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Capitol agenda: Thune stares down ‘Medicaid moderates’

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It’s megabill crunch time in the Senate.

Arm-twisting over what to change in the House-passed version of the “big, beautiful” bill will largely play out behind closed doors the next few days. Strategy huddles include Senate Finance’s meeting tonight and Wednesday’s “Big Six” confab between Senate Majority Leader John Thune, Speaker Mike Johnson, their tax committee chairs and lead administration officials.

One of Thune’s biggest challenges to pass the bill by July 4 will be winning over the “Medicaid moderates” — an ideological cross-section of members who are aligned against the cuts passed by the House and have the numbers to force changes. Among them: Sens. Josh Hawley of Missouri, Lisa Murkowski of Alaska and Susan Collins of Maine. Thune can lose only three GOP senators to pass the megabill.

Thune and Senate Finance Chair Mike Crapo (R-Idaho), who is juggling Medicaid and tax conflicts in the bill, are talking to key members in anticipation of difficult negotiations. Crapo told Jordain he personally supports the House’s Medicaid work requirements, which some GOP senators wary of benefit cuts say they could also support. But beyond that, they’re steering clear of public commitments.

One potentially major sticking point: The House-passed freeze on provider taxes, which most states use to help finance their share of Medicaid costs. Sen. Jim Justice, the former West Virginia governor, called it a “real issue,” and Hawley has also raised concerns. But other GOP senators, including Kevin Cramer (N.D.), want to go even further in reducing, not just freezing, the provider tax.

Republicans got a glimpse of the political minefield surrounding Medicaid while back home last week. Iowa Sen. Joni Ernst’s (R-Iowa) “we’re all going to die” response to town hall pushback about the cuts — and her decision to double down on the comments — generated days of negative headlines and ad fodder for Democrats.

Mehmet Oz, the head of the Centers for Medicare and Medicaid Services, told POLITICO’s Dasha Burns in the debut episode of her podcast “The Conversation” that the Medicaid work requirements in the bill would “future proof” the program.

Then there are the deficit hawks. President Donald Trump over the weekend warned Sen. Rand Paul (Ky.) to get behind the megabill, with Paul vowing to vote against it over an included debt-limit hike.

But it’s not just Paul making noise. Sen. Ron Johnson (Wis.) is calling for a line-by-line budget review to find places to slash more spending, and Sens. Mike Lee (Utah) and Rick Scott (Fla.) are also pushing for more cuts.

Paul hinted at hard-liners’ leverage Sunday on CBS’ “Face the Nation,” saying: “I would be very surprised if the bill at least is not modified in a good direction.”

What else we’re watching:

— Senate Dems make a move: Senate Democrats are preparing to challenge parts of the GOP megabill with the parliamentarian, Minority Leader Chuck Schumer wrote in a “Dear Colleague” letter Sunday. He highlighted a specific House provision that critics say would weaken judges’ power to enforce contempt orders.

— Trump’s budget request faces first tests: The House Appropriations Committee will begin marking up the Military Construction and Veterans Affairs and Agriculture portion of Trump’s fiscal 2026 budget request this Thursday. Trump’s request includes 22 percent cuts in non-defense spending and sweeping cuts that Democrats don’t appear interested in supporting (and their votes will be critical in September to avoid a government shutdown).

— Hitting the Hill: Trump administration officials will testify this week in defense of the president’s fiscal 2026 budget. That includes Education Secretary Linda McMahon on Tuesday, Acting FAA Administrator Chris Rocheleau on Wednesday and Commerce Secretary Howard Lutnick on Wednesday and Thursday.

Jordain Carney and Jennifer Scholtes contributed to this report.