After months of firmly opposing Medicaid cuts in the GOP’s reconciliation bill, Sen. Josh Hawley (R-MO) appears to be shifting his position, signaling a willingness to support parts of the proposal if changes are made to protect rural hospitals.
Once the Senate’s most vocal critic of any Medicaid reductions, Hawley now says he’d “be fine” with most of the cuts, provided one specific issue is addressed. “They’ve got to fix this hospital piece of it,” Hawley told NOTUS on Tuesday. “And if they do that, then I think that’d be fine.”
This marks a notable departure from Hawley’s earlier stance. Just last month, in a New York Times op-ed titled “Don’t Cut Medicaid,” Hawley urged Republicans to “ignore calls to cut Medicaid and start delivering on America’s promise for America’s working people.”
Despite the apparent shift, Hawley insists he has always supported certain Medicaid reforms. According to NOTUS, the Missouri senator now backs provisions like Medicaid work requirements and anti-fraud initiatives, while concentrating his opposition on elements that would impact rural health systems. “It’s a significant movement, though he is still a distance from supporting the reconciliation bill at the moment,” the report stated.
The Senate bill currently under negotiation would gradually reduce the Medicaid provider tax rate, a major funding stream for state Medicaid programs. Hawley previously warned that such cuts could cripple rural hospitals. The latest version of the bill, however, would freeze the tax rate rather than reduce it—an adjustment that Hawley reportedly “seems like he could live” with, according to NOTUS.
Still, Hawley has not offered full support for the bill. Speaking earlier Tuesday with MAGA media personality Steve Bannon, he doubled down on his concern that the legislation could hurt Trump supporters.
“We’ve got 1.3 million people, Steve, who are on Medicaid, including hundreds of thousands of kids,” Hawley said. “Most of these people are not folks who are deadbeats, staying at home, not working. These are working people who are on Medicaid because they don’t have a job that gives them insurance on the job.”
He added emphatically: “These are Trump people, these are our people. These are the people who voted for Donald Trump in the state of Missouri by 18 percentage points.”
Whether Hawley ultimately supports the final version of the reconciliation bill remains to be seen. For now, his evolving stance highlights the political balancing act many lawmakers face as they weigh fiscal policy against the practical needs of their constituents.