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Republicans once maligned Medicaid. Now some see a program too big to touch

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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.

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“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.

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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.

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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.

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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.”

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Associated Press writer Becky Bohrer in Juneau, Alaska and AP Congressional Correspondent Lisa Mascaro contributed to this report.

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A powerful bomb has exploded near railway track in southwest Pakistan, killing at least 19 people

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A powerful bomb has exploded near railway track in southwest Pakistan, killing at least 19 people

QUETTA, Pakistan (AP) — A suicide bomber detonated an explosives-laden vehicle near a railway track as a passenger train passed through the southwestern Pakistani city of Quetta on Sunday, killing at least 19 people and wounding over 70 others, officials said.

The force of the explosion caused two of the train cars to overturn and catch fire, sending thick black smoke into the air, according to footage shared online.

The attack happened in an area where security forces are usually stationed, badly damaging several nearby buildings and smashing more than a dozen vehicles parked along the road, according to witnesses and images circulating on social media.

Doctors at local hospitals said they had received the wounded, with 20 in critical condition. Three security officials told The Associated Press the bodies were transported to hospitals following the attack. The officials spoke on condition of anonymity to be able to speak to the media.

The outlawed Baloch Liberation Army, or BLA, which demands independence from Pakistan’s central government, has claimed responsibility for the attack in a statement sent to reporters. The militant group said it targeted a train carrying security personnel.

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Quetta is the capital of insurgency-hit Balochistan province. The oil- and mineral-rich region has long been the scene of a low-level insurgency. The insurgents have frequently targeted security forces, government installations and civilians in the province and elsewhere in the country.

“We strongly condemn the targeting of innocent civilians and are deeply saddened by the loss of precious human lives. Terrorist elements deserve no leniency,” said Shahid Rind, Balochistan provincial government spokesman.

He said following the explosion, a medical emergency was declared at hospitals in Quetta, and an investigation has been launched.

Prime Minister Shehbaz Sharif strongly condemned the attack, calling it a “cowardly act of terrorism” in a post on X and offering condolences to the families of the victims.

Balochistan Chief Minister Sarfraz Bugti strongly condemned the attack in Quetta, saying the militants targeted “innocent civilians, including women and children,” vowing to “hunt (them down)” in a post on X.

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Bugti and the federal government in Islamabad often use the phrase “Fitna al-Hindustan” to refer to the BLA, which they allege is backed by India. New Delhi denies the allegation.

Pakistan and India have long had strained relations and have fought two of their three wars over Kashmir, which is claimed by both in its entirety.

Although Pakistani authorities say they have quelled the insurgency, violence in Baluchistan has persisted.

At least 26 people, including soldiers, were killed in 2024 when a suicide bomber attacked a train station in Balochistan.

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US embassy in Ukraine warns of ‘potentially significant air attack’ that could happen in next 24 hours

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US embassy in Ukraine warns of ‘potentially significant air attack’ that could happen in next 24 hours

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The U.S. Embassy in Kyiv issued a security alert Saturday warning that a “potentially significant air attack” could hit the city in the next 24 hours.

The U.S. Mission Ukraine said in a statement, “The U.S. embassy in Kyiv has received information concerning a potentially significant air attack that may occur at any time over the next 24 hours.

“The embassy, as always, recommends U.S. citizens be prepared to immediately shelter in the event an air alert is announced.”

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A security guard stands outside the embassy of the United States of America Oct. 1, 2019, in Kyiv, Ukraine. (Sean Gallup/Getty Images)

The embassy urged Americans to “identify shelter locations before any air alert,” keep reserves of food, water and medication nearby, follow the “directions of Ukrainian officials and first responders in the event of an emergency,” to immediately take shelter if an alert is announced and to download an air raid app like Air Raid Siren or Alarm App. 

By early Sunday morning, the capital was rocked by a massive missile and drone strike, Reuters reported. 

At least three people were injured and some residential buildings were damaged, the mayor said on Telegram. 

The message follows a warning from Ukrainian President Volodmyr Zelenskyy that Russia was preparing to strike Ukraine with a hypersonic Oreshnik missile, citing Ukrainian as well as U.S. and European intelligence. 

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“We are seeing signs of preparation for a combined strike on Ukrainian territory, including Kyiv, involving various types of weaponry,” Zelenskyy wrote in an X post Saturday morning. 

“The specified intermediate-range weapons could be used in such a strike. It is important to act responsibly on air-raid alerts, starting this evening. Russian madness truly knows no bounds, so please protect your lives. Use shelters.”

The message follows a warning from Ukrainian President Volodmyr Zelenskyy that Russia was preparing to strike Ukraine with a hypersonic Oreshnik missile, citing Ukrainian as well as U.S. and European intelligence.  (AP Photo/Sergei Grits)

UKRAINE’S ‘SPIDER’S WEB’ DRONE STRIKE BURNS OVER 40 RUSSIAN WARPLANES, MOSCOW CALLS IT ‘TERRORIST ATTACK’

He added that the use of such weapons would set a precedent for future aggressors. 

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“If Russia is allowed to destroy lives on such a scale, then no agreement will restrain other similar hatred-based regimes from aggression and strikes,” he said. “We count on a response from the world and on a response that is not post factum, but preventive. Pressure must be put on Moscow so that it does not expand the war.”

Zelenskyy said Ukraine was preparing its air defenses as much as possible, and “we will respond fully justly to every Russian strike.”

“We have given permission for a parade,” he concluded his post, referring to the President Donald Trump-brokered three-day ceasefire earlier this month, “but Russia has no permission for madness. This war must be ended – we need peace, not some missiles satisfying the sick ambitions of one individual. I thank everyone helping to protect lives. Once again, please take care of yourselves and use shelters tonight.”

At the start of the three-day ceasefire May 9, Russian President Vladimir Putin told reporters he thought the war could come “to an end” soon. 

At the start of the President Donald Trump-brokered temporary ceasefire earlier this month, Russian President Vladimir Putin told reporters he thinks the war could come “to an end” soon.  (Andrew Harnik/Getty Images)

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On Friday, however, Putin vowed retaliation for a deadly Ukrainian drone strike in Starobilsk, an occupied town in eastern Luhansk, claiming that the Ukrainians hit a college dormitory in a “terrorist” act. 

Ukraine denied the claim, saying it struck a Russian drone command unit in the area. 

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At least two killed after massive Russian drone and missile attack on Kyiv

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The attack came after Ukrainian President Volodymyr Zelenskyy warned of intelligence that Russia would launch a significant attack using the hypersonic Oreshnik ballistic missile. It was not immediately clear if the missile had been used in the overnight attack.

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