Good morning and welcome to Thursday. A government health care program in Florida that covers 4.2 million vulnerable people is facing the prospect of an overhaul under the House’s plans for implementing President DONALD TRUMP’s agenda. The budget resolution House Republicans passed Tuesday night directs the Energy and Commerce Committee to cut $880 billion over a decade from Medicaid and other similar programs. The bill is intended to focus on paying for tax cuts, energy and border policy. Florida doesn't have as many residents on Medicaid as it could because it hasn’t implemented an Obamacare provision that would allow more low-income people to enroll in the program. Even so, Floridians could be affected by cuts to Medicaid, which is funded jointly by the state and federal government. Florida's Medicaid program covers 40 percent of Florida kids, 290,000 adults with disabilities, roughly 40 percent of new births and 60 percent of care in nursing homes. In Miami-Dade County, which Trump won by 11 points, more than one-quarter of residents are on Medicaid. One option the House considered — but that House Speaker MIKE JOHNSON said on Wednesday night was off the table — would have limited how much Medicaid could spend on each person enrolled, instead of leaving it open-ended like it is now. Johnson also said the federal government wouldn't cut its share to states' Medicaid programs. Both would have created the most painful cuts for states. They would have obligated Florida to find a way to make up the difference, including by shifting from other spending priorities, cutting benefits or paying providers less. ALISON YAGER, executive director of the Florida Health Justice Project, predicted during a press conference this week that cuts would have “absolutely devastating effects on Floridians.” LEO CUELLO, a Medicaid expert at Georgetown University McCourt School of Public Policy’s Center for Children and Families, said people should be “very, very worried.” Other proposals being considered would have states check people’s eligibility for Medicaid more regularly, would curb waste and fraud or limit how much states can tax hospitals so that the federal government could then kick in less to match. Various proposals have drawbacks. Less federal money to states makes it harder to pay for health care. Under an eligibility check in Florida that started in 2023, some residents said they were incorrectly kicked off the program. And while the Government Accountability Office has said Medicaid improperly spent $31 billion nationwide last year, Congress would still need to come up with another $57 billion a year in spending cuts to hit their targets, POLITICO’s Robert King reports. The House's eventual decision isn't the end of the matter. The Senate wants to avoid deep cuts to Medicaid and Trump also has expressed reservations. GOP members of the Florida delegation on the Energy and Commerce Committee include Reps. GUS BILIRAKIS, NEAL DUNN, KAT CAMMACK and LAUREL LEE. Lee told Playbook in a statement that she wanted to eliminate abuse and fraud, make sure taxpayer dollars were spent wisely while ensuring Congress protects "the most vulnerable in our state." "We will get to work to review these programs and ensure they are working as intended," she said. "This is what the American people elected us to do." One thing's certain: The threat to Medicaid is likely to feature in Democratic messaging for the 2026 midterms, similar to Trump’s attempted Obamacare repeal in 2017. Rep. SHEILA CHERFILUS-MCCORMICK has a town hall about Medicaid tonight, following others from Reps. LOIS FRANKEL and DEBBIE WASSERMAN SCHULTZ . Wasserman Schultz created a portal for residents to talk about how the cuts would hurt them and framed them as an extension of the “slash and burn” of Trump’s DOGE operation on federal agencies. — Arek Sarkissian contributed. WHERE'S RON? Gov. DeSantis has a 10 a.m. press conference in Starke. Have a tip, story, suggestion, birthday, anniversary, new job, or any other nugget that Playbook should look at? Get in touch at: kleonard@politico.com.
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