cutting people’s health care and using that money to give tax breaks to billionaires.”

Repealing clean-energy funds

The Republican proposal would repeal more than a dozen sections of Democrats’ 2022 reconciliation law related to energy and environment programs.

The law, known as the Inflation Reduction Act, included hundreds of billions in tax credits for renewable energy and energy-efficiency measures. It was considered the largest investment by the United States in tackling climate change.

The House bill would repeal sections including the $27 billion Greenhouse Gas Reduction Fund, which helps finance clean-energy projects, and a $40 billion Department of Energy loan program meant to stimulate production of clean-energy infrastructure.

Sections targeting carbon emissions, air pollution, offshore wind transmission, and other programs would also rescind any unspent funds for those purposes appropriated in the Biden-era law.

The measure would allow pipeline builders to pay fees to bypass environmental review. Natural gas pipelines could pay $10 million to access an expedited approval process and liquified natural gas exports could pay $1 million for the Energy Department to deem them “in the public interest.”

Rep. Kathy Castor, the ranking member on the Energy and Commerce Energy Subcommittee, said the proposal would sabotage efforts to drive down prices for consumers.

“Cleaner, cheaper energy for consumers gets left behind,” the Florida Democrat wrote in a statement. “Dismantling our landmark Inflation Reduction Act will kill jobs, hurt businesses, and drive-up Americans’ energy costs.”

Tax cuts

The Ways and Means Committee released its 28-page starter bill late last week and the full 389-page version Monday afternoon, but Republicans on the panel could add to it during the Tuesday markup.

House GOP tax writers propose making permanent the underlying 2017 tax law provisions while temporarily expanding several of them, including the child tax credit and standard deduction.

The child tax credit would increase to $2,500, up from $2,000, until 2028. The refundable amount of the tax credit per child — meaning how much taxpayers could get back — would now reach up to $1,400. Taxpayers claiming the credit would now have to provide a Social Security number, as well as the SSN of a spouse.

The standard deduction for single and married joint filers would temporarily increase until 2029 up to $2,000, depending on filing status.

Trump’s campaign promises, including no tax on tips, also made it into the proposal, though only until 2028. Those claiming the tax break on tips will also need to provide a Social Security number as well as the SSN of their spouse, if married.

Trump’s promise to eliminate taxes on car loan interest, also set to expire in 2028, would not apply to any vehicle that was not finally assembled in the U.S.

Tax writers increased but ultimately left a cap on the amount of state and local taxes, commonly referred to as SALT, that households can deduct, an incredibly contentious issue for lawmakers with constituents in high tax areas like New York and California. GOP lawmakers increased the SALT cap to $30,000, up from $10,000.

That level, however, might not have the support needed among Republicans’ extremely thin majorities and will likely lead to heated debate during markup, or on the floor.

Republicans from higher-tax states have repeatedly said they will not vote for the entire package unless they feel their constituents will benefit from raising the SALT cap.

The dispute has spilled over several times already, including in a statement last week from four New York Republicans, who wrote, “The Speaker and the House Ways and Means Committee unilaterally proposed a flat $30,000 SALT cap — an amount they already knew would fall short of earning our support.”

“It’s not just insulting—it risks derailing President Trump’s One Big Beautiful Bill,” they wrote. “New Yorkers already send far more to Washington than we get back—unlike many so-called ‘low-tax’ states that depend heavily on federal largesse.

“A higher SALT cap isn’t a luxury. It’s a matter of fairness.”

New York Republican Rep. Nick LaLota wrote on social media Monday afternoon: “Still a hell no.”

How much the tax proposal will cost has not yet been released, but government deficit watchdogs estimated a wholesale extension of the 2017 Tax Cuts and Jobs Act, without the enhancements, would cost north of $4 trillion over the next decade.

Erica York, vice president of federal tax policy at the Tax Foundation, said the proposal provides some certainty to individual taxpayers but it also adds complexity in many areas.

“You can clearly see the thinking here was probably just a straight-up extension (of the 2017 law), people wouldn’t feel like they got a tax cut because it’s just continuing. So they had to do something to make it feel like there’s a larger tax cut,” York said.

Ag cuts remain a mystery

The House Agriculture Committee, led by Pennsylvania Republican Glenn ‘GT’ Thompson, hadn’t released its bill as of Monday afternoon but was scheduled to begin the markup on Tuesday evening.

That panel is supposed to cut at least $230 billion in federal spending during the next decade, some of which will likely come from reworking elements of the Supplemental Nutrition Assistance Program, or SNAP.

Committee leaders are also planning to include elements of the much overdue farm bill, though those provisions could run into issues in the Senate if they don’t have a significant impact on federal revenue or spending.

Republicans are using the complex reconciliation process to move the package through Congress with simple majority votes in each chamber, avoiding the Senate’s 60-vote legislative filibuster, which would otherwise require bipartisanship. 

Reconciliation measures must address federal revenue, spending, or the debt limit in a way not deemed “merely incidental” by the Senate parliamentarian. That means the GOP proposals must carry some sort of price tag and cannot focus simply on changing federal policy.

Jacob Fischler and Ashley Murray contributed to this report.

Treasury advises Congress must deal with debt limit before August or face default

Treasury Secretary Scott Bessent prepares to testify before the Senate Finance Committee during his confirmation hearing  in the Dirksen Senate Office Building on Capitol Hill on Jan. 16, 2025, in Washington, D.C.  (Photo by Chip Somodevilla/Getty Images)

Treasury Secretary Scott Bessent prepares to testify before the Senate Finance Committee during his confirmation hearing  in the Dirksen Senate Office Building on Capitol Hill on Jan. 16, 2025, in Washington, D.C.  (Photo by Chip Somodevilla/Getty Images)

WASHINGTON — The Treasury Department announced Friday that Congress must address the debt limit before August, setting a firm deadline for Republicans to wrap up work on the “big, beautiful bill” that will raise the nation’s borrowing limit by up to $5 trillion.

Treasury Secretary Scott Bessent wrote in a letter to congressional leaders that “there is a reasonable probability that the federal government’s cash and extraordinary measures will be exhausted in August while Congress is scheduled to be in recess.

“Therefore, I respectfully urge Congress to increase or suspend the debt limit by mid-July, before its scheduled break, to protect the full faith and credit of the United States.”

The projection marks the first time the Trump administration has weighed in publicly on when the government will likely reach default since the last suspension expired in January. 

In the months since then, the Treasury Department has used accounting maneuvers known as extraordinary measures to pay all of the country’s bills in full and on time.

Treasury’s projection is similar to a report the nonpartisan Congressional Budget Office released in March predicting the country would reach default in August or September unless Congress acted before then.

Reconciliation package

Republicans are hoping to lift the debt limit without having to negotiate a bipartisan agreement with Democrats, which is typically how lawmakers have addressed the debt limit during the past couple decades.

GOP leaders plan to raise the debt limit by between $4 trillion and $5 trillion in the 11-bill reconciliation package they’re using to address tax law, overhaul higher education aid and cut federal spending.

Speaker Mike Johnson, R-La., expects his chamber will vote on that legislation before the end of May, though Senate leaders haven’t put a timeline on when they’d bring the bill to the floor in that chamber.

GOP senators are likely to propose several amendments to the package, and any changes by the Senate would require the bill to get a final sign-off in the House before it could head to President Donald Trump’s desk.

The Treasury Department’s projection that a debt limit default will likely take place if no action is taken before August puts a firm deadline on when Republicans will need to reach final agreement.

Caution against waiting

Bessent also cautioned lawmakers against waiting until the last minute to get their work done.

“Prior episodes have shown that waiting until the last minute to suspend or increase the debt limit can have serious adverse consequences for financial markets, businesses, and the federal government, harm businesses and consumer confidence, and raise short-term borrowing costs for taxpayers,” he wrote. “A failure to suspend or increase the debt limit would wreak havoc on our financial system and diminish America’s security and global leadership position.”

A default on the country’s debt would limit the federal government to spending only the money it has on hand, likely leading to delayed, incomplete, or nonexistent payments on thousands of programs, including Social Security, Medicare, Medicaid, troop pay, veterans benefits and nutrition programs, among many others.

It would also lead to a downturn in the global economy with a recession being among the better scenarios.

A default is vastly different from a partial government shutdown and would lead to more significant consequences for federal spending and the economy. 

Trump again tries to defund NPR and PBS, sparking a new congressional battle

A protester holds a sign in support of funding for public media during a May 1, 2025, rally at the Kansas Statehouse in Topeka as part of a 50501 national day of action. (Photo by Sherman Smith/Kansas Reflector)

A protester holds a sign in support of funding for public media during a May 1, 2025, rally at the Kansas Statehouse in Topeka as part of a 50501 national day of action. (Photo by Sherman Smith/Kansas Reflector)

WASHINGTON — President Donald Trump urged Congress to eliminate funding for the Corporation for Public Broadcasting during his first term, but was largely unsuccessful.

Now, in his second go-around, Trump is once again asking lawmakers to scrap federal spending on the private, nonprofit corporation that Congress established in the 1960s.

The Corporation for Public Broadcasting allocates funding to National Public Radio, or NPR, and the Public Broadcasting Service, or PBS, as well as more than 1,500 local radio and television stations throughout the country.

Trump’s renewed focus on public media — in his budget proposal, an executive order and an expected rescissions request — has led the organizations that benefit from the CPB to start talking more than they have in recent years about their funding and their journalism.

Katherine Maher, president and CEO of NPR, rejected the idea that ending funding for the CPB would have a significant impact on the federal ledger, since the “appropriation for public broadcasting, including NPR and PBS, represents less than 0.0001% of the federal budget.”

Maher also opposed what she viewed as the Trump administration seeking to influence journalists and news organizations.

“The President’s order is an affront to the First Amendment rights of NPR and locally owned and operated stations throughout America to produce and air programming that meets the needs of their communities,” Maher wrote in a statement. “It is also an affront to the First Amendment rights of station listeners and donors who support independent news and information.”

Paula Kerger, CEO and president at PBS, also defended the CBP as well as the news programs that receive its funding.

“There’s nothing more American than PBS, and our work is only possible because of the bipartisan support we have always received from Congress,” Kerger said. “This public-private partnership allows us to help prepare millions of children for success in school and in life and also supports enriching and inspiring programs of the highest quality.”

NPR receives about 1% of its direct funding from the Corporation for Public Broadcasting, while PBS receives about 15%. Those numbers fluctuate for the local stations, which tend to get more, but not all, of their operating budgets from CPB funding.

Senate likely to balk

House Republicans, who have sought to zero out funding for the Corporation for Public Broadcasting in recent appropriations bills, are likely to get on board. But senators, who write broadly bipartisan bills, haven’t taken that step and appear unlikely to do so this year — possibly helping public media resist Trump’s cutback attempts, as it did during his first term.

The differences between the House and Senate will lead to heated debate for months to come about future spending on the Corporation for Public Broadcasting as well as the dozens of other programs Trump told lawmakers to stop funding in his budget request.

Wisconsin Democratic Sen. Tammy Baldwin, ranking member on the panel that funds CPB, told States Newsroom during a brief interview she hopes lawmakers “can effectively fight back against that proposed budget.”

“I find that some of my Republican colleagues, especially those from rural states, hear from their constituents that they are reliant on public broadcasting, especially radio for local information, news, etcetera,” Baldwin said. “And there’s not a lot of other radio resources out there. But I think the same can be said about the public television offerings.”

Opinions among Republicans vary, though.

Louisiana Republican Sen. John Kennedy, who sits on the spending panel, said funding for CPB “may have made sense at one time, but the American taxpayer has no business spending half a billion dollars a year subsidizing media.”

Kennedy said he doesn’t expect rural residents will lose access to local television and radio programming should Congress eliminate the funding.

“Rural communities have the same access as everybody else to cable, to streaming, to getting their news off of this thing,” Kennedy said, pointing to his cell phone. “It’s just an argument by the Corporation for Public Broadcasting to hold on to a government subsidy.”

