World
Republicans once maligned Medicaid. Now some see a program too big to touch
WASHINGTON (AP) — Every time a baby is born in Louisiana, where Republican House Speaker Mike Johnson handily won reelection last year, there’s more than a 60% chance taxpayers will finance the birth through Medicaid.
In Republican Rep. David Valadao ’s central California district, 6 out of 10 people use Medicaid to pay for doctor visits and emergency room trips.
And one-third of the population is covered by Medicaid in GOP Sen. Lisa Murkowski’s Alaska, one of the nation’s costliest corners for health care.
Each of these Republicans — and some of their conservative colleagues — lined up last week to defend Medicaid, in a departure from long-held GOP policies. Republicans, who already have ruled out massive cuts to Social Security and Medicare, are turning their attention to siphoning as much as $880 billion from Medicaid over the next decade to help finance $4.5 trillion in tax cuts.
But as a deadline to avoid a partial government shutdown nears, hesitation is surfacing among Washington’s Republican lawmakers — once reliable critics of lofty government social welfare programs such as Medicaid — who say that deep cuts to the health care program could prove too untenable for people back home.
“I’ve heard from countless constituents who tell me the only way they can afford health care is through programs like Medicaid,” Valadao said on the House floor. “And I will not support a final reconciliation bill that risks leaving them behind.”
And on Wednesday, President Donald Trump, too, made his position on Medicaid clear: “We’re not going to touch it.”
States and the federal government jointly pay for Medicaid, which offers nearly-free health care coverage for roughly 80 million poor and disabled Americans, including millions of children. It cost $880 billion to operate in 2023.
Johnson has ruled out two of the biggest potential cuts: paying fixed, shrunken rates to states for care and changing the calculation for the share of federal dollars that each state receives for Medicaid. Just a few years ago, Johnson spearheaded a report that lobbied for some of those changes during the first Trump administration.
Johnson insisted in a CNN interview that the focus will instead be ferreting out “fraud, waste and abuse, in Medicaid, although it’s unlikely to deliver the savings Republicans seek.
GOP pressure over Medicaid is mounting, with some state party leaders joining the calls to preserve the program. States are already struggling with the growing cost of sicker patients and could be left to cover more if the federal government pulls back. In some states, the federal government picks up over 80%.
More than a dozen Minnesota GOP lawmakers wrote the president recently warning that “too deep of a cut is unmanageable in any instance.” Gov. Joe Lombardo, R-Nev., told Congress in a letter that “proposed reductions would put lives at risk.” In Alaska, state Senate Majority Leader Cathy Giessel, a Republican and nurse, cited “huge concerns” during a floor speech.
Nationally, 55% of Americans said the government spends too little on Medicaid, according to a January poll from The Associated Press-NORC Center for Public Affairs Research.
“It’s now a very popular program that touches a very broad cross-section of American society,” said Drew Altman, president of the health care research firm KFF. “Roughly half of the American people say that they or a family member have at one time been served by the program.”
Significant changes to Medicaid are still on the table. They have to be for Republicans get the savings they need to pay for tax cuts.
Work requirements, which could save as much as $109 billion over the next decade, seem to have solid support among GOP members, with some individual Republican-led states already moving to implement them.
Republicans also could consider cuts in benefits or coverage, as well as eliminating a provider tax that states use to finance Medicaid, Altman added.
Democrats warn that reductions are inevitable and could be dire.
Starting Monday, TV ads will caution people across 20 congressional districts that hospitals are at risk of closing and millions of people could lose coverage if Republicans cut Medicaid “to fund massive tax cuts for Elon Musk and billionaires.” The Democratic super political action committee House Majority Forward has launched the seven-figure campaign.
Trump and Republicans have for years called to lower government spending on health care, but they have struggled to formulate a serious plan that gains traction. Trump, for example, has spent nearly a decade arguing for an overhaul of the Affordable Care Act. His efforts to repeal the Obama-era national health care law failed during his first term and in his most recent presidential campaign he offered only “concepts of a plan” to adapt the program.
Michael Cannon, a director of health studies at libertarian Cato Institute, believes Medicaid needs an overhaul because it is a significant part of the federal budget and a contributor to the nation’s growing debt.
But Republicans, he said, are not looking at serious ways to drive down the cost of health care.
“The only reason for the cuts right now is to pay for the tax cuts,” Cannon said. “None of them are talking about the need to do better health reform.”
