PPC Update

April 18, 2025

CONGRESS PASSES BUDGET BLUEPRINT FOR TAX AND SPENDING CUTS, LEAVING MEDICAID SPENDING IN LIMBO. Last week, the House passed a Senate-approved budget resolution in a 216-214 vote. With both the House and Senate now in alignment on a budget blueprint, congressional committees will begin the process of crafting policy proposals to achieve the deficit reduction targets outlined in the budget resolution.

The budget resolution ultimately adopted is unique in that it gives different instructions for House and Senate committees. Senate committees were instructed to find around $4 billion in cuts to reduce the deficit while House committees were instructed to identify much larger spending cuts of around $2 trillion, posing a significant threat to Medicaid and the Children’s Health Insurance Program (CHIP). Specifically, the House Energy and Commerce Committee, which oversees Medicaid, was instructed to draft legislation that makes $880 billion in cuts to federal spending. An analysis by experts at the nonpartisan Congressional Budget Office (CBO) notes that it would be impossible for the committee to meet its instructed spending targets without significant cuts to these programs.

To get the resolution across the finish line, President Trump and Republican congressional leadership made a series of conflicting promises to concerned factions within the Republican party. On the one hand, moderates were assured that cuts would only come from “waste, fraud, and abuse” and that beneficiaries would be left unharmed. Fiscal hawks, on the other hand, were given assurances that cuts would be even deeper than those outlined in the budget resolution. While fiscal conservatives originally threatened to vote against the resolution until it was amended to meet their demands, most were ultimately satisfied by Senate Majority Leader John Thune’s (R-S.D.) promise that the Senate is aligned with the House’s deficit reduction goals. How Republican leadership ultimately squares this circle remains unclear.

Despite the budget resolution clearing the House and Senate in identical form, the road ahead will only get more difficult for Republicans as they will be forced to put forth actual legislation containing specific policy proposals that meet the specified spending targets. Already, a group of moderate House Republicans have warned House Republican leadership that they won’t support a reconciliation package that includes massive cuts to Medicaid.

— Advocacy Opportunity. As Congress negotiates the budget reconciliation bill, it is vital that they hear from academic pediatricians about the importance of Medicaid and CHIP. If you haven’t already, you can contact your lawmakers today and share why Medicaid and CHIP are lifelines for the children and families you care for and why any funding cuts would harm children’s health.

Here’s how to contact your members of Congress: 

  • By Phone: You can call the U.S. Capitol switchboard at (202) 224-3121 to be connected to your representative’s office and ask to speak with the health staff. You also can find your U.S. representative by going to gov and using the “Find Your Representative” feature at the top right of the page. To find your U.S. senators, visit Senate.gov and use the “Find Your Senators” feature at the top left of the page. The contact information for their Washington, DC, office is available on their websites. 
  • By Email: You can also send emails to your members of Congress using the contact form on their websites, using the discussion guidance below as a template.

Important note: To make your message as powerful as possible, we strongly encourage you to customize the template email below and explain why Medicaid and CHIP are so vital to the patients you care for. Here are some ways to do that effectively:

  • Share a short, deidentified patient story or example that illustrates how Medicaid has allowed a patient to access the care they need.
  • Incorporate a key data point or two on Medicaid and CHIP that is specific to your state – you can refer to these 2025 Medicaid fact sheets.
  • Elaborate on the important pediatric research you conduct and the negative impact of Medicaid and CHIP cuts on the ability of academic pediatric departments to continue supporting research.
  • Share briefly how specific populations of children that you care for rely on Medicaid – such as those with complex health care needs or those in foster care.

Template Email: 

As an academic pediatrician, I urge you to prioritize keeping Medicaid and the Children’s Health Insurance Program (CHIP) strong in your upcoming deliberations on the federal budget.

Medicaid and CHIP provide health care coverage for more than 37 million children–almost half of all children in the U.S. The programs are designed for children’s unique health needs and ensure they can access the health care, services and treatments they need to grow up healthy and thrive.    

Any significant funding cuts to Medicaid and CHIP would harm children’s health and impact their access to care. Our pediatric health system depends on Medicaid to keep pediatric practices and children’s hospitals open, which means cuts to the program would impact the health of all children. 

Please keep Medicaid and CHIP strong for children in our state and reject funding cuts to these vital programs.

Thank you for all you do.