\n<\/p>\n
For months, no<\/span> Republican in either the House or the Senate spoke out more forcefully, or more consistently, against cutting Medicaid than Josh Hawley. As President Donald Trump\u2019s \u201cbig beautiful bill\u201d was weaving its way through Congress, Hawley argued repeatedly that stripping health insurance from the poorest Americans would be \u201cmorally wrong and politically suicidal\u201d for a party that, in the Trump era, has relied on millions of votes from people who receive government assistance.<\/p>\n Back home in Missouri, the senator was making the same case in private, according to several people I spoke with who met with him or his staff this year. His deep engagement on the issue impressed advocates representing Missouri\u2019s hospitals, doctors, and rural health centers, all of whom were having trouble getting GOP lawmakers to take their concerns seriously. The changes, these advocates argued, could cost Missouri billions of dollars in federal funding, take away insurance from an estimated 170,000 residents, and force hospitals and rural health centers to close.<\/p>\n \u201cI did believe that he was genuine,\u201d Amy Blouin, the president of the Missouri Budget Project, a nonpartisan think tank, told me. \u201cI do see him as a different type of Republican.\u201d<\/p>\n Yet Hawley ultimately joined almost every other Republican in Congress and voted for the bill, which independent analysts project will cut nearly $1 trillion from Medicaid and leave 10 million Americans newly uninsured. With three Republicans opposing the legislation in the narrowly divided Senate, Hawley\u2019s support proved decisive.<\/p>\n In a statement, Hawley said that the bill\u2019s benefits\u2014chiefly the extension of Trump\u2019s first-term tax cuts\u2014outweighed his concerns. \u201cGotta take the wins where you can,\u201d the senator told a reporter. Then, last week, Hawley\u2019s Medicaid journey took yet another turn when he introduced legislation that would prevent some of the deepest reductions from taking effect\u2014essentially proposing to repeal a major provision of the legislation he had just voted to enact.<\/p>\n Hawley\u2019s contortions on the bill were perhaps the starkest illustration of how a Republican Party, under pressure to deliver a quick win for the president, ended up slashing a core social-safety-net program much more deeply than many people expected\u2014and more than some of its own members, including Trump himself at times, seemed to want. Republicans are only now beginning to assess the fallout from their enactment of such a far-reaching law. Polls have found that the bill is unpopular, and its Medicaid cuts especially so. But the law puts off its most painful provisions until after the 2026 midterm elections. Trump himself won\u2019t face voters again, so lawmakers like Hawley will be left to deal with the bill\u2019s political and real-world consequences.<\/p>\n Democrats have roundly<\/span> mocked Hawley, painting him as one more weak-kneed Republican who talked a big populist game on Medicaid only to fold quickly under pressure from Trump. \u201cIt was a performance worthy of a gold medal in political pretzel gymnastics,\u201d Russ Carnahan, a former Missouri representative in Congress who is now chair of the state Democratic Party, told me. Hawley\u2019s effort to immediately restore the cuts, Carnahan said, was a cynical attempt to fool Missourians: \u201cHe turned his back on helping people when he had the chance.\u201d A former three-term Republican senator from Missouri, John Danforth, was barely more sympathetic. Danforth was once a political mentor to Hawley but broke with him after he backed Trump\u2019s attempt to overturn the 2020 presidential election. He told me that Hawley\u2019s new legislative proposal is tantamount to a press release. \u201cIt has no real consequence,\u201d Danforth said, dismissing the measure as \u201csimply a way of saying \u2018whoops.\u2019\u201d<\/p>\n Hawley\u2019s office declined to make him available for an interview. Instead, a spokesperson pointed to victories that the senator had secured in the GOP bill, including additional relief for Missourians living with cancers linked to Manhattan Project work that took place in the state more than 80 years ago. This morning, at an event hosted by Axios<\/em>, Hawley said he had drawn a \u201cred line\u201d on benefit cuts for individual Medicaid recipients, and that the bill did not contain any.<\/p>\n Hawley had seemed to be an unlikely savior for those looking for a Republican willing to thwart Trump\u2019s agenda. Outside Missouri, he is best known as the senator who held up a fist of support for the Trump faithful storming the Capitol on January 6, 2021, and then, hours later, was seen on video fleeing the same mob. Unlike moderate Senators Susan Collins of Maine and Lisa Murkowski of Alaska, Hawley does not have an extensive record of breaking with Republicans on key votes. Nor does he have an imminent campaign to consider; Hawley won reelection last fall by nearly 14 points.<\/p>\n The Missourians I spoke with presume that Hawley\u2019s populist rhetoric reflects his national ambitions. With an eye toward the 2028 presidential race, he might be trying to stay loyal to Trump\u2014a requirement for political survival in today\u2019s GOP\u2014while separating himself from rivals whose emphasis on fiscal austerity alienates the president\u2019s working-class supporters. Hawley cited Trump\u2019s own past pledges to protect Medicaid in explaining his initial opposition to the cuts, and he was one of a few Senate Republicans who publicly welcomed the idea (which the party ultimately abandoned) of raising taxes on the rich in the GOP megabill.<\/p>\n The bill contains several major changes to Medicaid, and Hawley is trying to prevent only some of them. He continues to support, for example, the work requirements for nondisabled adults that could add administrative burdens to the program and result in millions of people losing insurance. The cuts that Hawley opposes would affect the amount of money that states such as Missouri could receive from the federal government for Medicaid. Hawley has taken credit for the fact that the enacted bill delays the start date of those provisions until at least 2028, and for securing a $50 billion rural health fund in the bill that could partially offset the loss of federal money for states. His new proposal would repeal the Medicaid funding changes altogether and double the rural fund.