This budgeting process allows the bill to bypass a Senate filibuster but also requires Republicans, with slim majorities in each chamber, to be almost completely in agreement among themselves in order to advance an agenda sure to get little or no Democratic support.
Representative Buddy Carter, of Georgia’s First District, said on Washington Watch Wednesday that he likes the pro-family initiatives the bill includes at this stage, several in particular: bans on Medicaid funding for abortion and gender-manipulation procedures for minors, and a requirement that able-bodied Medicaid recipients work 20 hours to remain eligible.
“I’ve very proud of the work we’ve done. We put out a great product,” Cater told show host Tony Perkins. “We have improved one of the most important programs in our government, Medicaid, which is for the most vulnerable patients in our society.”
The 20-hours requirement appears to be an attempt to mandate some type of productive contribution to society in exchange for free medical coverage. Carter said the 20 hours could include volunteer service or paid employment. Some exemptions apply.
“Now, if you’ve got children or you’re taking care of a parent or a child, you’ll be exempt from it. Otherwise, it’s going to be a requirement to be on the Medicaid program if you’re able-bodied,” said Carter, who serves on the Energy and Commerce Committee, which advanced the bill Tuesday night.
As it turns out, however, what one House member defines as “community involvement” is defined by another as “work requirement.”
Currently, the bill is being debated in the Budget Committee where Carter also serves.
The difference in Medicaid and Medicare
Medicaid began as part of the Social Security Act of 1965 and is designed to provide health care coverage to low-income individuals and families, including children, parents, pregnant women, seniors and people with disabilities. It differs from Medicare, which is designed primarily for people over 65 and for those with certain disabilities and does not limit enrollment based on income level.
Each state runs its own Medicaid program but must follow federal guidelines. States have some flexibility in designing and administering their programs, which can result in variations in eligibility and benefits across state lines.
The “community involvement” requirement will more closely align recipients with Medicaid’s intended purpose, the Republican lawmaker explained.
“The Democrats … want to call this ‘work requirements.’ It’s not work requirements – it’s community involvement,” Carter said. “We want to help people step up, get off Medicaid and get onto another insurance. If you’ve got an able-bodied adult not doing anything except getting Medicaid, that’s not what Medicaid is for.”
The ban on gender-manipulation funding means tax dollars will no longer pay for “child abuse,” Carter said, adding: “I was very proud we had that in there.”
The ban on funding for providers of abortion services would be a big hit on Planned Parenthood, which just announced a record year with more than 400,000 abortions in 2024.
More than 40% of Planned Parenthood’s revenue comes from government reimbursements and grants. Annual reports show the group taking in tens of millions from the federal government for a billion-dollar budget.
Known for abortion, Planned Parenthood offers other services as well, which means it’s able to skate around the Hyde Amendment, which specifically prohibits use of federal funding for abortion except in extreme cases. The budget reconciliation bill, in its current form, closes that loophole.
Republicans’ multiple legislative attempts to defund Planned Parenthood have resulted in numerous legal battles.
Planned Parenthood gets an estimated $800 million a year in federal funding, Perkins noted – drawing this response from Carter.
“They should not be getting one red cent a year. They should not be getting anything," the Georgia representative emphasized. "Taxpayers' dollars shouldn't be going to organizations that provide abortion services. It's as easy as that.”
Can GOP get on the same page?
But getting all Republicans, House and Senate, to pass the bill and send it to the White House for President Donald Trump’s signature may not be so easy.
All Republicans are not created equal. As Carter pointed out, some have strong Republican constituencies; others do not.
“It's a very diverse conference – and yes, we've got some people in swing districts and swing seats that have some strong feelings. Then we've got some other people in deep red seats, and they've got strong feelings. At the end of the day, we're all on the same team. We're all trying to achieve the same thing, and we need to understand that we need to come together,” he said.