Alaska Republican Sen. Lisa Murkowski, a senior member of the Appropriations Committee, pushed back against defunding.

She wrote in an op-ed published in the Fairbanks Daily News-Miner that while she shares “the desire to reduce government spending, defunding the CPB, and particularly the essential reporting it allows locally owned radio and television stations to provide in Alaska, is not the place to start.”

Alaska’s local stations received $12 million last year from CPB, which made up between 30% and 70% of their total budget, in addition to individual donation and state funding, according to the op-ed.

“Not only would a large portion of Alaska communities lose their local programming, but warning systems for natural disasters, power outages, boil water advisories, and other alerts would be severely hampered,” Murkowski wrote. “What may seem like a frivolous expense to some has proven to be an invaluable resource that saves lives in Alaska.”

CPB has a state-by-state breakdown on its website detailing how much it provided during each of the past six years. The individual profiles show what portion of each state’s funding went to different programs, like the Next Generation Warning System, radio programming, Ready to Learn and Television Community Service Grants.

Public media among multiple Trump targets

Trump’s skinny budget request, released last week, calls on Congress to cease funding the CPB as well as dozens of other organizations, including the National Endowment for Democracy and the Low Income Home Energy Assistance Program, or LIHEAP.

The section on CPB says the request is “consistent with the President’s efforts to decrease the size of the Federal Government to enhance accountability, reduce waste, and reduce unnecessary governmental entities.”

Trump has also signed an executive order directing the CPB Board of Directors as well as executive departments and agencies to halt funding NPR and PBS.

The order stated that the “viewpoints NPR and PBS promote does not matter. What does matter is that neither entity presents a fair, accurate, or unbiased portrayal of current events to taxpaying citizens.”

Patricia Harrison, president and CEO of the Corporation for Public Broadcasting, wrote in a statement responding to the executive order that Trump didn’t have the authority he was trying to wield.

“CPB is not a federal executive agency subject to the President’s authority,” Harrison wrote. “Congress directly authorized and funded CPB to be a private nonprofit corporation wholly independent of the federal government.

“In creating CPB, Congress expressly forbade ‘any department, agency, officer, or employee of the United States to exercise any direction, supervision, or control over educational television or radio broadcasting, or over [CPB] or any of its grantees or contractors…’ 47 U.S.C. § 398(c).”

There are also several news reports that the Trump administration will send a rescissions request to Capitol Hill, asking lawmakers to pull back funding already approved for CPB. But the Office of Management and Budget hasn’t yet taken that step.

The Corporation for Public Broadcasting received steady funding from Congress starting at its founding, before the last Trump administration asked lawmakers to phase out its appropriation.

The last Trump administration’s first budget request called on lawmakers to “conduct an orderly closeout” by providing $30 million for CPB that would have gone toward salaries, rent and other costs.

The proposal argued that “private fundraising has proven durable, negating the need for continued Federal subsidies.”

“Services such as PBS and NPR, which receive funding from the CPB, could make up the shortfall by increasing revenues from corporate sponsors, foundations, and members. In addition, alternatives to PBS and NPR programming have grown substantially since CPB was first established in 1967, greatly reducing the need for publicly funded programming options.”

Funding increased despite Trump

Congress didn’t go along with the fiscal 2018 budget request for the CPB, and it wouldn’t for the rest of Trump’s first term.

In March 2018, lawmakers approved $445 million, followed by the same amount in the next year’s bill. Congress then lifted spending to $465 million in December 2019 and then again just before Trump left office for a total funding level of $475 million.

Those allocations continued rising during the Biden administration, reaching a $535 million appropriation in March 2024, the last full-year spending law enacted before Trump returned to the Oval Office. 

House Republicans did, however, try to phase out funding for CPB during the second half of President Joe Biden’s term. The House GOP provided a two-year advanced appropriation until 2023, when Republicans announced they wanted “the Corporation for Public Broadcasting to compete with other programs in the bill for annual funding.”

Those efforts didn’t work and the final spending bill, which became law in March 2024, included funding for CPB.

Senate Democrats wrote after negotiating the bipartisan agreement that it “protects funding for the Corporation for Public Broadcasting to support more than 1,500 locally owned TV and radio stations nationwide—rejecting House Republicans’ proposal to zero out funding and weaken Americans’ access to local reporting.

“The bill maintains a critical investment of $60 million for digital interconnection and $535 million as a two-year advance appropriation, of which roughly 70% is provided directly to local public TV and radio stations.”

Final resolution far off

Congress is expected to begin work on its dozen annual appropriations bills sometime this summer, which collectively total about $1.8 trillion and make up about one-third of all federal spending. 

The House Appropriations Committee will likely propose phasing out CPB funding, or at least its advanced appropriation, in its bill.

The Senate Appropriations Committee tends to write more bipartisan bills, so as long as several of the panel’s members advocate for CPB in its funding measure, the program will likely receive its advanced funding in that bill.

Final agreement between the House and Senate is supposed to come before the start of the next fiscal year on Oct. 1. But that rarely happens and lawmakers often use a stopgap spending bill to push off final negotiations until mid-December.

That’s likely the earliest this year the Corporation for Public Broadcasting and those who rely on it will learn if Congress will reduce or eliminate its funding. That is, unless lawmakers fail to reach agreement on that particular funding bill.

Congress would then have to use a stopgap spending bill, which mostly keeps funding levels on autopilot, until it can enact a full-year bill. 

Puzzled senators question Trump’s FBI chief on nonexistent spending plan

FBI director Kash Patel testifies before a U.S. Senate Appropriations subcommittee on Thursday, May 8, 2025. (Photo from U.S. Senate webcast)

FBI director Kash Patel testifies before a U.S. Senate Appropriations subcommittee on Thursday, May 8, 2025. (Photo from U.S. Senate webcast)

WASHINGTON — The case of the missing Federal Bureau of Investigation budget request was on full display Thursday, when senators repeatedly asked the law enforcement agency’s director what resources he needed Congress to provide in the upcoming fiscal year.

FBI Director Kash Patel did not disclose a dollar amount, an unusual development at a hearing at which an agency head traditionally discusses a budget request in detail with lawmakers who hold the purse strings.

The Senate Appropriations Commerce-Justice-Science Subcommittee hearing came one day after Patel testified before a House panel that he needs more money from Congress than was asked for in the Trump administration’s budget request.

Patel’s written statement to the House subcommittee said the FBI’s total request was $10.1 billion, but during that hearing he told appropriators the agency needed at least $11.2 billion.

Patel rejecting the Trump administration’s official budget request in support of his own proposal to Congress was significant in that Cabinet secretaries almost always stick to the official request, at least during public hearings.

“The skinny budget is a proposal, and I’m working through the appropriations process to explain why we need more than what has been proposed,” Patel said during the House hearing Wednesday.

Never mind

Less than 24 hours later, he reversed course during the Senate hearing, saying his comments were misconstrued.

“President Trump has set new priorities and a focus on federal law enforcement. I’m here today in full support of the president’s budget, which reprioritizes and enhances our mission of law enforcement and national security,” Patel said in his opening statement. “We’re fighting for a fully funded FBI because we want a fully effective FBI.”

What that dollar amount might be was unclear, though.

During an exchange with Washington state Democratic Sen. Patty Murray, ranking member on the full Appropriations Committee, about what exactly the FBI needs in terms of funding, Patel said: “I’m not asking you for anything at this time.”

Murray responded by asking if he believed the FBI could “operate without a budget.” Patel responded that he “never said that.”

Republicans and Democrats on the Senate panel repeatedly brought up that the Trump administration’s “skinny” budget proposal, released last week, doesn’t actually include a total funding level for the FBI. It only has one paragraph calling for lawmakers to cut funding by $545 million.

Patel testified during the two-hour Senate hearing that he had identified most of the accounts that could lose funding, though he wasn’t prepared to share that information with the committee or give a timeline when he would.

Patel also declined to tell lawmakers when the FBI would send Congress its spending plan for the current fiscal year, which is required by law and past due.

“I don’t have a timeline on that,” Patel said.

Kansas senator pleads with Patel for details

Kansas Republican Sen. Jerry Moran, the subcommittee’s chairman, said he was holding the hearing to get the ball rolling on the upcoming appropriations process and encouraged Patel to get the committee more details.

“We wanted to get every piece of information we could as early as we could, even though the budgetary process and now the appropriations process is disjointed and things are lacking,” Moran said.

Moran said that he was “concerned by the scale of the cut, especially as I know full well it comes on the heels of two years where the FBI’s budget was essentially held flat, forcing it to absorb hundreds of millions of dollars in unavoidable inflationary increases.”

Patel declined to say if he would testify before the committee again after the Trump administration releases its full budget request, which should include considerably more detail and is expected to come out sometime later this year, though the White House hasn’t said when.

The House and Senate Appropriations subcommittees that fund the FBI will write the bill over the summer and will likely negotiate final bipartisan, bicameral bills this fall.

That bill is one of a dozen that provide funding for many of the departments and agencies that make up the federal government, including Agriculture, Energy, Defense, Health and Human Services. Homeland Security, Interior, State, and many more. 

FEMA leader ousted, one day after publicly opposing agency’s elimination

Cam Hamilton, at the time senior official performing the duties of the administrator at FEMA, testifies before a House Appropriations subcommittee on May 7, 2025. (Screenshot from House webcast)

Cam Hamilton, at the time senior official performing the duties of the administrator at FEMA, testifies before a House Appropriations subcommittee on May 7, 2025. (Screenshot from House webcast)

WASHINGTON — The Trump administration has ousted the leader of the Federal Emergency Management Agency and replaced him with another official, States Newsroom has confirmed.

Cam Hamilton, senior official performing the duties of the administrator at FEMA, was let go just one day after he testified before Congress about the size and scope of the federal agency.

President Donald Trump and Homeland Security Secretary Kristi Noem have both indicated they could support getting rid of FEMA and Trump has established a FEMA reform council to assess the agency’s role.

But during his testimony Wednesday before the House Appropriations Homeland Security Subcommittee, Hamilton said he personally did “not believe it is in the best interest of the American people to eliminate the Federal Emergency Management Agency.”

“Having said that, I’m not in a position to make decisions and impact outcomes on whether or not a determination such as consequential as that should be made,” Hamilton said. “That is a conversation that should be had between the president of the United States and this governing body on identifying the exact ways and methodologies, in which, what is prudent for federal investment, and what is not.”

Hamilton, a former Navy Seal and combat medic, said earlier in the hearing that he had served in five different administrations, but that the “highest honor of my career is serving right now in the Trump administration. Keeping the American people first.”

A Department of Homeland Security spokesperson confirmed to States Newsroom on Thursday that Hamilton was no longer in the lead role at FEMA, but opted not to detail why exactly the personnel change happened.

“Mr. David Richardson will be the senior official performing the duties of the Administrator,” the DHS spokesperson wrote in an email.

A FEMA spokesperson confirmed the firing as well, writing that “(e)ffective today, David Richardson is now serving as the Senior Official Performing the duties of the FEMA Administrator. Cameron Hamilton is no longer serving in this capacity.”

DHS Assistant Secretary for Public Affairs Tricia McLaughlin released a statement Friday saying the administration had named Hamilton as the senior adviser for school safety in the Office of Elementary & Secondary Education at the Department of Education.

Richardson was appointed the assistant secretary of Countering Weapons of Mass Destruction Office at the Department of Homeland Security in January, according to his biography

House Appropriations Committee ranking member Rosa DeLauro, D-Conn., released a statement saying the “Trump administration must explain why he has been removed from this position.

“Integrity and morality should not cost you your job, and if it does, it says more about your employer than it does you.”

Florida Democratic Rep. Debbie Wasserman Schultz, a senior member of the Appropriations Committee, wrote in a statement that firing “FEMA’s chief just three weeks before hurricane season begins shows how little President Trump cares about Floridians’ and Americans’ safety.

