Republicans struggle for an answer to Democrats’ Medicaid attacks

Democrats across battleground districts are holding Republicans’ feet to the fire over the Medicaid cuts in their signature One Big Beautiful Bill law.

In advertisements and on debate stages, the Democrats are hammering their opponents over their support for a law that will reduce Medicaid funding by nearly $1 trillion to pay for tax cuts primarily for wealthy individuals and corporations.

With less than two weeks before the midterm elections, Republicans are playing defense.

The Trump administration is focusing on fraud, suspending billions of dollars in Medicaid money to states and disenrolling hundreds of thousands of people from ObamaCare.

Some lawmakers are talking about smaller investments made as part of the law’s $50 billion rural health fund.

California Rep. David Valadao (R), who is running for reelection in a district with one of the highest Medicaid populations nationwide, defended his vote for the law.

“There are no actual cuts” to Medicaid, he said during a recent debate.

Valadao said the law preserved Medicaid for eligible groups and included additional funding for rural healthcare.

Last week, Maine Sen. Susan Collins (R) aired an advertisement about how she secured $190 million for her state’s rural hospitals — “the biggest federal investment in rural healthcare in more than 20 years.”

Collins voted to advance the legislation to the floor and was a key negotiator in securing $50 billion for the law’s rural health transformation fund. She ultimately voted against final passage, joining fellow Republican Sens. Thom Tillis (N.C.) and Rand Paul (Ky.).

During a heated debate against Democratic challenger Troy Jackson, Collins noted she had been able to secure funding for Maine’s rural healthcare in the law, which wouldn’t have been possible if she killed it in committee.

Jackson said Collins secured a “pittance” compared to the overall cuts in the law.

“Sen. Collins is like an arsonist who helped set the fire, and then she wants credit for bringing a cup of water to put it out,” Jackson said.

The rural health fund will ultimately give Maine $950 million, and only a small percentage can be used to directly pay providers. The One Big Beautiful Bill will cut more than $2.5 billion from the state, according to an analysis from KFF.

During a debate last month in a toss-up district in Arizona, Democrat JoAnna Mendoza used similar language to attack incumbent Rep. Juan Ciscomani (R) for his vote in favor of the bill.

“It’s like bringing a glass of water to a fire that you started,” Mendoza said.

Ciscomani said the cuts would have been larger had he not pushed back.

Ciscomani was among 15 House GOP moderates who told leadership they couldn’t support legislation with deep cuts to Medicaid that would threaten hospitals. He voted for the bill anyway.

“Had we done the FMAP [Federal Medical Assistance Percentage] changes that were proposed initially on this bill, then the entire expansion population of Medicaid would have been off the books,” Ciscomani said during the debate. “That would have been devastating for the state.”

Arizona received $167 million from the first tranche of the rural health fund this year; the One Big Beautiful Bill is projected to cut $34.5 billion from the state.

Polling over the past year has consistently shown that voters are worried about the cost of healthcare and trust Democrats more to fix it.

A survey from KFF earlier this month showed voters overall trust Democrats to handle healthcare costs by a nearly 2-to-1 margin over Republicans.

A Gallup survey from March found more Americans were concerned about the “availability and affordability of healthcare” more than any other domestic policy issue, and one-third made at least one tradeoff of daily living expenses to afford care.

According to data analyzed by the Cook Political Report and AdImpact, Democrats are also outspending Republicans on healthcare-focused ads; $70 million spent in House competitive races, and $96.5 million spent on competitive Senate races. Republicans have spent just under $68 million on healthcare in Senate races, and under $43 million in House races.

The One Big Beautiful Bill law is expected to reduce Medicaid spending by more than $900 billion through 2034, with the bulk of the cuts coming from a strict national work requirement on low-income childless adults, as well as new restrictions on state-levied taxes on health providers.

GOP strategists admit there isn’t a strong defense for Republican candidates if the Democratic attacks resonate.

Jason Cabel Roe, a Michigan-based Republican strategist working on Rep. Tom Barrett’s (R-Mich.) campaign, said Democrats are successfully warping the message about Medicaid.

“It is being portrayed as us, Republicans, cutting Medicaid as opposed to rooting out waste, fraud, abuse. Getting able-bodied people to have some minimum work requirements,” Roe said.

Roe said Democrats have been campaigning on “doom and gloom” about healthcare for decades.

“I think for a lot of voters, they just kind of tune it out,” Roe said. “Now, if you’re feeling the cuts, then that’s different.”

Chuck Coughlin, a Republican-turned-independent strategist in Arizona, said Republicans are being hammered no matter what they say.

Healthcare and Medicaid are part of the reason, but there are so many issues voters are angry about — like gas and food prices, tariffs and the war in Iran.