Far-right activist Laura Loomer is going after a prominent conservative health policy expert and former Trump administration official for his proposals to overhaul Medicaid — stoking larger intraparty tensions at a pivotal moment for negotiations over President Donald Trump’s “big, beautiful bill.”

In a social media post Monday, Loomer called Brian Blase, the president of Paragon Health Institute, a “RINO Saboteur” for helping draft a letter circulated by 20 House conservatives that advocated for deep cuts to Medicaid in the GOP’s domestic policy megabill.

His role in writing the missive was first reported by POLITICO.

“In a shocking betrayal of President Donald Trump’s unwavering commitment to America’s working-class families, and his promise to protect Medicaid, [Brian Blase] … is spearheading a dangerous campaign to undermine the Republican Party’s midterm prospects,” Loomer said on X.

Fiscal hawks believe cuts to the safety net program will deliver necessary savings to finance Trump’s desired package of tax cuts and extensions, border security spending, energy policy and more. But Trump has also continued to insist there will be no provisions included in the bill that would result in cutting Medicaid benefits — though he hasn’t detailed how that might be the case.

Loomer accused Blase of “currently pressuring congressional Republicans to defy the President’s ironclad pledge to protect Medicaid — a program critical to the heartland voters who propelled Donald Trump to his election victories.”

Blase worked in Trump’s first administration as a special assistant to the president on the National Economic Council. He’s one of the most influential conservative health policy thinkers in Washington, frequently writing op-eds in the Wall Street Journal and publishing a mountain of policy papers pushing Medicaid reform.

In a statement Tuesday, Blase defended himself and his work.

“I am proud to have served President Trump for two and a half years at the White House, leading the implementation of his health care agenda,” Blase said. “Paragon shares the president’s commitment to reducing waste, fraud, and abuse in government programs and reversing the harmful health policies of the Biden administration — like California’s $10 billion scheme to put illegal immigrants on Medicaid.”

A Paragon spokesperson said last week the group sent a list of Medicaid reform principles to policymakers and that it “It appears that the excellent letter by [Texas GOP Rep.] Chip Roy and colleagues incorporated some of our ideas.”

It’s significant that Loomer would make Blase a target: She has a history of crusading against people she sees as disloyal to Trump, having in the past personally persuaded the president to fire several top national security officials over their perceived lack of sufficient fealty.

The situation also speaks to the broader friction within the Republican Party between the moderate and the populist wings — which are wary of benefit cuts — and the more traditional conservative faction — bent on making major changes to safety-net programs.

The divide has threatened to imperil the package central to Trump’s agenda as Republicans are under immense pressure to find savings for the bill.

Roy and a handful of House Republicans who are in touch with Blase are full steam ahead to force GOP leaders to pursue deeper cuts across Medicaid and other safety-net programs, which they argue need massive reforms to curb long-term spending.

Freedom Caucus members met Tuesday morning to discuss reconciliation and to try to push back on attacks that they’re gutting Medicaid, according to three Republicans with direct knowledge of the matter.

Meredith Lee Hill contributed to this report.

Key Republican moderates said Tuesday they had grown more comfortable with a revised House GOP effort to overhaul Medicaid following an evening meeting with Speaker Mike Johnson and other leaders.

Johnson needs to find near-unanimity among House Republicans as he finalizes the GOP megabill central to President Donald Trump’s agenda, and several of the centrists emerged from the closed-door huddle sounding closer to yes. The plan is centered around work requirements for beneficiaries, more frequent eligibility checks in the program and cracking down on coverage for noncitizens, they said.

Meanwhile, some controversial changes the moderates had blanched at appear to be omitted from the latest plan: cutting the federal share of funding for states that expanded Medicaid under the Affordable Care Act and capping federal payments to those expansion states.

Asked if Republicans were pursuing changes to the federal cost share, known as FMAPs, Johnson replied: “No.”

Asked about “per capita caps” on Medicaid funding, he added, “I think we’re ruling that out as well, but stay tuned.”

Republicans discussed the caps proposal at length in the room, according to members in attendance. There was “lots of opposition” to applying the caps for expansion states, according to one attendee granted anonymity to describe the private meeting.

The retreat from the most ambitious cost-cutting proposals risks inciting House GOP hard-liners. One leader of that group, Rep. Chip Roy of Texas, said on X that caps were “necessary to stop robbing from the vulnerable to fund the able-bodied.”