“The added cruelty of his timing — a day after acting Administrator Hamilton publicly opposed dismantling the agency during a Congressional budget hearing — sends a chilling message from Trump that every American is on their own and that Trump Administration officials cannot be trusted to offer their candid, expert opinion to Congress or anyone, without consequences.”

U.S. House panel debates FEMA’s role, as Trump administration eyes ‘top-down reform’

Anna Schlobohm de Cruder stands in the remains of her home, which was destroyed in the Eaton Fire on March 20, 2025 in Altadena, California.  (Photo by Mario Tama/Getty Images)

Anna Schlobohm de Cruder stands in the remains of her home, which was destroyed in the Eaton Fire on March 20, 2025 in Altadena, California.  (Photo by Mario Tama/Getty Images)

WASHINGTON — U.S. House lawmakers on Wednesday began debating when the Federal Emergency Management Agency should provide state and local communities with help addressing natural disasters and when aid should be handled by others.

The Appropriations Homeland Security Subcommittee’s hearing on FEMA’s budget for the upcoming fiscal year came just days after the Trump administration sent its spending proposal to Capitol Hill.

That “skinny” request, however, didn’t include an actual spending level for FEMA, only suggesting that Congress cut $646 million for various non-disaster grant programs, including Targeting Violence and Terrorism Prevention, and the National Domestic Preparedness Consortium.

Chairman Mark Amodei, R-Nevada, urged the FEMA official at the hearing to get the full budget request to the committee sooner rather than later.

“If we don’t have the information, it’s going to be a problem,” he said. “And I’m not threatening. You don’t need threatening. We don’t work that way.”

Amodei also told Cam Hamilton, senior official performing the duties of the administrator at FEMA, that the agency needs to communicate with lawmakers better, especially those on the panel that provides its funding.

“I’m not trying to horn in on your guys’ discretion of running your program,” Amodei said. “But what I am definitely trying to horn in on is, not being faced with a situation where the bell’s already been rung. Now I’ve got to un-ring the bell.”

Amodei was referencing FEMA halting funding for Building Resilient Infrastructure and Communities, or BRIC, grants, including for three projects within a few miles of his front porch that he didn’t know existed until recently.

Hamilton said that Trump administration officials “found a lot of inefficiencies with the design of the program itself, which caused us to have serious concern over whether it was the appropriate use of taxpayer funds for many projects that were funded that we believe were very wasteful.”

“But there are also projects that were fully funded that we intend to move forward to completion,” Hamilton added. “We’re unpacking and analyzing that. Every grant recipient, under BRIC, should receive some form of notification” soon from FEMA regional offices. 

No budget numbers

The 90-minute hearing, which would typically have centered around the numbers in FEMA’s budget request, was instead a bit of a referendum on the size and scope of the agency, as well as expectations the Trump administration will seek to significantly reduce its mission.

Hamilton, asked point-blank if FEMA should continue to exist, testified that he personally did “not believe it is in the best interest of the American people to eliminate the Federal Emergency Management Agency.”

“Having said that, I’m not in a position to make decisions and impact outcomes on whether or not a determination, such as consequential as that should be made,” he said. “That is a conversation that should be had between the president of the United States and this governing body on identifying the exact ways and methodologies, in which, what is prudent for federal investment, and what is not.”

Illinois Democratic Rep. Lauren Underwood, ranking member on the panel, said she would not support efforts to completely shift FEMA responsibilities onto state and local governments.

State emergency management leaders, she said, “are not equipped to handle the roles FEMA currently plays—- marshaling emergency resources for multiple federal agencies, providing flood insurance, conducting damage assessments and distributing billions of dollars in recovery funds.”

“Pushing disaster response and recovery fully back to the states is dangerous and unrealistic,” Underwood said.

Hamilton said the Trump administration is looking at ways to institute “top-down reform” and “overhaul the grant process entirely” as well as other possible recommendations from the FEMA review council.

“FEMA was established to provide focused support in truly catastrophic disasters,” Hamilton said. “Yet at times, we have strayed far from that core mission and evolved into an over-extended federal bureaucracy; attempting to manage every type of emergency, no matter how minor.

“Instead of being a last resort, FEMA is all too often used by states and public officials as a financial backstop for routine issues that, frankly, should be handled locally. This misalignment has fostered a culture of dependency, waste, inefficiency, while also delaying crucial aid to Americans who are in genuine need.”

Disaster relief deficit

One of the more immediate budgetary issues facing FEMA is that its disaster relief fund is slated to run at least a $9 billion deficit before the end of the year, which several lawmakers raised concerns about during the hearing.

The Trump administration, however, does not plan to send Congress a supplemental spending request, asking lawmakers for more money for that account.

The disaster relief fund is able to run deficits, unlike the vast majority of federal programs. When the DRF runs out of funding, FEMA uses something called immediate needs funding to keep providing response and recovery to communities with declared disasters.

Hamilton said, even with the expected use of immediate needs funding again this year, FEMA was prepared to respond to hurricane season and ongoing wildfires.

“There are always challenges that we have to work through,” Hamilton said. “So we are focusing on ways to make us operationally more capable, and also finding ways to be more fiscally practical with our means, so that we don’t buttress us up against those kinds of thresholds nearly as quickly as before.”

 

Congressional budget agency projects sweeping Medicaid cutbacks in states under GOP plans

U.S. House Republicans are debating cutbacks to Medicaid, the health care program for lower-income Americans and some people with disabilities. (Photo by Thomas Barwick/Getty Images)

U.S. House Republicans are debating cutbacks to Medicaid, the health care program for lower-income Americans and some people with disabilities. (Photo by Thomas Barwick/Getty Images)

WASHINGTON — The Congressional Budget Office said Wednesday that potential major cuts and changes to Medicaid under consideration by Republicans could mean states would have to spend more of their own money on the program, reduce payments to health care providers, limit optional benefits and reduce enrollment.

The end result, under some scenarios, could be millions of Americans would be kicked off Medicaid and possibly left without health insurance, said the nonpartisan agency relied on by Congress for budget estimates.

The letter from CBO stemmed from a request by Senate Finance Committee ranking member Ron Wyden, D-Ore., and House Energy and Commerce ranking member Frank Pallone, D-N.J.

Both oppose GOP attempts to slash federal funding for the health care program for lower-income Americans and some people with disabilities. Republicans, who have not settled on an approach, say they are interested in ending waste, fraud and abuse in the program.

CBO Director Phillip Swagel wrote that possible Medicaid changes would likely lead to several outcomes in the states. The impact on states would occur because the federal government covers at least 50% of the cost of the program, with that share increasing in states with lower per capita incomes and those that expanded eligibility under the Affordable Care Act.

Wyden wrote in a statement the CBO letter showed “the Republican plan for health care means benefit cuts and terminated health insurance for millions of Americans who count on Medicaid.”

Pallone wrote in a statement of his own that reducing federal funding for the program by hundreds of billions of dollars would lead to “millions of people losing their health care.”

“(President Donald) Trump has repeatedly claimed Republicans are not cutting health care, but CBO’s independent analysis confirms the proposals under consideration will result in catastrophic benefit cuts and people losing their health care,” Pallone wrote. “It’s time for Republicans to stop lying to the American people about what they’re plotting behind closed doors in order to give giant tax breaks to billionaires and big corporations.”

Federal Fallout

As federal funding and systems dwindle, states are left to decide how and whether to make up the difference. Read the latest.

The Medicaid changes would come as Republicans use the complex budget reconciliation process to move a sweeping legislative package through Congress with simple majority votes in each chamber, avoiding the Senate’s 60-vote filibuster, which would otherwise require bipartisanship. 

The House Energy and Commerce Committee, which is tasked with cutting at least $880 billion from the programs it oversees — including Medicaid — during the next decade, has yet to release its bill that if approved by the committee will become part of that package.

The panel, led by Kentucky Republican Rep. Brett Guthrie, is expected to debut its proposed changes next week before debating the legislation during a yet-to-be-scheduled markup.

Republicans plan to use the reconciliation package to permanently extend the 2017 tax law, increase spending on border security and defense by hundreds of billions of dollars, overhaul American energy production, restructure higher education aid and cut spending.

Five scenarios

CBO’s analysis looked at five specific Medicaid scenarios including:

  • Congress reducing the federal match rate for the 40 states that expanded Medicaid eligibility under the Affordable Care Act, also known as Obamacare.
  • Lawmakers eliminating a 6% threshold that exists for states that collect higher taxes from health care providers and then return that additional money in the form of higher Medicaid payments. CBO writes those “higher Medicaid payments increase the contributions from the federal government to states’ Medicaid programs.”
  • Republicans creating a per-enrollee cap on federal spending.
  • Congress establishing a cap on federal spending for Medicaid enrollees who became eligible for the program after their state expanded eligibility under the ACA.
  • Lawmakers repealing two Biden-era rules that addressed the Medicare Savings Programs and standardized how states approached enrollment and renewals.

The analysis said states could raise taxes or cut spending on other programs to replace the lost federal revenue that would coincide with the first four scenarios, though CBO “expects that such steps would prove challenging for many states.”

“In CBO’s view, different states would make different choices regarding how much of the reduced Medicaid funds to replace,” the analysis states. “Instead of modeling separate responses for each state, the agency estimated state responses in the aggregate, accounting for a range of possible outcomes.”

Overall, CBO expects state governments would be able to replace about half of the lost federal revenue and that they would “reduce provider payment rates, reduce the scope or amount of optional services, and reduce Medicaid enrollment” to address the other half.

Alternatives studied

The first scenario, where lawmakers reduce the federal matching rate for expanded Medicaid populations, would save the government $710 billion during the next decade.

But in 2034, CBO expects that “2.4 million of the 5.5 million people who would no longer be enrolled in Medicaid under this option would be without health insurance.”

CBO wrote that in the second, third and fourth scenarios, “Medicaid enrollment would decrease and the number of people without health insurance would increase.”

The second scenario of limiting state taxes on health care providers would save the federal government $668 billion during the 10-year budget window. It would lead to 8.6 million people losing access to Medicaid with a 3.9 million increase in the uninsured population by 2034.

The third projection that looked at a federal cap on spending per enrollee would reduce federal spending by $682 billion during the next decade. A total of 5.8 million people would lose Medicaid coverage and 2.9 million would become uninsured under that proposal. 

And the fourth scenario, where Congress caps federal spending per enrollee in the expansion population, would cut the deficit by $225 billion during the next 10 years. More than 3 million people would lose Medicaid coverage and 1.5 million would become uninsured under this scenario.

Under the fifth scenario, where GOP lawmakers would change two Biden-era rules, CBO expects that the federal government would spend $162 billion less over the 2025–2034 window.

“CBO estimates that, in 2034, 2.3 million people would no longer be enrolled in Medicaid under this option,” the letter states. “Roughly 60 percent of the people who would lose Medicaid coverage would be dual-benefit enrollees who would retain their Medicare coverage.” 

U.S. Senate confirms Bisignano to lead Social Security, with all Dems in opposition

Frank Bisignano, Social Security commissioner nominee, at his Senate Finance Committee confirmation hearing on March 25, 2025. (Senate webcast)

Frank Bisignano, Social Security commissioner nominee, at his Senate Finance Committee confirmation hearing on March 25, 2025. (Senate webcast)

WASHINGTON — The U.S. Senate on Tuesday confirmed Frank Bisignano as Social Security commissioner, putting him in charge of a $1.5 trillion entitlement program that’s relied on by tens of millions of Americans.

The 53-47 party-line vote drops a considerable amount of responsibility onto Bisignano, who will not only be tasked with fixing the Social Security Administration’s customer services issues, but ensuring plans to cut its staff by at least 7,000 workers doesn’t hinder the safety net program that helps to keep seniors out of poverty.

Oregon Democratic Sen. Ron Wyden said during a floor speech just before the vote that Bisignano should have been disqualified from consideration after he “lied multiple times” during the confirmation process.

Wyden also argued that Bisignano would institute substantial changes at the Social Security Administration, which could negatively affect people who rely on the program.