___
Associated Press writer Becky Bohrer in Juneau, Alaska and AP Congressional Correspondent Lisa Mascaro contributed to this report.
In a setback for Europe’s surging nationalist forces, Nicusor Dan, a centrist mayor and former mathematics professor, on Sunday won the presidential election in Romania, defeating a hard-right candidate who is aligned with President Trump and has opposed military aid to Ukraine.
With more than 98 percent of ballots counted, preliminary official results gave 54 percent of the vote in the presidential runoff to Mr. Dan, 55, the mayor of Romania’s capital, Bucharest. His opponent, George Simion, a nationalist and fervent admirer of Mr. Trump who had been widely seen as the front-runner, drew only 46 percent.
As he slipped behind Mr. Dan in early counting, Mr. Simion told supporters that “we are the clear winners of these elections.” He called for national protests should the final count show him as the loser, railing against what he said was an attempt “to steal the victory of the Romanian people.”
Mr. Dan’s victory will likely calm fears in Europe’s political mainstream that Romania, which borders Ukraine and plays a vital role in defending NATO’s eastern flank against Russia, might join Hungary and Slovakia in opposing help for Ukraine and in cozying up to Moscow.
But it will likely inflame Romania’s nationalist camp and its supporters abroad, including Vice President JD Vance, and stoke accusations that the system is rigged. Last year, a Romanian court ordered a last-minute cancellation of a presidential election that an ultranationalist appeared well positioned to win.
In the final days of the campaign, as opinion polls showed the race tightening, Mr. Simion laid the groundwork for a Romanian version of Mr. Trump’s “stop the steal” efforts in 2020. He insisted that only electoral fraud could prevent him from winning.
On Sunday, shortly before voting ended, Mr. Simion claimed that “many deceased people” had appeared on electoral lists, echoing the claims of Mr. Trump after he lost the 2020 election in the United States. Mr. Simion provided no evidence to support accusations that his victorious rival had benefited from fraud.
A mathematics prodigy in his youth who earned a Ph.D. in France before becoming a professor in Bucharest, Mr. Dan campaigned as a moderate conservative committed to both the European Union, which Romania joined in 2007, and to NATO, which it has been a member of since 2004.
Though supported, at least tacitly, by much of Romania’s political establishment, Mr. Dan ran as an independent and presented himself as an outsider untainted by close association with Romania’s two main political parties. Those parties have cycled in and out of power since the 1989 overthrow of communist dictator Nicolae Ceausescu.
Mr. Dan began his public career campaigning against corruption and the destruction of old buildings by real estate developers tied to corrupt politicians. Both candidates were involved in rallies in the early 2000s to save Bucharest’s historic center.
But while Mr. Simion embraced nationalist politics, campaigning to “unite” Romania with the former Soviet republic of Moldova, which is largely Romanian-speaking, and bits of Ukraine inhabited by ethnic Romanians, Mr. Dan pursued a more moderate agenda.
Mr. Dan helped found the Save Romania Union, a liberal party, but split with it over the issue of same-sex marriage, which progressives in the party supported. When Romania, at the urging of right-wing activists, held a referendum in 2018 on changing the Constitution to prohibit same-sex unions, Mr. Dan urged his party to stay out of the issue. The referendum failed because of low turnout.
Leftists view him as a conservative and nationalists as a sellout to the European Union, but his victory on Sunday indicated that voters wanted a middle path between bitterly polarized political camps.
Campaigning this past week, he said voters had a choice “between a democratic, stable and respected Romania in Europe — and a dangerous path of isolation, populism and defiance of the rule of law.”
Andrada Lautaru contributed reporting from Bucharest.
Pope Leo XIV spoke of unity and those suffering due to war during his inaugural mass in St. Peter’s Square.
The 69-year-old Augustinian missionary, who is the first American pope, spoke before 200,000 people on Sunday, Vatican News said.
“I would like that our first great desire be for a united church, a sign of unity and communion, which becomes a leaven for a reconciled world,” he said during his homily, the Associated Press reported.
“In this our time, we still see too much discord, too many wounds caused by hatred, violence, prejudice, the fear of difference, and an economic paradigm that exploits the Earth’s resources and marginalizes the poorest.”
POPE LEO SAYS FAMILY BASED ON ‘UNION BETWEEN A MAN AND A WOMAN,’ DEFENDS DIGNITY OF UNBORN
Pope Leo XIV holds Mass during the formal inauguration of his pontificate in St. Peter’s Square attended by heads of state, royalty and ordinary faithful, Sunday, May 18, 2025. (Alessandra Tarantino)
His call for unity was significant, given the polarization in the Catholic Church in the United States and beyond.