<\/p>\n Hawley\u2019s attempt at a balancing act has found him few friends so far. Democrats are happy to use his critique of Medicaid cuts as campaign fodder for next year\u2019s midterm elections\u2014the Democratic Congressional Campaign Committee hailed him as its \u201cnewest surrogate\u201d\u2014while denouncing his vote for the bill. Republicans have mostly ignored him. None have signed on as co-sponsors of his new proposal. When I surveyed the seven other Republicans who represent Missouri in Congress on whether they share Hawley\u2019s concerns about Medicaid or support his new legislation, none responded. (A spokesperson for Missouri\u2019s GOP governor, Mike Kehoe, said that Hawley \u201cis right to be concerned about the long-term sustainability of rural hospitals in Missouri and across the country.\u201d)<\/p>\n Danforth told me he never thought Hawley\u2019s vote on the GOP bill\u2014which the former senator called \u201cterrible\u201d\u2014was in doubt. \u201cIt would just be impossible to be a Republican in good standing in this era and vote against it,\u201d Danforth said. \u201cYou\u2019re going to be heckled. People are going to abuse you, and you\u2019ll just never come up for air. So you must vote for the \u2018big, beautiful bill,\u2019 even though it means voting for elements that are against what you\u2019ve been saying.\u201d<\/p>\n Missouri\u2019s Medicaid advocates haven\u2019t given up on Hawley, however. In some respects, his lonely, politically awkward fight might be their best hope to stave off cuts that Heidi Lucas, the executive director of the Missouri Rural Health Association, described to me as \u201cdevastating.\u201d \u201cPeople are going to die because of these, especially when rural hospitals start closing,\u201d Lucas said. \u201cThey were already running on very thin margins, and this is going to put them over the edge.\u201d Lucas said the rural health fund, even if it gets doubled, is \u201ca drop in the bucket\u201d compared with the total loss of federal dollars. \u201cWe need stitches to fix the problem, and he\u2019s doing it more like a Band-Aid,\u201d she said of Hawley.<\/p>\n Still, Lucas offered Hawley some praise for introducing his bill. \u201cWhatever we can do to mitigate the damage these cuts are going to have, we need to be supportive of,\u201d she said. \u201cSo we\u2019ll support Hawley pushing for these fixes in the hopes that in the long term, these will get into place, and then we can roll back some of the other provisions.\u201d Maybe, Lucas allowed, \u201cthis ends up being a great thing.\u201d<\/p>\n Hawley\u2019s bill stands little chance of passing while Republicans control Congress. And Democrats aren\u2019t interested in partnering with Hawley after he voted for the bill that contained the cuts in the first place. \u201cIt\u2019s a cynical play, and people see that,\u201d Representative Suzan DelBene of Washington State, the chair of the Democratic Congressional Campaign Committee, told me. \u201cIt\u2019s not an honest attempt to address the issue, because this issue wouldn\u2019t exist if he hadn\u2019t voted for it.\u201d<\/p>\n If Democrats can harness voter anger to recapture one or both chambers of Congress next year, Hawley could become more useful to them as a Republican willing to revisit the president\u2019s signature bill. A political backlash to the bill could make Hawley\u2019s critique look prescient. And Trump, who was never that excited about slashing Medicaid to begin with, could use a further delay or repeal of the cuts as a bargaining chip for other legislative priorities. \u201cWhat we\u2019ve just seen is these election cycles lead to policy decisions, and they do truly have consequences,\u201d Jon Doolittle, the president of the Missouri Hospital Association, told me. \u201cThere is time for these laws to change before they take effect.\u201d<\/p>\n Amy Blouin is hoping that\u2019s true. I asked her whether she still thinks that Hawley was \u201cgenuine\u201d in his opposition to Medicaid cuts. She said she does, but his vote for the president\u2019s bill stung nonetheless. \u201cI don\u2019t know the right word to describe the feeling. It\u2019s not necessarily betrayed<\/em>,\u201d Blouin said. She settled on \u201cextremely disappointed<\/em>.\u201d Like others I spoke with, she had wondered whether Hawley could withstand the intense pressure all Republican lawmakers were facing to back Trump\u2019s bill. A few of them did, most notably Senator Thom Tillis of North Carolina, who voted no, after criticizing the Medicaid cuts. \u201cI was hoping,\u201d Blouin told me with a rueful laugh, \u201cthat Senator Hawley would be a Tillis.\u201d<\/p>\n Unlike Hawley, however, Tillis was not voting with his political future in mind: Shortly after declaring his opposition to the bill, he announced his retirement from the Senate.<\/p>\n","protected":false},"excerpt":{"rendered":" For months, no Republican in either the House or the Senate spoke out more forcefully, or more consistently, against cutting Medicaid than Josh Hawley. As President Donald Trump\u2019s \u201cbig beautiful bill\u201d was weaving its way through Congress, Hawley argued repeatedly that stripping health insurance from the poorest Americans would be \u201cmorally wrong and politically suicidal\u201d<\/p>\n","protected":false},"author":1,"featured_media":11905,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[55],"tags":[1671,5415,2326,985,1680],"class_list":{"0":"post-11904","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-social-issues","8":"tag-atlantic","9":"tag-hawleys","10":"tag-josh","11":"tag-journey","12":"tag-medicaid"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/11904","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11904"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/11904\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/11905"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11904"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=11904"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=11904"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}