“Every single member of this body that votes to confirm this nominee is going to own the consequences,” Wyden said. “Mr. Bisignano is unfit to be the steward of Americans’ hard-earned Social Security benefits.”

Sen. Mike Crapo, R-Idaho, said during a floor speech last week that he was “confident” Bisignano held the “experience needed to lead this important agency.”

“The Social Security Administration needs steady, Senate-confirmed leadership,” Crapo said. “Mr. Bisignano would bring his decades-long focus on customer service and operational excellence to the Social Security Administration.”

Wait times, error rate

Bisignano said during his nearly three-hour confirmation hearing in March that he would make sure beneficiaries could visit an office, use the website, or speak to a real person after calling the 1-800 number.

“On the phone, I’m committed to reducing wait times and providing beneficiaries with a better experience; waiting 20 minutes-plus to get an answer will be of yesteryear,” Bisignano said at the time. “I also believe we can significantly improve the length of the disability claim process.”

Bisignano told lawmakers during the hearing he would reduce the 1% error rate in payments, which he said was “five decimal places too high.”

Whistleblower allegations

The Senate Finance Committee voted along party lines in April to send Bisignano’s nomination to the floor, though Chairman Crapo said at the time the panel would look into a whistleblower’s allegations.

“Even though the timing of the anonymous letter suggests a political effort to delay the committee vote on this nominee, my staff have told Sen. Wyden’s staff — and we have discussed this just now — we are open to meeting with the author of the letter and keeping the individual anonymous,” Crapo said. “However, any information provided by the individual must be thoroughly vetted, including allowing the nominee the opportunity to respond.”

Wyden, ranking member on the panel, urged Republicans to delay that committee vote until after the investigation concluded.

“This nominee lied multiple times to every member of this committee, including the bipartisan Finance staff and the nominee’s actions and communications with DOGE remain very much at the heart of my objection here,” Wyden said. “My office received an account from a whistleblower about the ways the nominee was deeply involved in and aware of DOGE’s activities at the agency.”

Crapo said during his floor speech last week that the whistleblower “allegations focused on the frequency and details of communications between the nominee and Social Security Administration officials.”

“Mr. Bisignano addressed these allegations during the hearing and responded in writing as part of the questions for the record,” Crapo added. “He has stated clearly that he does not currently have a role at the Social Security Administration and was not part of the decision-making process led by the Acting Commissioner, Lee Dudek, about Social Security operations, personnel, or management.”

Bisignano, of New Jersey, most recently worked as chairman of the board and chief executive officer at Fiserv, Inc., which “enables money movement for thousands of financial institutions and millions of people and businesses,” according to its website. The company is based in Wisconsin.

He previously worked as co-chief operating officer and chief executive officer of Mortgage Banking at JPMorgan Chase & Co.

Nonpartisan poll finds ‘remarkably low’ trust in federal health agencies

Robert F. Kennedy Jr., the secretary of Health and Human Services, testifies during his Senate Finance Committee confirmation hearing at the Dirksen Senate Office Building on Jan. 29, 2025, in Washington, D.C. (Photo by Win McNamee/Getty Images)

Robert F. Kennedy Jr., the secretary of Health and Human Services, testifies during his Senate Finance Committee confirmation hearing at the Dirksen Senate Office Building on Jan. 29, 2025, in Washington, D.C. (Photo by Win McNamee/Getty Images)

WASHINGTON — Less than half of Americans have confidence in federal public health agencies’ ability to regulate prescriptions, approve vaccines and respond to outbreaks, according to a poll released Tuesday by the nonpartisan health research organization KFF.

The survey shows that just 46% of the people questioned have at least some confidence in federal agencies ensuring the safety and effectiveness of prescription drugs.

Even fewer, 45%, have confidence in the safety and effectiveness of vaccines and only 42% said they have confidence federal health agencies to respond to infectious disease outbreaks, like bird flu and measles.

An especially low percentage of those polled, 32%, had either some confidence or a lot of confidence in federal health agencies acting independently without interference from outside interests.

“There are remarkably low levels of trust in the nation’s scientific agencies, shaped by partisan perspectives, and that presents a real danger for the country if and when another pandemic hits,” KFF President and CEO Drew Altman wrote in a statement accompanying the poll.

Confidence in agencies sags or rises by party affiliation

The percentage of people overall who hold confidence in the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention to provide reliable information about vaccines has dropped since a similar survey in September 2023, though party affiliation shows differing trends.

Democrats with a fair amount or great deal of trust in the FDA’s vaccine information has decreased from 86% to 67%, while trust among Republicans has increased from 42% to 52%.

When combined with independents, overall trust in the FDA’s information about vaccines has decreased, from 61% to 57%.

Confidence in the CDC providing reliable information about vaccines has also shifted based on party affiliation.

During the Biden administration, 88% of Democrats had a fair amount or great deal of trust in the CDC, though that has since dropped to 70%. Republicans have started to come back around to the CDC’s vaccine information, with their level of trust increasing from 40% to 51%.

Altogether, trust in CDC has dropped from 63% to 59%, according to the survey.

“The overall level of trust in each case is similar to where it stood in September 2023, though the poll reveals significant partisan shifts as the second Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr. have started to change vaccine policies and messaging,” the poll states.

Local sources trusted

Health care providers and local public health departments are overwhelmingly looked to as trusted sources for reliable information on vaccines, according to the survey.

Eighty-two percent of respondents said they either have a great deal or a fair amount of trust in doctors and health care providers to give them reliable information about vaccines.

Eighty-one percent said they trust their child’s pediatrician, 66% responded they have confidence in their local public health department, 59% believe in the CDC, 57% trust the FDA and 51% have confidence in pharmaceutical companies to provide factual information about vaccines.

Those polled held less trust in politicians, with 41% believing Kennedy’s comments about vaccines and 37% trusting President Donald Trump “to provide reliable information about vaccines,” according to the poll.

A majority of those surveyed, however, are somewhat or very confident in the safety of several vaccines, including 83% for measles, mumps and rubella, or the MMR vaccine; 82% for pneumonia; 79% for shingles; 74% for the flu; and 56% for COVID-19.

The poll included 1,380 U.S. adults contacted online or via telephone from April 8-15, for a margin of error of plus or minus 3 percentage points. 

Trump administration asks to dismiss suit by 3 GOP states trying to limit abortion pill

Idaho, Kansas and Missouri want a federal judge to let them intervene in a case that’s already been to the U.S. Supreme Court, so they can argue the FDA erred when it updated prescribing guidelines for abortion medication, shown in photo, in 2016.  (Photo by Peter Dazeley/Getty Images)

Idaho, Kansas and Missouri want a federal judge to let them intervene in a case that’s already been to the U.S. Supreme Court, so they can argue the FDA erred when it updated prescribing guidelines for abortion medication, shown in photo, in 2016.  (Photo by Peter Dazeley/Getty Images)

WASHINGTON — The Department of Justice wrote in a legal filing released Monday that three GOP-led states attempting to overturn federal prescribing guidelines for medication abortion have sought to keep a case going in the wrong place at the wrong time.

The filing is significant since it appears to indicate the Trump administration will defend the U.S. Food and Drug Administration’s decision nine years ago to broaden access to mifepristone. The Biden administration also sought to keep the newer prescribing guidelines intact.

Idaho, Kansas and Missouri want a federal judge to let them intervene in a case that’s already been to the U.S. Supreme Court, so they can argue the FDA erred when it updated prescribing guidelines for mifepristone in 2016.

The goal is to get those changes thrown out so use of mifepristone, one of two pharmaceuticals used in medication abortion, reverts to what was in place between 2000 and 2016.

That would cap medication abortion at seven weeks gestation instead of the current 10 weeks and patients seeking medication abortions would need to attend three, in-person doctor appointments. Medication abortion would no longer be available via telehealth and it could no longer be legally mailed to patients.

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The Trump administration wrote in a 15-page brief filed with the U.S. District Court for Northern District of Texas that the three states “cannot keep alive a lawsuit in which the original plaintiffs were held to lack standing, those plaintiffs have now voluntarily dismissed their claims, and the States’ own claims have no connection to this District.”

“The States are free to pursue their claims in a District where venue is proper … but the States’ claims before this Court must be dismissed or transferred pursuant to the venue statute’s mandatory command,” the brief adds.

The Department of Justice also wrote that at “a minimum, the States’ challenge to FDA’s 2016 actions is time-barred because the States sought to intervene more than six years after FDA finalized those actions.”

Original suit began in 2022

The original case challenging the federal government’s 2000 approval and current prescribing guidelines for medication abortion began in November 2022 when anti-abortion groups filed their lawsuit in the U.S. District Court for Northern District of Texas.

That case worked its way up to the U.S. Supreme Court, which ruled in June 2024 that the anti-abortion organizations lacked standing to bring the case.

But Idaho, Kansas and Missouri state officials sought to intervene in the case before it reached the high court and have tried to keep the challenge to the 2016 prescribing guidelines moving forward.

The Department of Justice wrote in its brief that there were several reasons the case shouldn’t continue in the Northern District of Texas.

Among those is that the three states “fail to identify any actual or imminent controversy over whether any of their laws are preempted” and that they lack Article III standing since “they failed to exhaust their claims; and their challenge to FDA’s 2016 actions is outside the six-year statute of limitations.”

The case is assigned to Judge Matthew Joseph Kacsmaryk, who overturned the FDA’s original 2000 approval of mifepristone in April 2023 in the original lawsuit.

That ruling never took effect as the original lawsuit worked its way through the 5th Circuit Court of Appeals and up to the Supreme Court. 

Trump asks Congress to cut $163B in non-defense spending, ax dozens of programs

From left to right, Secretary of State Marco Rubio, President Donald Trump and Secretary of Defense Pete Hegseth attend a Cabinet meeting at the White House on April 30, 2025, in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

From left to right, Secretary of State Marco Rubio, President Donald Trump and Secretary of Defense Pete Hegseth attend a Cabinet meeting at the White House on April 30, 2025, in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — President Donald Trump released a budget request Friday that would dramatically slash some federal spending, the initial step in a monthslong process that will include heated debate on Capitol Hill as both political parties work toward a final government funding agreement.

The proposal, for the first time, details how exactly this administration wants lawmakers to restructure spending across the federal government — steep cuts to domestic appropriations, including the elimination of dozens of programs that carry a long history of bipartisan support, and a significant increase in defense funding.

Trump wants more than 60 programs to be scrapped, some with long histories of assistance to states, including Community Services Block Grants, the Low Income Home Energy Assistance Program, the National Endowment for Democracy, the National Institute on Minority and Health Disparities within the National Institutes of Health, and the Sexual Risk Avoidance and Teen Pregnancy Prevention programs.

Congress will ultimately decide how much funding to provide to federal programs, and while Republicans hold majorities in both chambers, regular funding bills will need Democratic support to move through the Senate’s 60-vote legislative filibuster.

White House budget director Russ Vought wrote in a letter that the request proposes shifting some funding from the federal government to states and local communities.

“Just as the Federal Government has intruded on matters best left to American families, it has intruded on matters best left to the levels of government closest to the people, who understand and respect the needs and desires of their communities far better than the Federal Government ever could,” Vought wrote.

The budget request calls on Congress to cut non-defense accounts by $163 billion to $557 billion, while keeping defense funding flat at $893 billion in the dozen annual appropriations bills.

The proposal assumes the GOP Congress passes the separate reconciliation package that is currently being written in the House, bringing defense funding up to $1.01 trillion, a 13.4% increase, and reducing domestic spending to $601 billion, a 16.6% decrease.

Many domestic cuts

Under Trump’s request many federal departments and agencies would be slated for significant spending reductions, though defense, border security and veterans would be exempt. 

