Republicans are currently eyeing deep cuts to federal health spending, a move they say is necessary to help fund a massive budget bill that includes as much as $200 billion for the Iran war and immigration enforcement. This effort to rein in health programs is definitely going to be controversial, with some critics already saying they are cutting healthcare just to pay for an unpopular war.
Top House Republicans are looking at a few different health care offsets, specifically with fraud in federal programs, which isn’t new territory for them. They did something similar last year, which led to cuts in federal Medicaid spending. House Majority Leader Steve Scalise (R-La.) confirmed this, stating, “There’s other items we’re looking at right now, especially in the areas of fraud and waste and abuse that we’re working through with our members.”
House Budget Committee chairman Jodey Arrington (R-Tx) is also bringing back an idea from last year: to fund Affordable Care Act (ACA) payments known as cost-sharing reductions. Per Axios, this move would save the government over $30 billion, but at the cost of higher out-of-pocket premiums and by leaving 300,000 people uninsured. However, it is unclear how a goal of fighting fraud will translate into actual legislative language.
A healthcare cut to fund war and ICE is a level of irony I can’t even fathom
Democrats are pretty firmly against funding both the Iran war and ICE, especially after the Iran war already cost $11 billion in the first week. So, Republicans are gearing up to use the party-line process called reconciliation to bypass a Senate filibuster. Many Republicans want any bill to be fully paid for, and these potential health care changes are the key to that.
However, moderate Republicans are sure to push back against any policies that could be widely seen as cuts, especially with an election year looming. Even a few defections could easily sink any effort in the House. Scalise acknowledged this challenge, saying, “Obviously we need to put the vote coalition together.”
Arrington also shared that he’d personally love to include two major health care savers in Medicare. One of these, known as “site-neutral” payments, would equalize payments across hospital outpatient facilities and doctors’ offices. The second would crack down on insurance companies’ attempts to ‘upcode’ patient medical conditions.
Despite his personal interest, Arrington expressed skepticism that either of these would actually be included, saying they would open up “a false narrative that we’re cutting Medicare.” On Medicaid, which has already seen cuts with Trump’s Big Beautiful Bill, he noted there’s hesitancy “to open that back up.” However, some policies, like limiting states’ ability to cover undocumented immigrants in their programs, could be tried again.
While the exact details of any health care changes are still taking shape, Democrats aren’t waiting around. Sen. Elizabeth Warren (D-Mass.) put it pretty bluntly on X, writing, “Republicans in Congress want to cut Americans’ health care to pay for more war in Iran. Let that sink in.”
Published: Mar 31, 2026 11:11 am