The National Governors Association last week declined to join other bipartisan groups of local and state elected officials in raising concerns over the Trump administration’s plans to slash Medicaid funding after Republicans declined Democratic entreaties to object to cuts that could put deep holes in state budgets.
The impasse has left Democrats frustrated at a moment when congressional Republicans have proposed cutting $880 billion from Medicaid to finance an extension of tax cuts passed during Trump’s first term in office.
In a letter to congressional leadership, six other bipartisan groups of elected officials warned that such cuts would have severe ramifications.
“Policy changes that mandate specific eligibility requirements and alter the fiscal makeup of the program threaten Medicaid’s effectiveness and reduce state flexibility in program design,” the groups wrote. “[R]educing the 90% federal match rate for Medicaid expansion could cut federal spending by $561 billion over nine years, forcing states to either drop expansion or absorb higher costs — jeopardizing coverage for millions and harming state economies.”
The National Association of Counties, the U.S. Conference of Mayors, the National League of Cities, the National Conference of State Legislatures, the Council of State Governments and the International City/County Management Association all signed the letter, addressed to U.S. Senate Majority Leader John Thune (R-S.D.), Minority Leader Chuck Schumer (D-N.Y.), House Speaker Mike Johnson (R-La.) and Minority Leader Hakeem Jeffries (D-N.Y.).
Colorado Gov. Jared Polis (D), who heads the National Governors Association, asked Republican governors to sign on as well. NGA vice chair and Oklahoma Gov. Kevin Stitt (R), along with other Republican governors on the NGA’s executive committee, vetoed the letter. Instead, the NGA on Saturday said governors had agreed to a statement “supporting flexibility and waiver opportunities and funding” for Medicaid and other programs.
Five sources, who asked for anonymity to preserve relationships and discuss internal deliberations, independently confirmed the dispute within NGA’s executive panel. Several said some Republican governors feared backlash from President Trump, who routinely targets officials who disagree with him, whether those officials are Democrats or Republicans.
“They are afraid,” one lobbyist close to several governors said.
Polis’s office declined to comment for this story. A Stitt spokesperson did not return a request for comment, nor did two NGA spokespeople.
The bipartisan groups — collectively known as the Big Seven, including NGA — routinely write to congressional and federal officials to weigh in on public policy. In the last months of the Biden administration, the NGA weighed in on the National Defense Authorization Act, disaster relief funding, cybersecurity grant programs and the National Guard.
But since Trump took office, Republicans have objected to several letters to the administration. The NGA did not respond to Trump’s proposal to end the Federal Emergency Management Agency and the National Flood Insurance Program.
Trump has offered conflicting pronouncements on Medicaid’s future. In a joint interview with Elon Musk aired on Fox News this week, Trump said: “Medicare, Medicaid — none of that stuff is going to be touched.”
But he has also endorsed the House GOP’s budget plan, which calls for $880 billion in cuts to Medicaid over the next decade.
Medicaid is jointly funded by federal and state governments. It provides health insurance for about 80 million people with low incomes and disabilities across the United States. It accounts for about one-sixth of the nation’s health care spending and a large share of state budgets.
Cutting so much from the federal side of the program would force states to choose between kicking millions of people off Medicaid or spending far greater shares of their budgets to maintain the rolls. Twenty-one states that voted for Trump in November’s elections have expanded Medicaid coverage under the Affordable Care Act.
“Everybody’s budgets are going to get fucked by this,” one senior adviser to a Democratic governor told Pluribus News.
As governors met over the past few days for the annual NGA conference in Washington, Democrats are frustrated that the group’s collective silence allows the Trump administration to ignore the interests of state governments.
“NGA’s in big trouble right now,” the lobbyist said. “People feel like what’s the point if you’re not going to express governors’ needs in the face of radical changes?”