The cuts include:

  • Agriculture: – $5 billion, or 18.3%
  • Commerce: – $1.7 billion, or 16.5%
  • Education: – $12 billion, or 15.3%
  • Energy: – $4.7 billion, or 9.4%
  • Health and Human Services: – $33 billion, or 26.2%
  • Housing and Urban Development: – $33.6 billion, or 43.6%
  • Interior: – $5.1 billion, or 30.5%
  • Justice: – $2.7 billion, or 7.6%
  • Labor: – $4.6 billion, or 34.9%
  • State: – $49.1 billion, or 83.7%
  • Treasury: – $2.7 billion, or 19%

Increases include:

  • Defense: + $113 billion, or 13.4% with reconciliation package
  • Homeland Security: + $42.3 billion, or 64.9% with reconciliation package
  • Transportation: + $1.5 billion, or 5.8%
  • Veterans Affairs: + $5.4 billion, or 4.1%

The budget request also asks Congress to eliminate AmeriCorps, which operates as the Corporation for National and Community Service; the Corporation for Public Broadcasting, which provides some funding to National Public Radio and the Public Broadcasting Service; the Institute of Museum and Library Sciences; and the 400 Years of African American History Commission.

What if Congress won’t act on the cuts?

Debate over the budget proposal will take place throughout the summer months, but will come to a head in September, when Congress must pass some sort of funding bill to avoid a partial government shutdown.

A senior White House official, speaking on background on a call with reporters to discuss details of the budget request, suggested that Trump would take unilateral action to cut funding if Congress doesn’t go along with the request.

“Obviously, we have never taken impoundment off the table, because the president and myself believe that 200 years of the president and executive branch had that ability,” the official said. “But we’re working with Congress to see what they will pass. And I believe that they have an interest in passing cuts.”

The 1974 Impoundment Control Act bars the president from canceling funding approved by Congress without consulting lawmakers via a rescissions request, which the officials said the administration plans to release “soon.”

The annual appropriations process is separate from the reconciliation process that Republicans are using to pass their massive tax cuts, border security, defense funding and spending cuts package.

Huge boost for Homeland Security

The budget proposal aligns with the Trump’s administration’s plans for mass deportations of people without permanent legal status, and would provide the Department of Homeland Security with $42.3 billion, or a 64.9% increase.

The budget proposal suggests eliminating $650 million from a program that reimburses non-governmental organizations and local governments that help with resettling and aiding newly arrived migrants released from DHS custody, known as the Shelters and Services Program.

The Trump administration also seeks to eliminate the agency that handles the care and resettlement of unaccompanied minors within Health and Human Services. The budget proposal recommends getting rid of the Refugee and Unaccompanied Alien Children Programs’ $1.97 billion budget. The budget proposal argues that because of an executive order to suspend refugee resettlement services, there is no need for the programs.

A federal judge from Washington state issued a nationwide injunction, and ruled the Trump administration must continue refugee resettlement services.

The budget proposal also calls for axing programs that help newly arrived migrant children or students for whom English is not a first language.

For the Education Department, the budget proposal suggests eliminating $890 million in funding for the English Language Acquisition and $428 million for the Migrant Education and Special Programs for Migrant Students.

Key GOP senator rejects defense request

Members of Congress had mixed reactions to the budget request, with some GOP lawmakers praising its spending cuts, while others took issue with the defense budget.

Senate Armed Services Committee Chairman Roger Wicker, R-Miss., outright rejected the defense funding level, writing in a statement that relying on the reconciliation package to get military spending above $1 trillion was unacceptable. 

“OMB is not requesting a trillion-dollar budget. It is requesting a budget of $892.6 billion, which is a cut in real terms. This budget would decrease President Trump’s military options and his negotiating leverage,” Wicker wrote. “We face an Axis of Aggressors led by the Chinese Communist Party, who have already started a trade war rather than negotiate in good faith. We need a real Peace Through Strength agenda to ensure Xi Jinping does not launch a military war against us in Asia, beyond his existing military support to the Russians, the Iranians, Hamas, and the Houthis.”

The senior White House official who spoke on a call with reporters to discuss details of the budget request said that splitting the defense increase between the regular Pentagon spending bill and the reconciliation package was a more “durable” proposal.

Maine Republican Sen. Susan Collins, chairwoman of the Appropriations Committee, wrote the panel will have “an aggressive hearing schedule to learn more about the President’s proposal and assess funding needs for the coming year.”

“This request has come to Congress late, and key details still remain outstanding,” Collins wrote. “Based on my initial review, however, I have serious objections to the proposed freeze in our defense funding given the security challenges we face and to the proposed funding cuts to – and in some cases elimination of – programs like LIHEAP, TRIO, and those that support biomedical research. 

“Ultimately, it is Congress that holds the power of the purse.”

Senate Appropriations Committee ranking member Patty Murray, D-Wash., wrote in a statement she will work with others in Congress to block the domestic funding cuts from taking effect.

“Trump wants to rip away funding to safeguard Americans’ health, protect our environment, and to help rural communities and our farmers thrive. This president wants to turn our country’s back on Tribes—and let trash pile up at our national parks,” Murray wrote. “Trump is even proposing to cut investments to prevent violent crime, go after drug traffickers, and tackle the opioids and mental health crises.”

A press release from Murray’s office noted the budget request lacked details on certain programs, including Head Start.

House Speaker Mike Johnson R-La, praised the budget proposal in a statement and pledged that House GOP lawmakers are “ready to work alongside President Trump to implement a responsible budget that puts America first.”

“President Trump’s plan ensures every federal taxpayer dollar spent is used to serve the American people, not a bloated bureaucracy or partisan pet projects,” Johnson wrote.

Spending decisions coming

The House and Senate Appropriations committees are set to begin hearings with Cabinet secretaries and agency heads next week, where Trump administration officials will explain their individual funding requests and answer lawmakers’ questions.

The members on those committees will ultimately write the dozen annual appropriations bills in the months ahead, determining funding levels and policy for numerous programs, including those at the departments of Agriculture, Defense, Education, Health and Human Services, Homeland Security, Interior, Justice, State and Transportation.

The House panel’s bills will skew more toward Republican funding levels and priorities, though the Senate committee has a long history of writing broadly bipartisan bills. 

The leaders of the two committees — House Chairman Tom Cole, R-Okla., House ranking member Rosa DeLauro, D-Conn., Senate Chairwoman Collins and Senate ranking member Murray — will ultimately work out a final deal later in the year alongside congressional leaders.

Differences over the full-year bills are supposed to be solved before the start of the new fiscal year on Oct. 1, but members of Congress regularly rely on a stopgap spending bill through mid-December to give themselves more time to complete negotiations.

Failure to pass some sort of government funding measure, either a stopgap bill or all 12 full-year spending bills, before the funding deadline, would lead to a partial government shutdown.

This round of appropriations bills will be the first debated during Trump’s second-term presidency and will likely bring about considerable disagreement over the unilateral actions the administration has already taken to freeze or cancel federal spending, many of which are the subject of lawsuits arguing the president doesn’t have that impoundment authority. 

Puzzled senators question Trump’s FBI chief on nonexistent spending plan

FBI director Kash Patel testifies before a U.S. Senate Appropriations subcommittee on Thursday, May 8, 2025. (Photo from U.S. Senate webcast)

FBI director Kash Patel testifies before a U.S. Senate Appropriations subcommittee on Thursday, May 8, 2025. (Photo from U.S. Senate webcast)

WASHINGTON — The case of the missing Federal Bureau of Investigation budget request was on full display Thursday, when senators repeatedly asked the law enforcement agency’s director what resources he needed Congress to provide in the upcoming fiscal year.

FBI Director Kash Patel did not disclose a dollar amount, an unusual development at a hearing at which an agency head traditionally discusses a budget request in detail with lawmakers who hold the purse strings.

The Senate Appropriations Commerce-Justice-Science Subcommittee hearing came one day after Patel testified before a House panel that he needs more money from Congress than was asked for in the Trump administration’s budget request.

Patel’s written statement to the House subcommittee said the FBI’s total request was $10.1 billion, but during that hearing he told appropriators the agency needed at least $11.2 billion.

Patel rejecting the Trump administration’s official budget request in support of his own proposal to Congress was significant in that Cabinet secretaries almost always stick to the official request, at least during public hearings.

“The skinny budget is a proposal, and I’m working through the appropriations process to explain why we need more than what has been proposed,” Patel said during the House hearing Wednesday.

Never mind

Less than 24 hours later, he reversed course during the Senate hearing, saying his comments were misconstrued.

“President Trump has set new priorities and a focus on federal law enforcement. I’m here today in full support of the president’s budget, which reprioritizes and enhances our mission of law enforcement and national security,” Patel said in his opening statement. “We’re fighting for a fully funded FBI because we want a fully effective FBI.”

What that dollar amount might be was unclear, though.

During an exchange with Washington state Democratic Sen. Patty Murray, ranking member on the full Appropriations Committee, about what exactly the FBI needs in terms of funding, Patel said: “I’m not asking you for anything at this time.”

Murray responded by asking if he believed the FBI could “operate without a budget.” Patel responded that he “never said that.”

Republicans and Democrats on the Senate panel repeatedly brought up that the Trump administration’s “skinny” budget proposal, released last week, doesn’t actually include a total funding level for the FBI. It only has one paragraph calling for lawmakers to cut funding by $545 million.

Patel testified during the two-hour Senate hearing that he had identified most of the accounts that could lose funding, though he wasn’t prepared to share that information with the committee or give a timeline when he would.

Patel also declined to tell lawmakers when the FBI would send Congress its spending plan for the current fiscal year, which is required by law and past due.

“I don’t have a timeline on that,” Patel said.

Kansas senator pleads with Patel for details

Kansas Republican Sen. Jerry Moran, the subcommittee’s chairman, said he was holding the hearing to get the ball rolling on the upcoming appropriations process and encouraged Patel to get the committee more details.

“We wanted to get every piece of information we could as early as we could, even though the budgetary process and now the appropriations process is disjointed and things are lacking,” Moran said.

Moran said that he was “concerned by the scale of the cut, especially as I know full well it comes on the heels of two years where the FBI’s budget was essentially held flat, forcing it to absorb hundreds of millions of dollars in unavoidable inflationary increases.”

Patel declined to say if he would testify before the committee again after the Trump administration releases its full budget request, which should include considerably more detail and is expected to come out sometime later this year, though the White House hasn’t said when.

The House and Senate Appropriations subcommittees that fund the FBI will write the bill over the summer and will likely negotiate final bipartisan, bicameral bills this fall.

That bill is one of a dozen that provide funding for many of the departments and agencies that make up the federal government, including Agriculture, Energy, Defense, Health and Human Services. Homeland Security, Interior, State, and many more. 

FEMA leader ousted, one day after publicly opposing agency’s elimination

Cam Hamilton, at the time senior official performing the duties of the administrator at FEMA, testifies before a House Appropriations subcommittee on May 7, 2025. (Screenshot from House webcast)

Cam Hamilton, at the time senior official performing the duties of the administrator at FEMA, testifies before a House Appropriations subcommittee on May 7, 2025. (Screenshot from House webcast)

WASHINGTON — The Trump administration has ousted the leader of the Federal Emergency Management Agency and replaced him with another official, States Newsroom has confirmed.

Cam Hamilton, senior official performing the duties of the administrator at FEMA, was let go just one day after he testified before Congress about the size and scope of the federal agency.

President Donald Trump and Homeland Security Secretary Kristi Noem have both indicated they could support getting rid of FEMA and Trump has established a FEMA reform council to assess the agency’s role.

But during his testimony Wednesday before the House Appropriations Homeland Security Subcommittee, Hamilton said he personally did “not believe it is in the best interest of the American people to eliminate the Federal Emergency Management Agency.”

“Having said that, I’m not in a position to make decisions and impact outcomes on whether or not a determination such as consequential as that should be made,” Hamilton said. “That is a conversation that should be had between the president of the United States and this governing body on identifying the exact ways and methodologies, in which, what is prudent for federal investment, and what is not.”

Hamilton, a former Navy Seal and combat medic, said earlier in the hearing that he had served in five different administrations, but that the “highest honor of my career is serving right now in the Trump administration. Keeping the American people first.”