Republicans have debated for months how to handle states that have expanded Medicaid to people with higher incomes, though still near the poverty line, under the Affordable Care Act. Several states have so-called trigger laws that would end or pull back on the expansion program if the federal government reduces their role, and many lawmakers are leery invoking those provisions.

Even beyond the moderates, conservative Republicans across Virginia and other expansion states have warned GOP leaders not to pursue deeper spending cuts that would throw hundreds of thousands of Americans off Medicaid rolls. Republicans are now parsing what the fallout would be in their individual states over some per capita cap changes.

“I have to see in Arizona if the per capita cap impacts the trigger laws. I don’t think I’m 100 percent clear on that,” Rep. Juan Ciscomani (R-Ariz.) told reporters. “That would be a deal-breaker for me if it does trigger it, obviously.”

Rep. Mike Lawler (R-N.Y.) said he remains opposed to both controversial proposals: “I don’t support any change to FMAP. I don’t support per capita caps.”

“We’re coming up with options, we’re discussing them, hashing through them, debating them,” said Rep. Nicole Malliotakis (R-N.Y.). “They’ll come back with a revision.” Malliotakis left the door open to capping the federal government’s payments for certain beneficiaries in states that have expanded Medicaid.

“States need to have some skin in the game,” she said.

Members said a policy the Trump administration has pushed as an alternative to the steep Medicaid cuts — linking what the program pays for drugs to the lower prices paid abroad — wasn’t a focus.

Several other Republicans said the meeting was more productive than previous conversations around Medicaid changes.

“I feel better about it,” said one vulnerable House Republican who was in the room.

“I think he’s got something that’s workable,” Rep. Dan Newhouse (R-Wash.) said, adding, “there’s a few wrinkles that need to be worked out, but I think he’s on … a good path.”

Some members said they want to know more about what Trump thinks.

“We have to make sure that we know where the president is on this and also where the Senate is,” Ciscomani said. “We can’t be just unilaterally moving this without knowing where they’re going to be and then have some surprises there at the end.”

House Democratic leaders said Tuesday they would launch a longshot effort to force a vote on a bill preventing cuts to key federal safety-net programs.

The discharge petition is meant to put political pressure on Republicans as they eye cuts to Medicaid and the Supplemental Nutrition Assistance Program in writing their domestic policy megabill.

“All we need are four House Republicans to join Democrats in protecting the health care and nutritional assistance of the American people,” House Minority Leader Hakeem Jeffries told reporters Tuesday.

If 218 members sign the discharge petition, it would force a floor vote on a bill that would prevent the House from taking up bills under the party-line reconciliation process that would cut Medicaid or SNAP. Members are generally reluctant to buck party leadership to sign discharge petitions, and GOP leaders have taken steps this Congress to block the process entirely.

Rep. Robert Garcia is starting to make quiet moves toward a bid to lead Democrats on the House Oversight Committee, according to five people granted anonymity to discuss his behind-the-scenes maneuvers.

The Californian has started to round up support from other Democrats who are encouraging him to run and is testing the waters by making calls to other colleagues, the people said.

Both privately and publicly, Garcia is showing deference to Rep. Gerry Connolly (D-Va.), who announced last week he will step aside as top Oversight Democrat due to a battle with cancer.

“Right now there’s like no election, and so I think those of us on the Oversight Committee are just focused on Gerry’s health,” Garcia told reporters Tuesday. “We just wish him the very best.”

Still, many Democrats are eyeing the high-profile post after Rep. Alexandria Ocasio-Cortez said Monday she would forgo a bid. That decision is likely to open up the field for a host of other ambitious young Democrats — including Garcia, 47.

Connolly has yet to formally step aside, so no election has been scheduled. He designated Rep. Stephen Lynch of Massachusetts as the interim top Democrat; Lynch said last week he intends to seek the job permanently.

Any contest is expected to be hotly contested, and lawmakers have made preliminary moves to lock down support. Rep. Jasmine Crockett (D-Texas) has already started to privately maneuver for the job, and Reps. Ro Khanna (D-Calif.) and Maxwell Frost (D-Fla.) could also be in the mix. Frost and Garcia are close, and some Democrats believe the two would not run against each other.

