GOP Push for Second Budget Reconciliation Accelerates Amid DHS Shutdown

April 16, 2026

Republicans are moving quickly toward a second budget reconciliation package as they seek to break the ongoing Department of Homeland Security (DHS) funding stalemate and advance the President’s priorities following release of his Fiscal Year 2027 budget request. Recent White House meetings with GOP leaders signal growing alignment around using reconciliation to fund immigration enforcement, with additional defense and security priorities potentially addressed in subsequent packages.

Senate Majority Leader John Thune (R‑SD), Senate Budget Chair Lindsey Graham (R‑SC), and House Budget Chair Jodey Arrington (R‑TX) are working to advance a budget resolution later this month—the procedural step required to unlock reconciliation. GOP leaders are aiming to pass an initial, narrowly scoped reconciliation bill by late May, potentially before Memorial Day recess.

The immediate focus is funding for Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP), as the DHS shutdown stretches beyond 60 days and continues to strain agency operations, including disaster response. Senate leaders have emphasized keeping the bill tightly focused to avoid procedural complications and limit intraparty conflict. However, pressure remains—particularly from House conservatives—to expand reconciliation to fund all of DHS rather than relying on bipartisan appropriations.

Offsets, “Waste and Fraud,” and Medicaid in the Crosshairs

As in prior reconciliation debates, disputes over offsets are re‑emerging. Fiscal conservatives are pressing for spending reductions to pay for new enforcement and defense funding, while Republican leaders increasingly point to “waste, fraud, and abuse” as a source of potential savings. Medicaid has again become central to those discussions.

Although the President’s FY 2027 budget does not explicitly propose Medicaid cuts, it calls for steep reductions in nondefense spending and shifts greater responsibility to states, raising concern among advocates. Arrington and other conservatives have publicly suggested revisiting Medicaid policies that failed Senate reconciliation rules last year, framing potential changes as antifraud or program‑integrity measures rather than benefit reductions.

Advocacy organizations warn that this framing obscures real risks to coverage and services—particularly home‑ and community‑based services—and note that recent polling shows voters prioritize protecting access to basic needs over preventing fraud. They argue that the resurgence of antifraud rhetoric is less about program integrity and more about creating political cover for cuts that would otherwise be difficult to advance.

Divisions Within the GOP Complicate the Path Forward

Despite White House pressure to move quickly, internal GOP divisions continue to complicate the path forward. Senate appropriators are uneasy about sidestepping the traditional funding process, while politically vulnerable Republicans remain wary of being forced into tough votes during reconciliation “vote‑a‑rama” sessions. In the House, razor‑thin margins amplify tension between leadership and hard‑line conservatives pushing for broader scope and deeper offsets.

Why it matters for Medicaid: By relying on reconciliation to fund homeland security and defense priorities, the administration has intensified pressure on Republicans to identify large offsets. Medicaid remains one of the few programs sizable enough to generate those savings, making it likely to stay in the crosshairs—particularly under the banner of antifraud reforms—even as leaders insist benefits will be protected.

Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.

What the Budget Bill Means for Medicaid and our Network

July 17, 2025

On July 4, President Trump signed into law a sweeping budget reconciliation package that was passed in the Senate on July 1 and House on July 3 on party-line votes of 51–50 and 218–214, respectively. The law contains a number of provisions that will impact our network in several areas.

  • Healthcare:
    • Medicaid: The law imposes more stringent work reporting requirements for “able-bodied” adults between 19 and 64; lowers the allowable rate for state provider taxes for some provider types, with specific carve-outs for nursing homes and intermediate care facilities; grants states new authority to offer HCBS through standalone waivers that don’t require individuals to meet institutional-level of need.
    • SNF minimum staffing: Prohibits implementation of the SNF minimum staffing regulation for 10 years.
    • Rural hospitals: Includes a $50 billion rural hospital stabilization fund designed to support states with approved rural health transformation plans, allocating $10 billion annually from 2026 to 2030.
    • Medicare: The CBO projects that the law will trigger future cuts to Medicare totaling nearly $500 billion due to the Statutory Pay‑As‑You‑Go Act of 2010 (S-PAYGO). This law kicks in when legislation increases the deficit and would trigger an estimated $45 billion in Medicare cuts for fiscal year 2026.
  • Housing: Creates a permanent 12% allocation increase in low-income housing tax credits (LIHTC) starting in 2026, while also permanently reducing the 50% bond financing threshold test to 25% beginning in 2026, lowering a barrier to affordable housing production.
  • Refugees: It institutes a permanent ban on refugees and other humanitarian-status immigrants from getting Medicaid.
  • Nonprofit tax provisions:
    • Charitable deduction: It establishes a non-itemizer deduction for charitable contributions at $1000 for individuals and $2000 for joint filers;
    • Excludes two provisions we opposed: one putting nonprofit status in jeopardy if an organization was deemed to have ties to a “terrorist” group and a second levying UBIT on transportation and fringe-benefit related costs.

The focus now turns to implementation of the law, with much of the impact depending on which state is being discussed. For example, the Kaiser Family Foundation has prepared a state-by-state analysis of the impact of Medicaid spending reductions.

Looking ahead, we anticipate another budget reconciliation bill in the fall. In a recent interview, House Budget Committee Chair Jodey Arrington (R-TX) said that majority Republicans seek deeper cuts to Medicaid and spending reductions in Medicare that weren’t included in the first bill. They also plan to cut funding for states that fail to enforce existing laws against Medicaid benefits for undocumented immigrants and reimbursement rates for “healthy, able-bodied adults” added to Medicaid under President Barack Obama’s Affordable Care Act.

We will be tracking both implementation of the current law and further legislative efforts carefully and will update you as needed.

Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.

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