“In the joy of faith and communion, we cannot forget our brothers and sisters who are suffering because of war,” Leo said while praying the Regina Caeli, mentioning Gaza, Myanmar and Ukraine.
IN PICTURES: POPE LEO XIV ADDRESSES 150,000 FAITHFUL IN INAUGURAL MASS
Pope Leo XIV on his popemobile tours St. Peter’s Square at the Vatican prior to the inaugural Mass of his pontificate, Sunday, May 18, 2025. (Andrew Medichini)
The pope said he “strongly felt the spiritual presence of Pope Francis accompanying us from heaven.”
He concluded by inviting Catholics to pray to the Blessed Virgin Mary, under her titles as “Star of the Sea and Our Lady of Good Counsel,” to entrust his ministry.
Pope Leo XIV on his popemobile tours St. Peter’s Square at the Vatican prior to the inaugural Mass of his pontificate, Sunday, May 18, 2025. (Domenico Stinellis)
“We implore her intercession,” he said, “for the gift of peace, for support and comfort for those who suffer, and for the grace for all of us to be witnesses to the Risen Lord.”
Leo officially opened his pontificate by taking his first popemobile tour through the piazza, a rite of passage that has become synonymous with the papacy’s global reach.
The Associated Press contributed to this report.
Portugal’s ruling centre-right Democratic Alliance (AD) is poised to win the most votes in an early parliamentary election, but is short of a full majority, exit polls have shown, paving the way for more political instability in the country.
Sunday’s election, the third in as many years, was called just one year into the minority government’s term after Prime Minister Luis Montenegro failed to win a parliamentary vote of confidence in March when the opposition questioned his integrity over the dealings of his family’s consultancy firm.
Montenegro has denied any wrongdoing, and most opinion polls showed that voters have dismissed the opposition’s criticism.
The election, also dominated by issues such as housing and immigration, follows a decade of fragile governments. And the only one of those governments to have a parliamentary majority collapsed halfway through its term last year.
Exit polls published by the three main television channels – SIC, RTP and TVI – put Montenegro’s AD as receiving between 29 percent and 35.1 percent of the vote, garnering the biggest share but again no parliamentary majority, similar to what happened in the previous election in March 2024.
Outside the polling station where Montenegro voted in the northern city of Espinho, Irene Medeiros, 77, told Reuters the “best candidate must win”, but that she feared more uncertainty ahead.
According to the exit polls, Montenegro’s main rival, the centre-left Socialist Party (PS), garnered between 19.4 percent and 26 percent of the vote, nearly tied with the far-right Chega party’s 19.5 percent to 25.5 percent share, which is higher than the 18 percent it won in 2024. Montenegro has refused to make any deals with Chega.
With that tally, the DA could get between 85 and 96 seats, short of the 116 needed for a majority in Portugal’s 230-seat parliament. It could form a minority government or forge partnerships with smaller parties to obtain a majority.
Most official results are expected by midnight (23:00 GMT).
For the last half century, two parties have dominated politics in Portugal, with the Social Democrats, who head the DA, and the PS alternating in power.
Public frustration with their record in government has fuelled the search and for growth of new alternatives in recent years.
“This campaign was very, very weak, had ridiculous moments, like clownish. Very little was spoken about Portugal within the European Union – it’s like we are not part of it,” teacher Isabel Monteiro, 63, told the Associated Press news agency in Lisbon, adding that she felt “disenchantment” with all parties.
Political scientist Antonio Costa Pinto said the new parliament would likely be similar to the last, and it was impossible to predict how long the government would last, as it depended on factors ranging from the international situation to the AD’s ability to reach deals with other parties.
“The only doubt is whether the AD will form a new minority government … or whether it will form a post-electoral coalition with IL, even if this coalition does not guarantee an absolute majority,”, referring to the pro-business Liberal Initiative (IL) party, according to Reuters.
Shortly after casting his own ballot, Montenegro told reporters he was confident stability could be achieved.
“There is a search for a stable solution, but that will now depend on [people’s] choices,” he said.
A second consecutive minority government in Portugal would dash hopes for an end to the worst spell of political instability in decades for the European Union country of 10.6 million people.
For the past 50 years, two parties have dominated politics, with the Social Democrats, who head the DA, and the Socialist Party alternating in power.
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