Hospitals are plotting a long-shot push to roll back $1 trillion in Medicaid cuts

Hospital leaders, stung by a law that will cut nearly $1 trillion in Medicaid funding over the next decade, have begun laying the groundwork to delay, roll back, or mitigate the cuts, according to four people familiar with the efforts. The cuts were used to help fund President Trump's tax cut bill, making them a difficult target with a potentially lengthy timeline.

Even if Democrats win majorities in Congress, any changes would need the president's approval and would require substantial money to pay for them, as well as possibly a handful of Republican lawmakers willing to undo a landmark legislative achievement. Despite these obstacles, health system leaders believe they can harness the growing political power around the cuts, especially as the midterms approach and Democrats see the cuts as odious to voters.

The efforts are still vague and focused on driving home how much the cuts will hurt health systems, with hopes of winning carveouts, favorable rule changes, or boosted payments from other parts of the federal health care enterprise. Leaders also see a long-term goal: even small tweaks now could build support among Democrats for boosted funding if they win the White House and Congress in 2028.

Some lawmakers are listening. Sen. Tim Kaine (D-Va.) said Democrats have begun discussing how to roll back the cuts should they retake the Senate in November. Sen. Ron Wyden (D-Ore.) included rollback of the GOP cuts and boosting coverage in his party's health care agenda document. Senate Minority Leader Chuck Schumer pledged hospitals a "seat at the table" should Democrats return to power. Sen. Josh Hawley (R-Mo.) is among Republicans interested despite voting for the bill, and Sens. Lisa Murkowski, Susan Collins, and Jerry Moran have each voiced concerns about the cuts.