The basic arithmetic of politics is likely causing some consternation at the House Energy and Commerce Committee these days.
This is the committee that the House Republican leadership directed to find $880 billion in savings for the upcoming budget. Republican messaging is focused on the fact that the word “Medicaid” does not appear in the budget resolution, but even the most naïve congressperson understands what a $880 billion cut would do to the program.
It’s just basic math.
The House Energy and Commerce Committee oversees a broad range of programs, but more than 96% of that funding goes to either Medicaid or Medicare, and the Republicans have assured everyone that Medicare is off the table.
So, if you have to cut $880 billion and you can only work with 42% of the budget, and Medicaid makes up 98 percent of that remaining part, it’s impossible to cut without slashing Medicaid.
“They’re not going to be able to get there [to $880 billion] unless they cut … Medicaid,” says Jack Stelzner with Congresswoman Diana DeGette’s office. “There’s only about $200 billion in non-health care spending under the Committee’s jurisdiction,” Stelzner points out. So even if they cut everything else, Medicaid is still going to bleed.
While that math is what is worrying DeGette, U.S. Rep. Alexandria Ocasio-Cortez (D-NY) and the other Democratic committee members who are champions of the social safety net, a different kind of math is likely causing four Republican members of the committee some agita.
Specifically, those Republican representatives who barely eked out a win in their districts last election. Representing districts in New Jersey, Michigan, Iowa and Colorado, these four seats are considered up for grabs in 2026. And for their current Republican occupants, prospects are looking especially dark if they vote for Medicaid cuts.
Just look at the numbers.
New Jersey favorite son Tom Kean, Jr. won his seat with just 51.6% of the vote, and by an arguably breathable margin of 23,306 votes. But more than 9% of his constituents are Medicaid beneficiaries, and that means his vote will impact 69,750 of his own constituents, about three times his win margin. Suddenly that breathing room isn’t so large.
Michigan Republican congressman John James won his 10th district seat by 26,000 votes, which was an improvement over his 2022 margin of 1,600 votes. But over 22% of the population in Michigan’s 10th district is on Medicaid, which means if he votes to cut those benefits he directly affects 169,000 constituents in his district. Some might call it political suicide.
Mariannette Miller-Weeks from Iowa’s first district was delighted when Speaker of the House Mike Johnson stopped by during her campaign in October. But she’s not going to be thrilled if she has to vote on this issue in committee, given she won by a razor thin 768 votes in November. More than 18% of her district are Medicaid beneficiaries, which means voting against 142,000 of her constituents – or 184 times the number of votes she won by.
Colorado’s Gabe Evans won the relatively new district 8 seat by a mere 2,596 votes in November. He ran on an anti-immigration platform and even brought Liz Hardy, mother of a fentanyl overdose victim, to the State of the Union (to remind everyone that the fentanyl crisis is caused by immigration issues). Over 21% of Evans’ constituents are Medicaid beneficiaries, which means his committee vote puts more than 155,000 of his constituents directly in the crosshairs – about 60 times his voting margin.
Interestingly enough, another program on the chopping block because of the budget resolution is The Substance Abuse and Mental Health Administration or SAMHSA. It provides funding for Narcan, the anti-opioid drug that can reverse an overdose and has saved an estimated 27,000 lives in the US to date according to the CDC. Liz Hardy is an outspoken proponent of Narcan, which she believes could’ve saved her daughter.
The final calculation in all this number crunching is the vote count. On the House Energy and Commerce Committee, there are 30 Republican members and 24 Democratic members. Colorado’s DeGette has been out in front on this issue since day one, calling press conferences and shining a light on the damage that could happen should cuts happen and be deep.
But the Republicans can pass this out of committee on a party line vote, no matter how vociferously DeGette and the others object. So long as they don’t lose three votes to the other side.
Sometimes math is interesting.
