The US House of Representatives narrowly voted 215–214 to pass legislation that puts restrictions on who will be eligible for Medicaid coverage. Republican Rep. Rob Wittman (1st District) voted in support of the bill, promising that it protects vulnerable people and ensures the government-funded insurance program will be sustainable for people who are in need in the future.
The legislation, which Republicans have coined the “One Big Beautiful Bill Act,” is at the centerpiece of President Donald Trump’s domestic agenda. The House tax and spending bill would extend tax cuts passed in 2017, remove taxes on tips, provide deductions for state and local taxes, lift the nation’s debt limit by $4 trillion and end clean energy tax breaks.
The budget proposal also makes historic changes to Medicaid; adding work requirements and a second annual renewal requirement for Medicaid recipients. The legislation also cuts federal Medicaid funding for states offering coverage to undocumented people and blocks federal funding for gender-affirming care.
The Congressional Budget Office estimates the House’s budget would cut $698 billion in federal Medicaid subsidies and add $3.8 trillion dollars to the federal deficit. The US Senate is set to vote on its version of the budget by July 4.
In Virginia, about 1.9 million adults and children are enrolled in Medicaid according to the Virginia Department of Medical Assistance Services.
Wittman spoke with VPM News health care reporter Adrienne Hoar McGibbon about the legislation shortly after his vote on Thursday.
This interview has been lightly edited for clarity and style.
Adrienne Hoar McGibbon: The House voted to pass its reconciliation bill. How did you vote?
Rob Wittman: Yeah, I voted “yes” to pass the bill. I thought it had good necessary reforms to make sure that Medicaid is sustainable — to make sure, too, that we're doing the things necessary to protect our vulnerable populations and make sure that they have access to those benefits.
The same too, with making sure that we provide sustainability for this nation's energy. I'm on the Armed Services Committee, so making sure we're modernizing our military in face of the threats that we have, that our working families continue to enjoy the lower tax rates. Because if not, the average family in Virginia’s 1st Congressional District would see a $2,300 increase in their federal tax bill if we didn't pass it.
So, it had a lot of good provisions in the bill.
You talk about protecting vulnerable people on Medicaid. How, in your mind, does this bill do that?
For me, this is personal: You know, I am adopted. At 8 months of age, the Children's Home Society of Virginia provided an opportunity for my birth mother to make sure that I had a great home, and I did. I know how important it is to make sure that expectant mothers have access to health care, that children have access, individuals with disabilities, seniors.
And we know that as Medicaid continues in the years to come, it faces some challenges, so what this does is to make sure the resources are going to be there for those folks that rely on Medicaid. It's so incredibly important.
I've seen estimates from the Commonwealth Institute and other organizations that this bill could remove Medicaid coverage from about 250,000 Virginians.
What would you say to people who hear those estimates and may be concerned about losing coverage?
Well, I can assure folks that if you're in those vulnerable populations, your coverage is going to continue. There will be no interruptions there. The changes that are made is to make sure that there are work requirements for those folks that are able to work — and if you're not able to work, or if you have children at home or parents at home, or if you have a physical disability, you're not going to be required to go to work.
But if you are able-bodied, you're going to be required to either go to work or to train, to go to work or to volunteer. We provide lots of opportunities there, and if you meet any of those criteria, you'll still continue to receive Medicaid.
For those folks that are here undocumented, this system is designed for US citizens — so if you're here and undocumented, you will not receive Medicaid.
Also, if you're deceased, [it] just makes sense, we don't want deceased individuals on the Medicaid rolls. Those are resources that need to go for people in need. If you're dual-enrolled — if you're in two states — and unfortunately, receiving benefits in both states, we're going to make sure that we take out that duality of those individuals that are receiving benefits.
It is really getting after waste, fraud and abuse. It's also making sure, too, that the system is functioning for those people that it's designed for.
Remember, this is designed for our vulnerable populations. And as we have more people that come onto the Medicaid rolls, we have to make sure that the resources are there.
What do you say to folks who argue this is just adding barriers for folks who are in need of care?
This is an incredibly simple process, so it's not creating barriers. It's just making sure that we have very, very high accuracy of people receiving Medicaid. We want to do that. We want to make sure that those dollars are there, and having that high level of accuracy there assures that those resources will be there — not only now, but in the future.