“At this point I feel like half the committee is wanting to run for the seat,” said Rep. Becca Balint (D-Vt.), who served on the Oversight panel last Congress. She stood up in House Democrats’ closed-door caucus meeting Monday to say “we need to be utilizing all of our talent in the caucus” by elevating younger lawmakers, she said.

Another Democrat, who spoke on the condition of anonymity to discuss caucus dynamics, said he was “really excited” to support Garcia should he choose to run. That Democrat said he had supported Connolly for the Oversight position last year.

Garcia currently serves in Democratic leadership, holding a position reserved for lawmakers who have served fewer than five terms in Congress. Should he mount an Oversight run, he could draw the backing of the Congressional Hispanic Caucus. Only one CHC member, Rep. Nydia Velazquez of New York, holds a committee leadership position.

Should Democrats take control of the House in the 2026 midterms, the Oversight chair would have broad jurisdiction to investigate the Trump administration and a central role in the party’s accountability efforts over the executive branch. For now, the ranking member is a key foil to Oversight Republicans’ continued efforts to investigate former President Joe Biden’s administration.

GOP Sen. Thom Tillis said Tuesday he has told the White House he will oppose Ed Martin’s nomination to be the top federal prosecutor for the District of Columbia, a potentially fatal blow to his already dicey confirmation chances.

Tillis spoke to reporters after meeting with Martin on Monday night. The North Carolinian, who is seeking reelection next year, had previously signaled he had concerns with Martin’s nomination as U.S. attorney because of his previous comments related to the Jan. 6, 2021, Capitol attack and his work defending those who took part in the riot.

“I have no tolerance for anybody that entered the building on Jan. 6, and that’s probably where most of the friction was,” Tillis said Tuesday.

Senate Majority Leader John Thune told reporters after Tillis’ comments that Martin is now unlikely to emerge from the Senate Judiciary Committee.

Martin is now serving as acting U.S. attorney for D.C. — an appointment that expires May 20. President Donald Trump is lobbying hard for Martin’s confirmation, posting about it on Truth Social Monday: “Ed is coming up on the deadline for Voting and, if approved, HE WILL NOT LET YOU DOWN.”

Tillis is a member of the Judiciary Committee, and his opposition means the panel would likely deadlock on Martin’s nomination, 11-11, with several other Judiciary Republicans still uncommitted. Senate Republicans could try to advance him out of committee without a recommendation, but Martin would face bigger headaches on the floor: GOP Sens. Lisa Murkowski of Alaska, Susan Collins of Maine, John Curtis of Utah and Mitch McConnell of Kentucky are viewed as votes to watch.

Tillis said he did not expect Martin to come up in the Senate Judiciary Committee for a vote. Asked about Martin’s prospects Tuesday, Judiciary Chair Chuck Grassley (R-Iowa) said, “I want the president’s nominees to be successful, and that means we put on [the committee agenda] people who have the votes.”

Tillis’ opposition, Grassley added, “isn’t the end of it, but that’s where we are right now.”

House Republicans revisited the 2017 congressional baseball shooting Tuesday, releasing a report attacking the FBI over its initial characterization of the event as a “suicide by cop.”

The report from the House Intelligence Committee incorporated FBI records released to Congress by Director Kash Patel in March. In an early morning news conference Tuesday, Intelligence Chair Rick Crawford (R-Ark.) accused the bureau of acting with “a complete disregard and lack of investigative integrity.”

As first reported by POLITICO, the FBI in November 2017 briefed lawmakers who had been present for the shooting that it had determined that the attack was “suicide by cop” rather than a politically motivated act of terrorism. House Majority Leader Steve Scalise and three others were wounded in the attack.

The shooter, 66-year-old Illinois man James Hodgkinson, was killed by Capitol Police after repeatedly firing his rifle at House Republicans who were practicing for the congressional baseball game. He had espoused left-wing political opinions and opposition to President Donald Trump before traveling to Washington and opening fire.

For Republicans, the FBI’s characterization at the time was a sign of the political motivation of the federal law enforcement agency which was used to “mislead and influence public opinion” in the words of Rep. Ronny Jackson (R-Texas). In 2021, Jill Sanborn, the executive assistant director of the FBI, testified before Congress that the shooting was “something that we would today characterize as a domestic terrorism event.”

House Republicans are preparing one of the largest overhauls to the country’s largest anti-hunger programs in decades, with a plan to limit future increases to benefits, implement new work requirements and push costs to states in a move that risks millions of low-income Americans being removed from the program.