A Department of Homeland Security spokesperson confirmed to States Newsroom on Thursday that Hamilton was no longer in the lead role at FEMA, but opted not to detail why exactly the personnel change happened.

“Mr. David Richardson will be the senior official performing the duties of the Administrator,” the DHS spokesperson wrote in an email.

A FEMA spokesperson confirmed the firing as well, writing that “(e)ffective today, David Richardson is now serving as the Senior Official Performing the duties of the FEMA Administrator. Cameron Hamilton is no longer serving in this capacity.”

Richardson was appointed the assistant secretary of Countering Weapons of Mass Destruction Office at the Department of Homeland Security in January, according to his biography

House Appropriations Committee ranking member Rosa DeLauro, D-Conn., released a statement saying the “Trump administration must explain why he has been removed from this position.

“Integrity and morality should not cost you your job, and if it does, it says more about your employer than it does you.”

Florida Democratic Rep. Debbie Wasserman Schultz, a senior member of the Appropriations Committee, wrote in a statement that firing “FEMA’s chief just three weeks before hurricane season begins shows how little President Trump cares about Floridians’ and Americans’ safety.

“The added cruelty of his timing — a day after acting Administrator Hamilton publicly opposed dismantling the agency during a Congressional budget hearing — sends a chilling message from Trump that every American is on their own and that Trump Administration officials cannot be trusted to offer their candid, expert opinion to Congress or anyone, without consequences.”

U.S. House panel debates FEMA’s role, as Trump administration eyes ‘top-down reform’

Anna Schlobohm de Cruder stands in the remains of her home, which was destroyed in the Eaton Fire on March 20, 2025 in Altadena, California.  (Photo by Mario Tama/Getty Images)

Anna Schlobohm de Cruder stands in the remains of her home, which was destroyed in the Eaton Fire on March 20, 2025 in Altadena, California.  (Photo by Mario Tama/Getty Images)

WASHINGTON — U.S. House lawmakers on Wednesday began debating when the Federal Emergency Management Agency should provide state and local communities with help addressing natural disasters and when aid should be handled by others.

The Appropriations Homeland Security Subcommittee’s hearing on FEMA’s budget for the upcoming fiscal year came just days after the Trump administration sent its spending proposal to Capitol Hill.

That “skinny” request, however, didn’t include an actual spending level for FEMA, only suggesting that Congress cut $646 million for various non-disaster grant programs, including Targeting Violence and Terrorism Prevention, and the National Domestic Preparedness Consortium.

Chairman Mark Amodei, R-Nevada, urged the FEMA official at the hearing to get the full budget request to the committee sooner rather than later.

“If we don’t have the information, it’s going to be a problem,” he said. “And I’m not threatening. You don’t need threatening. We don’t work that way.”

Amodei also told Cam Hamilton, senior official performing the duties of the administrator at FEMA, that the agency needs to communicate with lawmakers better, especially those on the panel that provides its funding.

“I’m not trying to horn in on your guys’ discretion of running your program,” Amodei said. “But what I am definitely trying to horn in on is, not being faced with a situation where the bell’s already been rung. Now I’ve got to un-ring the bell.”

Amodei was referencing FEMA halting funding for Building Resilient Infrastructure and Communities, or BRIC, grants, including for three projects within a few miles of his front porch that he didn’t know existed until recently.

Hamilton said that Trump administration officials “found a lot of inefficiencies with the design of the program itself, which caused us to have serious concern over whether it was the appropriate use of taxpayer funds for many projects that were funded that we believe were very wasteful.”

“But there are also projects that were fully funded that we intend to move forward to completion,” Hamilton added. “We’re unpacking and analyzing that. Every grant recipient, under BRIC, should receive some form of notification” soon from FEMA regional offices. 

No budget numbers

The 90-minute hearing, which would typically have centered around the numbers in FEMA’s budget request, was instead a bit of a referendum on the size and scope of the agency, as well as expectations the Trump administration will seek to significantly reduce its mission.

Hamilton, asked point-blank if FEMA should continue to exist, testified that he personally did “not believe it is in the best interest of the American people to eliminate the Federal Emergency Management Agency.”

“Having said that, I’m not in a position to make decisions and impact outcomes on whether or not a determination, such as consequential as that should be made,” he said. “That is a conversation that should be had between the president of the United States and this governing body on identifying the exact ways and methodologies, in which, what is prudent for federal investment, and what is not.”

Illinois Democratic Rep. Lauren Underwood, ranking member on the panel, said she would not support efforts to completely shift FEMA responsibilities onto state and local governments.

State emergency management leaders, she said, “are not equipped to handle the roles FEMA currently plays—- marshaling emergency resources for multiple federal agencies, providing flood insurance, conducting damage assessments and distributing billions of dollars in recovery funds.”

“Pushing disaster response and recovery fully back to the states is dangerous and unrealistic,” Underwood said.

Hamilton said the Trump administration is looking at ways to institute “top-down reform” and “overhaul the grant process entirely” as well as other possible recommendations from the FEMA review council.

“FEMA was established to provide focused support in truly catastrophic disasters,” Hamilton said. “Yet at times, we have strayed far from that core mission and evolved into an over-extended federal bureaucracy; attempting to manage every type of emergency, no matter how minor.

“Instead of being a last resort, FEMA is all too often used by states and public officials as a financial backstop for routine issues that, frankly, should be handled locally. This misalignment has fostered a culture of dependency, waste, inefficiency, while also delaying crucial aid to Americans who are in genuine need.”

Disaster relief deficit

One of the more immediate budgetary issues facing FEMA is that its disaster relief fund is slated to run at least a $9 billion deficit before the end of the year, which several lawmakers raised concerns about during the hearing.

The Trump administration, however, does not plan to send Congress a supplemental spending request, asking lawmakers for more money for that account.

The disaster relief fund is able to run deficits, unlike the vast majority of federal programs. When the DRF runs out of funding, FEMA uses something called immediate needs funding to keep providing response and recovery to communities with declared disasters.

Hamilton said, even with the expected use of immediate needs funding again this year, FEMA was prepared to respond to hurricane season and ongoing wildfires.

“There are always challenges that we have to work through,” Hamilton said. “So we are focusing on ways to make us operationally more capable, and also finding ways to be more fiscally practical with our means, so that we don’t buttress us up against those kinds of thresholds nearly as quickly as before.”

 

Congressional budget agency projects sweeping Medicaid cutbacks in states under GOP plans

U.S. House Republicans are debating cutbacks to Medicaid, the health care program for lower-income Americans and some people with disabilities. (Photo by Thomas Barwick/Getty Images)

U.S. House Republicans are debating cutbacks to Medicaid, the health care program for lower-income Americans and some people with disabilities. (Photo by Thomas Barwick/Getty Images)

WASHINGTON — The Congressional Budget Office said Wednesday that potential major cuts and changes to Medicaid under consideration by Republicans could mean states would have to spend more of their own money on the program, reduce payments to health care providers, limit optional benefits and reduce enrollment.

The end result, under some scenarios, could be millions of Americans would be kicked off Medicaid and possibly left without health insurance, said the nonpartisan agency relied on by Congress for budget estimates.

The letter from CBO stemmed from a request by Senate Finance Committee ranking member Ron Wyden, D-Ore., and House Energy and Commerce ranking member Frank Pallone, D-N.J.

Both oppose GOP attempts to slash federal funding for the health care program for lower-income Americans and some people with disabilities. Republicans, who have not settled on an approach, say they are interested in ending waste, fraud and abuse in the program.

CBO Director Phillip Swagel wrote that possible Medicaid changes would likely lead to several outcomes in the states. The impact on states would occur because the federal government covers at least 50% of the cost of the program, with that share increasing in states with lower per capita incomes and those that expanded eligibility under the Affordable Care Act.

Wyden wrote in a statement the CBO letter showed “the Republican plan for health care means benefit cuts and terminated health insurance for millions of Americans who count on Medicaid.”

Pallone wrote in a statement of his own that reducing federal funding for the program by hundreds of billions of dollars would lead to “millions of people losing their health care.”

“(President Donald) Trump has repeatedly claimed Republicans are not cutting health care, but CBO’s independent analysis confirms the proposals under consideration will result in catastrophic benefit cuts and people losing their health care,” Pallone wrote. “It’s time for Republicans to stop lying to the American people about what they’re plotting behind closed doors in order to give giant tax breaks to billionaires and big corporations.”

Federal Fallout

As federal funding and systems dwindle, states are left to decide how and whether to make up the difference. Read the latest.

The Medicaid changes would come as Republicans use the complex budget reconciliation process to move a sweeping legislative package through Congress with simple majority votes in each chamber, avoiding the Senate’s 60-vote filibuster, which would otherwise require bipartisanship. 

The House Energy and Commerce Committee, which is tasked with cutting at least $880 billion from the programs it oversees — including Medicaid — during the next decade, has yet to release its bill that if approved by the committee will become part of that package.

The panel, led by Kentucky Republican Rep. Brett Guthrie, is expected to debut its proposed changes next week before debating the legislation during a yet-to-be-scheduled markup.

Republicans plan to use the reconciliation package to permanently extend the 2017 tax law, increase spending on border security and defense by hundreds of billions of dollars, overhaul American energy production, restructure higher education aid and cut spending.

Five scenarios

CBO’s analysis looked at five specific Medicaid scenarios including:

  • Congress reducing the federal match rate for the 40 states that expanded Medicaid eligibility under the Affordable Care Act, also known as Obamacare.
  • Lawmakers eliminating a 6% threshold that exists for states that collect higher taxes from health care providers and then return that additional money in the form of higher Medicaid payments. CBO writes those “higher Medicaid payments increase the contributions from the federal government to states’ Medicaid programs.”
  • Republicans creating a per-enrollee cap on federal spending.
  • Congress establishing a cap on federal spending for Medicaid enrollees who became eligible for the program after their state expanded eligibility under the ACA.
  • Lawmakers repealing two Biden-era rules that addressed the Medicare Savings Programs and standardized how states approached enrollment and renewals.

The analysis said states could raise taxes or cut spending on other programs to replace the lost federal revenue that would coincide with the first four scenarios, though CBO “expects that such steps would prove challenging for many states.”

“In CBO’s view, different states would make different choices regarding how much of the reduced Medicaid funds to replace,” the analysis states. “Instead of modeling separate responses for each state, the agency estimated state responses in the aggregate, accounting for a range of possible outcomes.”

Overall, CBO expects state governments would be able to replace about half of the lost federal revenue and that they would “reduce provider payment rates, reduce the scope or amount of optional services, and reduce Medicaid enrollment” to address the other half.

Alternatives studied

The first scenario, where lawmakers reduce the federal matching rate for expanded Medicaid populations, would save the government $710 billion during the next decade.

But in 2034, CBO expects that “2.4 million of the 5.5 million people who would no longer be enrolled in Medicaid under this option would be without health insurance.”

CBO wrote that in the second, third and fourth scenarios, “Medicaid enrollment would decrease and the number of people without health insurance would increase.”

The second scenario of limiting state taxes on health care providers would save the federal government $668 billion during the 10-year budget window. It would lead to 8.6 million people losing access to Medicaid with a 3.9 million increase in the uninsured population by 2034.

The third projection that looked at a federal cap on spending per enrollee would reduce federal spending by $682 billion during the next decade. A total of 5.8 million people would lose Medicaid coverage and 2.9 million would become uninsured under that proposal. 

And the fourth scenario, where Congress caps federal spending per enrollee in the expansion population, would cut the deficit by $225 billion during the next 10 years. More than 3 million people would lose Medicaid coverage and 1.5 million would become uninsured under this scenario.

Under the fifth scenario, where GOP lawmakers would change two Biden-era rules, CBO expects that the federal government would spend $162 billion less over the 2025–2034 window.

“CBO estimates that, in 2034, 2.3 million people would no longer be enrolled in Medicaid under this option,” the letter states. “Roughly 60 percent of the people who would lose Medicaid coverage would be dual-benefit enrollees who would retain their Medicare coverage.” 

