With massive changes to Medicaid on the horizon, House Republicans acknowledged they do not anticipate receiving a full analysis from the Congressional Budget Office before their markup at the Energy and Commerce Committee — leaving a cloud of political uncertainty over the impact of their proposals as they aim at achieving at least $880 billion in savings.
Nevertheless, a new letter sent Monday from the CBO to committee Chairman Brett Guthrie confirms that the panel’s legislative recommendations, released late Sunday, would meet its lofty target for $880 billion of savings over the next decade.
“CBO estimates that the Committee’s reconciliation recommendations would reduce deficits by more than $880 billion over the 2025-2034 period and would not increase on-budget deficits in any year after 2034,” CBO director Phillip Swagel wrote Monday.
But that’s about as much as Republicans expect to hear from CBO prior to their markup on Tuesday, with Republican committee aides conceding that “we are not holding our breath” for a full analysis of their bill.
President Donald Trump has repeatedly promised on the campaign trail and in the White House not to cut Medicaid and he and Republicans said they’ll come up with the savings by cutting waste and fraud in the program.
He gave House Republicans’ effort a boost on Monday as he headed off on a four-day trip to the Middle East, urging Republicans to “UNIFY” around the bill and saying the executive order he signed Monday that would “slash the cost of prescription drugs” and the “hundreds of billions of tariff money coming in” should be factored into the bill’s scoring.
“The Bill is GREAT. We have no alternative, WE MUST WIN!” he posted on Truth Social. “But now, with the tremendous Drug and Pharmaceutical Cuts, plus massive incoming Tariff Money, our “GREAT, BIG, BEAUTIFUL BILL” just got much BIGGER and BETTER.
As Democrats highlight prior CBO analysis of a menu of legislative options showing millions could lose Medicaid insurance by 2034, Republicans insist that criticism is misguided because it does not encompass their actual policy revisions included in their bill.
“So when you’re citing the 13 million coverage loss, those are including policies that are not in our bill,” a Republican committee aide told reporters at a briefing at the Capitol on Monday. “So if you want to stick to the provisions that are in the bill, we’ll have that information from CBO as soon as it’s ready.”
Asked to quantify the savings anticipated through work requirements for Medicaid recipients, Republican aides again begged off of an answer — urging patience for CBO’s pending analysis.
“It is a big driver in savings for us. But it’s hard to ascribe particular scores to individual policies at this stage of the game, because of how interactive everything is with each other,” an aide explained. “A policy that saves X amount of money on its own — that changes when you’re interacting with a lot of different policies in the same space. So I don’t really [want] tell you it’s X amount before CBO is ready to do that.”
Republicans also criticized Democrats for twice baiting CBO into hypothetical analyses that were not necessarily intended to be published.
“I would really encourage folks to be mindful before just putting whatever number is in our counterpart’s press releases to actually look at what the CBO would know that they chose to publish, what is actually in the bill and related to the bill, and what is not. But again, it is pretty irresponsible to put that information out there before CBO is ready to actually publish it.”
Republicans have a 29-23 edge at the committee, so the marathon markup is expected to succeed — putting the bill on a path to be included in the full reconciliation bill.
Speaker Mike Johnson can afford to lose only three GOP defections in a full vote of the whole House, and some hardliners are already signaling a brewing battle once the so-called “big, beautiful bill” comes to the floor.
“I sure hope 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…” Texas Republican Rep. Chip Roy posted on X.
