House Republicans on Wednesday pushed forward on their sweeping domestic policy bill, slogging through marathon drafting sessions that began Tuesday and stretched into the night as they haggled over Medicaid and tax cuts.
The meetings in three key committees, a crucial part of advancing what President Trump has labeled the “one big beautiful bill” carrying his agenda, came as Republican leaders raced to push the legislation through the House before a Memorial Day recess that begins at the end of next week.
Republicans are seeking to extend Mr. Trump’s 2017 tax cut and temporarily enact his campaign pledges not to tax tips or overtime pay. They want to partly offset the roughly $3.8 trillion cost of those tax measures — as well as plans to increase spending on the military and immigration enforcement — by making cuts to Medicaid, food stamps and subsidies for clean energy.
“The American people are counting on us to get this done and get it done quickly, and we are on target to do it,” Speaker Mike Johnson said on Wednesday morning at a news conference at the Capitol.
But even as they moved toward winning committee approval of the plan, House Republican leaders faced pushback in their own ranks that could delay or derail passage. Conservative lawmakers have argued the proposed cuts to Medicaid, which stopped short of an overhaul in an effort to protect vulnerable Republicans from political blowback, do not go far enough in restructuring and slashing costs of the program. They are unhappy that the largest reduction included — new work requirements for beneficiaries — would not take effect until 2029, putting off any savings until then, after the next presidential election.
And Republicans from high-tax states like New York were furious about a provision that would increase the limit on the state and local tax deduction to $30,000 from $10,000, a cap they regard as far too low and which was still being negotiated.
Democrats, who are expected to oppose the package en masse, have aimed most of their criticism at the bill’s health care provisions, which are estimated to cause more than 8 million Americans to lose insurance coverage, and which they believe will be politically damaging.
In three simultaneous meetings beginning on Tuesday, House panels moved to push through the major elements of the sprawling legislation.
The Ways and Means Committee approved the tax provisions of the bill, estimated to cost $3.8 trillion over a decade, just after 8 a.m. after a session that lasted more than 17 hours. The committee that oversees agriculture, which is considering major cuts to food assistance programs, chose a different path, taking a break from debate for the evening hours and planning to reconvene later on Wednesday.
The House Energy and Commerce Committee, whose portion of the bill includes major funding cuts and policy changes to Medicaid, plowed ahead through the night. The Congressional Budget Office has estimated that the committee’s proposed changes, which are concentrated on health care programs, would save more than $900 billion over the next decade.
Direct debate on provisions to reshape the Medicaid program began after midnight on Wednesday. By the time lawmakers began discussing those proposals, the committee had approved parts of the bill that rolled back Biden-era energy and environmental policies.
The overnight debate was contentious, including an extended debate about whether lawmakers should be allowed to mention one another by name. A decision that names should not be used led to the partial censorship of a poster describing high Medicaid enrollment in certain Republican congressional districts. (Later in the morning, Representative Frank Pallone Jr. of New Jersey, the top Democrat on the committee, broke the rule. “I know I’m not supposed to say it,” he said, before naming Representative John Joyce, Republican of Pennsylvania.)
Much of the discussion centered on work requirements that the bill would impose on adult Medicaid beneficiaries without children, the centerpiece of the Republican proposal. The policy is expected to push millions of Americans off the program and achieve significant spending reductions. Under the provision, Medicaid beneficiaries would need to submit paperwork every month showing that they worked at least 80 hours or qualified for an exception.
Republicans defended the requirements, noting that they were generally supported by the public and arguing that they would create incentives for work.
“We don’t want people to be on this program for forever,” Representative Cliff Bentz, Republican of Oregon, said on Wednesday morning. “And this is a really good way to get off it and get a job.”
But Democrats assailed the provisions for complex reporting rules that they said would cause eligible people to lose health coverage. Republican committee aides were asked to answer detailed questions about what would happen if a person failed to file required paperwork while hospitalized for a psychiatric issue, or whether someone could lose coverage for failing to work a year ago.
Many of the details of the work requirement in the bill were modeled on a program in Georgia, which has resulted in low enrollment and high administrative costs. Studies suggest that most Medicaid beneficiaries who would be subject to the new rules already work, and previous state experiments with work requirements nevertheless resulted in large coverage losses.
Representative Brett Guthrie of Kentucky, the chairman of the Energy and Commerce Committee, said that Republicans had “crafted this bill carefully to avoid the issues” that Georgia had faced.
“We absolutely don’t want people who qualify for Medicaid to not receive Medicaid because of red tape, particularly when they’re trying to work and be gainfully employed,” Mr. Guthrie said.
Debate also focused on a new co-payment requirement for when some Medicaid patients go to the doctor, a change that some Democrats characterized as a “sick tax” that would prevent low-income people from seeking care.
Discussion of the tax provisions of the bill wrapped up relatively more quickly, with the Ways and Means Committee concluding their work around 8:30 on Wednesday.
But at least one major element of the tax package — the state and local tax deduction — remained unresolved. Mr. Johnson has been negotiating with New York Republicans to raise the cap their party established in 2017 on the amount of state and local taxes Americans can write off on their federal returns.
“This is clearly an unfinished product,” said Representative Richard E. Neal of Massachusetts, the top Democrat on the Ways and Means Committee. “There is a long way to go, and my sense is that even many of the items that are included here, if this legislation moves out of committee in the next couple of days here, that it is likely to be altered substantially.”
Michael Gold and Andrew Duehren contributed reporting.