U.S. Senate confirms Bisignano to lead Social Security, with all Dems in opposition

Frank Bisignano, Social Security commissioner nominee, at his Senate Finance Committee confirmation hearing on March 25, 2025. (Senate webcast)

Frank Bisignano, Social Security commissioner nominee, at his Senate Finance Committee confirmation hearing on March 25, 2025. (Senate webcast)

WASHINGTON — The U.S. Senate on Tuesday confirmed Frank Bisignano as Social Security commissioner, putting him in charge of a $1.5 trillion entitlement program that’s relied on by tens of millions of Americans.

The 53-47 party-line vote drops a considerable amount of responsibility onto Bisignano, who will not only be tasked with fixing the Social Security Administration’s customer services issues, but ensuring plans to cut its staff by at least 7,000 workers doesn’t hinder the safety net program that helps to keep seniors out of poverty.

Oregon Democratic Sen. Ron Wyden said during a floor speech just before the vote that Bisignano should have been disqualified from consideration after he “lied multiple times” during the confirmation process.

Wyden also argued that Bisignano would institute substantial changes at the Social Security Administration, which could negatively affect people who rely on the program.

“Every single member of this body that votes to confirm this nominee is going to own the consequences,” Wyden said. “Mr. Bisignano is unfit to be the steward of Americans’ hard-earned Social Security benefits.”

Sen. Mike Crapo, R-Idaho, said during a floor speech last week that he was “confident” Bisignano held the “experience needed to lead this important agency.”

“The Social Security Administration needs steady, Senate-confirmed leadership,” Crapo said. “Mr. Bisignano would bring his decades-long focus on customer service and operational excellence to the Social Security Administration.”

Wait times, error rate

Bisignano said during his nearly three-hour confirmation hearing in March that he would make sure beneficiaries could visit an office, use the website, or speak to a real person after calling the 1-800 number.

“On the phone, I’m committed to reducing wait times and providing beneficiaries with a better experience; waiting 20 minutes-plus to get an answer will be of yesteryear,” Bisignano said at the time. “I also believe we can significantly improve the length of the disability claim process.”

Bisignano told lawmakers during the hearing he would reduce the 1% error rate in payments, which he said was “five decimal places too high.”

Whistleblower allegations

The Senate Finance Committee voted along party lines in April to send Bisignano’s nomination to the floor, though Chairman Crapo said at the time the panel would look into a whistleblower’s allegations.

“Even though the timing of the anonymous letter suggests a political effort to delay the committee vote on this nominee, my staff have told Sen. Wyden’s staff — and we have discussed this just now — we are open to meeting with the author of the letter and keeping the individual anonymous,” Crapo said. “However, any information provided by the individual must be thoroughly vetted, including allowing the nominee the opportunity to respond.”

Wyden, ranking member on the panel, urged Republicans to delay that committee vote until after the investigation concluded.

“This nominee lied multiple times to every member of this committee, including the bipartisan Finance staff and the nominee’s actions and communications with DOGE remain very much at the heart of my objection here,” Wyden said. “My office received an account from a whistleblower about the ways the nominee was deeply involved in and aware of DOGE’s activities at the agency.”

Crapo said during his floor speech last week that the whistleblower “allegations focused on the frequency and details of communications between the nominee and Social Security Administration officials.”

“Mr. Bisignano addressed these allegations during the hearing and responded in writing as part of the questions for the record,” Crapo added. “He has stated clearly that he does not currently have a role at the Social Security Administration and was not part of the decision-making process led by the Acting Commissioner, Lee Dudek, about Social Security operations, personnel, or management.”

Bisignano, of New Jersey, most recently worked as chairman of the board and chief executive officer at Fiserv, Inc., which “enables money movement for thousands of financial institutions and millions of people and businesses,” according to its website. The company is based in Wisconsin.

He previously worked as co-chief operating officer and chief executive officer of Mortgage Banking at JPMorgan Chase & Co.

Nonpartisan poll finds ‘remarkably low’ trust in federal health agencies

Robert F. Kennedy Jr., the secretary of Health and Human Services, testifies during his Senate Finance Committee confirmation hearing at the Dirksen Senate Office Building on Jan. 29, 2025, in Washington, D.C. (Photo by Win McNamee/Getty Images)

Robert F. Kennedy Jr., the secretary of Health and Human Services, testifies during his Senate Finance Committee confirmation hearing at the Dirksen Senate Office Building on Jan. 29, 2025, in Washington, D.C. (Photo by Win McNamee/Getty Images)

WASHINGTON — Less than half of Americans have confidence in federal public health agencies’ ability to regulate prescriptions, approve vaccines and respond to outbreaks, according to a poll released Tuesday by the nonpartisan health research organization KFF.

The survey shows that just 46% of the people questioned have at least some confidence in federal agencies ensuring the safety and effectiveness of prescription drugs.

Even fewer, 45%, have confidence in the safety and effectiveness of vaccines and only 42% said they have confidence federal health agencies to respond to infectious disease outbreaks, like bird flu and measles.

An especially low percentage of those polled, 32%, had either some confidence or a lot of confidence in federal health agencies acting independently without interference from outside interests.

“There are remarkably low levels of trust in the nation’s scientific agencies, shaped by partisan perspectives, and that presents a real danger for the country if and when another pandemic hits,” KFF President and CEO Drew Altman wrote in a statement accompanying the poll.

Confidence in agencies sags or rises by party affiliation

The percentage of people overall who hold confidence in the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention to provide reliable information about vaccines has dropped since a similar survey in September 2023, though party affiliation shows differing trends.

Democrats with a fair amount or great deal of trust in the FDA’s vaccine information has decreased from 86% to 67%, while trust among Republicans has increased from 42% to 52%.

When combined with independents, overall trust in the FDA’s information about vaccines has decreased, from 61% to 57%.

Confidence in the CDC providing reliable information about vaccines has also shifted based on party affiliation.

During the Biden administration, 88% of Democrats had a fair amount or great deal of trust in the CDC, though that has since dropped to 70%. Republicans have started to come back around to the CDC’s vaccine information, with their level of trust increasing from 40% to 51%.

Altogether, trust in CDC has dropped from 63% to 59%, according to the survey.

“The overall level of trust in each case is similar to where it stood in September 2023, though the poll reveals significant partisan shifts as the second Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr. have started to change vaccine policies and messaging,” the poll states.

Local sources trusted

Health care providers and local public health departments are overwhelmingly looked to as trusted sources for reliable information on vaccines, according to the survey.

Eighty-two percent of respondents said they either have a great deal or a fair amount of trust in doctors and health care providers to give them reliable information about vaccines.

Eighty-one percent said they trust their child’s pediatrician, 66% responded they have confidence in their local public health department, 59% believe in the CDC, 57% trust the FDA and 51% have confidence in pharmaceutical companies to provide factual information about vaccines.

Those polled held less trust in politicians, with 41% believing Kennedy’s comments about vaccines and 37% trusting President Donald Trump “to provide reliable information about vaccines,” according to the poll.

A majority of those surveyed, however, are somewhat or very confident in the safety of several vaccines, including 83% for measles, mumps and rubella, or the MMR vaccine; 82% for pneumonia; 79% for shingles; 74% for the flu; and 56% for COVID-19.

The poll included 1,380 U.S. adults contacted online or via telephone from April 8-15, for a margin of error of plus or minus 3 percentage points. 

Trump administration asks to dismiss suit by 3 GOP states trying to limit abortion pill

Idaho, Kansas and Missouri want a federal judge to let them intervene in a case that’s already been to the U.S. Supreme Court, so they can argue the FDA erred when it updated prescribing guidelines for abortion medication, shown in photo, in 2016.  (Photo by Peter Dazeley/Getty Images)

Idaho, Kansas and Missouri want a federal judge to let them intervene in a case that’s already been to the U.S. Supreme Court, so they can argue the FDA erred when it updated prescribing guidelines for abortion medication, shown in photo, in 2016.  (Photo by Peter Dazeley/Getty Images)

WASHINGTON — The Department of Justice wrote in a legal filing released Monday that three GOP-led states attempting to overturn federal prescribing guidelines for medication abortion have sought to keep a case going in the wrong place at the wrong time.

The filing is significant since it appears to indicate the Trump administration will defend the U.S. Food and Drug Administration’s decision nine years ago to broaden access to mifepristone. The Biden administration also sought to keep the newer prescribing guidelines intact.

Idaho, Kansas and Missouri want a federal judge to let them intervene in a case that’s already been to the U.S. Supreme Court, so they can argue the FDA erred when it updated prescribing guidelines for mifepristone in 2016.

The goal is to get those changes thrown out so use of mifepristone, one of two pharmaceuticals used in medication abortion, reverts to what was in place between 2000 and 2016.

That would cap medication abortion at seven weeks gestation instead of the current 10 weeks and patients seeking medication abortions would need to attend three, in-person doctor appointments. Medication abortion would no longer be available via telehealth and it could no longer be legally mailed to patients.

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The Trump administration wrote in a 15-page brief filed with the U.S. District Court for Northern District of Texas that the three states “cannot keep alive a lawsuit in which the original plaintiffs were held to lack standing, those plaintiffs have now voluntarily dismissed their claims, and the States’ own claims have no connection to this District.”

“The States are free to pursue their claims in a District where venue is proper … but the States’ claims before this Court must be dismissed or transferred pursuant to the venue statute’s mandatory command,” the brief adds.

The Department of Justice also wrote that at “a minimum, the States’ challenge to FDA’s 2016 actions is time-barred because the States sought to intervene more than six years after FDA finalized those actions.”

Original suit began in 2022

The original case challenging the federal government’s 2000 approval and current prescribing guidelines for medication abortion began in November 2022 when anti-abortion groups filed their lawsuit in the U.S. District Court for Northern District of Texas.

That case worked its way up to the U.S. Supreme Court, which ruled in June 2024 that the anti-abortion organizations lacked standing to bring the case.

But Idaho, Kansas and Missouri state officials sought to intervene in the case before it reached the high court and have tried to keep the challenge to the 2016 prescribing guidelines moving forward.

The Department of Justice wrote in its brief that there were several reasons the case shouldn’t continue in the Northern District of Texas.

Among those is that the three states “fail to identify any actual or imminent controversy over whether any of their laws are preempted” and that they lack Article III standing since “they failed to exhaust their claims; and their challenge to FDA’s 2016 actions is outside the six-year statute of limitations.”

The case is assigned to Judge Matthew Joseph Kacsmaryk, who overturned the FDA’s original 2000 approval of mifepristone in April 2023 in the original lawsuit.

That ruling never took effect as the original lawsuit worked its way through the 5th Circuit Court of Appeals and up to the Supreme Court. 

Trump asks Congress to cut $163B in non-defense spending, ax dozens of programs

From left to right, Secretary of State Marco Rubio, President Donald Trump and Secretary of Defense Pete Hegseth attend a Cabinet meeting at the White House on April 30, 2025, in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

From left to right, Secretary of State Marco Rubio, President Donald Trump and Secretary of Defense Pete Hegseth attend a Cabinet meeting at the White House on April 30, 2025, in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — President Donald Trump released a budget request Friday that would dramatically slash some federal spending, the initial step in a monthslong process that will include heated debate on Capitol Hill as both political parties work toward a final government funding agreement.

The proposal, for the first time, details how exactly this administration wants lawmakers to restructure spending across the federal government — steep cuts to domestic appropriations, including the elimination of dozens of programs that carry a long history of bipartisan support, and a significant increase in defense funding.

Trump wants more than 60 programs to be scrapped, some with long histories of assistance to states, including Community Services Block Grants, the Low Income Home Energy Assistance Program, the National Endowment for Democracy, the National Institute on Minority and Health Disparities within the National Institutes of Health, and the Sexual Risk Avoidance and Teen Pregnancy Prevention programs.

Congress will ultimately decide how much funding to provide to federal programs, and while Republicans hold majorities in both chambers, regular funding bills will need Democratic support to move through the Senate’s 60-vote legislative filibuster.

White House budget director Russ Vought wrote in a letter that the request proposes shifting some funding from the federal government to states and local communities.

“Just as the Federal Government has intruded on matters best left to American families, it has intruded on matters best left to the levels of government closest to the people, who understand and respect the needs and desires of their communities far better than the Federal Government ever could,” Vought wrote.

The budget request calls on Congress to cut non-defense accounts by $163 billion to $557 billion, while keeping defense funding flat at $893 billion in the dozen annual appropriations bills.

The proposal assumes the GOP Congress passes the separate reconciliation package that is currently being written in the House, bringing defense funding up to $1.01 trillion, a 13.4% increase, and reducing domestic spending to $601 billion, a 16.6% decrease.

Many domestic cuts

Under Trump’s request many federal departments and agencies would be slated for significant spending reductions, though defense, border security and veterans would be exempt. 

The cuts include:

  • Agriculture: – $5 billion, or 18.3%
  • Commerce: – $1.7 billion, or 16.5%
  • Education: – $12 billion, or 15.3%
  • Energy: – $4.7 billion, or 9.4%
  • Health and Human Services: – $33 billion, or 26.2%
  • Housing and Urban Development: – $33.6 billion, or 43.6%
  • Interior: – $5.1 billion, or 30.5%
  • Justice: – $2.7 billion, or 7.6%
  • Labor: – $4.6 billion, or 34.9%
  • State: – $49.1 billion, or 83.7%
  • Treasury: – $2.7 billion, or 19%

Increases include:

  • Defense: + $113 billion, or 13.4% with reconciliation package
  • Homeland Security: + $42.3 billion, or 64.9% with reconciliation package
  • Transportation: + $1.5 billion, or 5.8%
  • Veterans Affairs: + $5.4 billion, or 4.1%

The budget request also asks Congress to eliminate AmeriCorps, which operates as the Corporation for National and Community Service; the Corporation for Public Broadcasting, which provides some funding to National Public Radio and the Public Broadcasting Service; the Institute of Museum and Library Sciences; and the 400 Years of African American History Commission.

What if Congress won’t act on the cuts?

Debate over the budget proposal will take place throughout the summer months, but will come to a head in September, when Congress must pass some sort of funding bill to avoid a partial government shutdown.

A senior White House official, speaking on background on a call with reporters to discuss details of the budget request, suggested that Trump would take unilateral action to cut funding if Congress doesn’t go along with the request.

“Obviously, we have never taken impoundment off the table, because the president and myself believe that 200 years of the president and executive branch had that ability,” the official said. “But we’re working with Congress to see what they will pass. And I believe that they have an interest in passing cuts.”

The 1974 Impoundment Control Act bars the president from canceling funding approved by Congress without consulting lawmakers via a rescissions request, which the officials said the administration plans to release “soon.”

The annual appropriations process is separate from the reconciliation process that Republicans are using to pass their massive tax cuts, border security, defense funding and spending cuts package.

Huge boost for Homeland Security

The budget proposal aligns with the Trump’s administration’s plans for mass deportations of people without permanent legal status, and would provide the Department of Homeland Security with $42.3 billion, or a 64.9% increase.

The budget proposal suggests eliminating $650 million from a program that reimburses non-governmental organizations and local governments that help with resettling and aiding newly arrived migrants released from DHS custody, known as the Shelters and Services Program.

The Trump administration also seeks to eliminate the agency that handles the care and resettlement of unaccompanied minors within Health and Human Services. The budget proposal recommends getting rid of the Refugee and Unaccompanied Alien Children Programs’ $1.97 billion budget. The budget proposal argues that because of an executive order to suspend refugee resettlement services, there is no need for the programs.

A federal judge from Washington state issued a nationwide injunction, and ruled the Trump administration must continue refugee resettlement services.

The budget proposal also calls for axing programs that help newly arrived migrant children or students for whom English is not a first language.

For the Education Department, the budget proposal suggests eliminating $890 million in funding for the English Language Acquisition and $428 million for the Migrant Education and Special Programs for Migrant Students.

Key GOP senator rejects defense request

Members of Congress had mixed reactions to the budget request, with some GOP lawmakers praising its spending cuts, while others took issue with the defense budget.

Senate Armed Services Committee Chairman Roger Wicker, R-Miss., outright rejected the defense funding level, writing in a statement that relying on the reconciliation package to get military spending above $1 trillion was unacceptable. 

“OMB is not requesting a trillion-dollar budget. It is requesting a budget of $892.6 billion, which is a cut in real terms. This budget would decrease President Trump’s military options and his negotiating leverage,” Wicker wrote. “We face an Axis of Aggressors led by the Chinese Communist Party, who have already started a trade war rather than negotiate in good faith. We need a real Peace Through Strength agenda to ensure Xi Jinping does not launch a military war against us in Asia, beyond his existing military support to the Russians, the Iranians, Hamas, and the Houthis.”

The senior White House official who spoke on a call with reporters to discuss details of the budget request said that splitting the defense increase between the regular Pentagon spending bill and the reconciliation package was a more “durable” proposal.

Maine Republican Sen. Susan Collins, chairwoman of the Appropriations Committee, wrote the panel will have “an aggressive hearing schedule to learn more about the President’s proposal and assess funding needs for the coming year.”

“This request has come to Congress late, and key details still remain outstanding,” Collins wrote. “Based on my initial review, however, I have serious objections to the proposed freeze in our defense funding given the security challenges we face and to the proposed funding cuts to – and in some cases elimination of – programs like LIHEAP, TRIO, and those that support biomedical research. 

“Ultimately, it is Congress that holds the power of the purse.”

Senate Appropriations Committee ranking member Patty Murray, D-Wash., wrote in a statement she will work with others in Congress to block the domestic funding cuts from taking effect.

“Trump wants to rip away funding to safeguard Americans’ health, protect our environment, and to help rural communities and our farmers thrive. This president wants to turn our country’s back on Tribes—and let trash pile up at our national parks,” Murray wrote. “Trump is even proposing to cut investments to prevent violent crime, go after drug traffickers, and tackle the opioids and mental health crises.”

A press release from Murray’s office noted the budget request lacked details on certain programs, including Head Start.

House Speaker Mike Johnson R-La, praised the budget proposal in a statement and pledged that House GOP lawmakers are “ready to work alongside President Trump to implement a responsible budget that puts America first.”

“President Trump’s plan ensures every federal taxpayer dollar spent is used to serve the American people, not a bloated bureaucracy or partisan pet projects,” Johnson wrote.

Spending decisions coming

The House and Senate Appropriations committees are set to begin hearings with Cabinet secretaries and agency heads next week, where Trump administration officials will explain their individual funding requests and answer lawmakers’ questions.

The members on those committees will ultimately write the dozen annual appropriations bills in the months ahead, determining funding levels and policy for numerous programs, including those at the departments of Agriculture, Defense, Education, Health and Human Services, Homeland Security, Interior, Justice, State and Transportation.

The House panel’s bills will skew more toward Republican funding levels and priorities, though the Senate committee has a long history of writing broadly bipartisan bills. 

The leaders of the two committees — House Chairman Tom Cole, R-Okla., House ranking member Rosa DeLauro, D-Conn., Senate Chairwoman Collins and Senate ranking member Murray — will ultimately work out a final deal later in the year alongside congressional leaders.

Differences over the full-year bills are supposed to be solved before the start of the new fiscal year on Oct. 1, but members of Congress regularly rely on a stopgap spending bill through mid-December to give themselves more time to complete negotiations.

Failure to pass some sort of government funding measure, either a stopgap bill or all 12 full-year spending bills, before the funding deadline, would lead to a partial government shutdown.

This round of appropriations bills will be the first debated during Trump’s second-term presidency and will likely bring about considerable disagreement over the unilateral actions the administration has already taken to freeze or cancel federal spending, many of which are the subject of lawsuits arguing the president doesn’t have that impoundment authority. 

Three-quarters of Americans oppose Medicaid cuts, poll shows

A poll released Thursday, May 1 showed 76% of Americans oppose cuts to Medicaid. (Photo via Getty Images)

A poll released Thursday, May 1 showed 76% of Americans oppose cuts to Medicaid. (Photo via Getty Images)

WASHINGTON — A majority of Americans, including most Republicans, oppose major cuts in federal funding for Medicaid, according to a poll released Thursday by the nonpartisan health research organization KFF.

The survey shows that 76% of those questioned wouldn’t support  Congress slashing the amount of spending dedicated to the state-federal health program for lower-income Americans and some people with disabilities.

Democrats held the highest rate of opposition at 95%. A small majority of Republicans surveyed, 55%, said they don’t support substantial federal spending cuts for the program.

The breakdown was nearly even among respondents who identified as Make America Great Again supporters — President Donald Trump’s base — with 51% of that group saying they support less federal funding for Medicaid and 49% saying they oppose major cuts to the federal allocation.

The survey comes just days before House Republicans are expected to release a bill that will likely propose cutting hundreds of billions in federal funding for Medicaid.

That legislation, as well as bills from several other committees, is supposed to help Republicans offset some of the $4.5 trillion deficit impact that comes with extending the 2017 tax law.

The KFF poll also showed strong opposition to slashing federal funding to other health care programs — 74% were against cuts to states for mental health and addiction prevention services, 71% didn’t support reducing federal spending to track infectious disease outbreaks, 69% opposed limiting federal dollars for research at universities and medical centers, 65% were against cuts to HIV prevention program allocations and 65% didn’t support reducing federal funding to help people buy health insurance through the Affordable Care Act.

Polling of 1,380 U.S. adults took place from April 8 to April 15 via telephone and online. The margin of error is plus or minus 3 percentage points.

Senate GOP watching House action

Senate Republicans are closely watching how their House colleagues restructure federal funding for Medicaid, and will likely propose changes when the entire 11-bill package comes over from the House later this year.

Several GOP senators told reporters at the Capitol on Wednesday they will judge the package based on how changes to Medicaid will impact their constituents.

Missouri Sen. Josh Hawley said he’s unlikely to support any changes to Medicaid that “will result in cutting benefits or denying eligibility for people who are otherwise working.”

Sen. Josh Hawley, R-Mo., leaves a meeting with Vice President-elect JD Vance and former Rep. Matt Gaetz, R-Fla., at the U.S. Capitol on November 20, 2024. (Photo by Chip Somodevilla/Getty Images)
U.S. Sen. Josh Hawley, Republican of Missouri, at the U.S. Capitol on Nov. 20, 2024. (Photo by Chip Somodevilla/Getty Images)

“I’m all for work requirements,” he said. “I don’t think you get any Republican objection to that.”

But Hawley said going beyond that might be pressing the issue too far to get his vote.

“I just met with the governor of my state this morning. He’s in town. We just sat down and we talked about this issue,” Hawley said, adding that Gov. Mike Kehoe, a Republican, was “very worried about” potential changes to federal Medicaid funding.

Maine Sen. Susan Collins said she’s planning to evaluate the House bill once it makes it through that chamber based on “the impact on low-income seniors who are dual eligible, families with children with disabilities, low-income families, our rural hospitals, healthcare providers.”

Dual eligibility refers to people who are on Medicare and Medicaid.

“I am open to carefully crafted work requirements for able-bodied adults who do not have preschool children,” Collins said. “But I have no idea what the package is going to contain at this point.”

Kansas Sen. Jerry Moran said he’s told his chamber’s Republican leadership that “Medicaid is an important issue” for him in determining whether he votes for the entire package once it’s on the floor.

“I’m going to look at overall how it impacts citizens, particularly people with disabilities, and how it impacts my state and the hospitals that provide services to people in Kansas,” Moran said.

North Dakota Sen. John Hoeven said “the challenge is going to be to find savings in line with what the president has described.”

“He said he doesn’t want any cuts to Medicaid,” Hoeven said. “But how do you make sure that you eliminate waste, fraud and abuse? And that the folks that should be getting it are getting it, rather than an able-bodied person who should be out there working and is able to do that and take care of themselves.”

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