The Agriculture bill has faced delays since last recess amid centrist backlash over the deep food aid spending cuts. But GOP leaders are targeting a markup for next week, May 13 or 14, after deciding late last week to push back this week’s expected meeting, according to four people with direct knowledge of the matter.

Republicans in the last day have altered the most controversial piece of the House Agriculture Committee’s portion of the Trump megabill: a plan to force states to pay a portion of benefits under the Supplemental Nutrition Assistance Program for the first time. The program helps to feed more than 40 million low-income Americans.

A previous proposal the panel was pursuing would have seen the states’ share of costs reach 25 percent by the end of a10-year window, while stair-stepping in and not starting until after 2027. Several centrists, including Reps. Don Bacon (R-Neb.) and David Valadao (R-Calif.), have raised concerns about the plan. Rep. Derrick Van Orden, who represents a more competitive district in Wisconsin, walked out of an Agriculture panel GOP briefing last week over the matter, slinging an insult at staff before he left. Van Orden also stood up in the closed-door House GOP conference meeting to raise concerns about the reworked cost-share proposal, arguing his state was being unfairly penalized. California Rep. Doug LaMalfa later stood up and reiterated the panel needs to reach $230 billion cuts. White House officials and other Republicans have been wary of the impact of the SNAP plans in combination with Medicaid spending cuts on deep-red states. But White House officials effectively green-lit the proposal in recent days.

The latest plan would phase in for the 2028 fiscal year and skew more of the financial burden to states with higher payment error payment rates while decreasing the percentage of the cost share on states with fewer penalties to start as low as 10 percent, as Republicans were considering amid the backlash.

A spokesperson for Agriculture Committee Republicans declined to comment.

Senior House Republicans say they need the cost-share measure to hit the $230 billion in cuts across the Agriculture panel’s jurisdiction, with the bulk focusing on spending cuts to SNAP.

But beyond the cost-share plan, Agriculture Republicans will increase the age of recipients who need to complete work requirements to receive food aid, reaching so-called able-bodied adults with children age 7 and older for the first time. That move alone is expected to save at least $40 billion, according to projections from the Congressional Budget Office.

Another piece of Republicans’ plan, which has long been panned by Democrats, is to limit future increases to families’ SNAP benefits after a recent Biden-era update created a record increase that shocked Republican lawmakers. Republicans would effectively limit future updates to the Thrifty Food Plan that serves as the basis of SNAP benefits in order to make any future updates cost-neutral and also include a cost-of-living adjustment.

The bill will also crack down on what Republicans say are largely blue-state abuses of waivers that skirt current SNAP rules, including waivers of certain layers of work requirements. And it will end a so-called internet utility loophole from the Biden administration and another loophole associated with the Low Income Home Energy Assistance Program that Republicans argue allows states to skirt a standard utility deduction in the SNAP program.

The Agriculture panel is also planning to fit a raft of farm bill program funding into its portion of the megabill, with the goal to pass a smaller, slimmed-down farm bill later this year without major fights over mandatory funding.

One aim is to rescind billions in climate-focused agriculture program dollars from the Biden administration and reinvest it into the farm bill baseline. Agriculture Republicans also want to add tens of billions of dollars for crop reference prices but also trade export promotion, livestock biosecurity, additional so-called orphan programs and more pieces that represent mandatory funding to the GOP package. But some Republicans are skeptical GOP leaders will accept such a tall order, especially with hard-line House fiscal hawks deeply opposed to such spending and time running out.

“It’s still gotta math,” hard-liner Rep. Chip Roy (R-Texas) warned Tuesday morning. “Now they want to add more?”

Republicans will be “hard pressed” to finish their megabill by Memorial Day, a key Republican said Tuesday at a hospital industry conference.

This acknowledgment from Rep. Buddy Carter of Georgia, the top Republican on the House Energy and Commerce health subcommittee, is a significant concession that Republicans face a steep hill to climb to meet Speaker Mike Johnson’s deadline for getting the bill through the House by the end of May.

Republicans are still sorting through major divisions on how deeply to make cuts to Medicaid and issues related to state and local tax deductions. At stake is extending President Donald Trump’s tax cuts and enacting his broader agenda on tax, energy and border policy.

Johnson also suggested Monday the timeline could change as lawmakers work to resolve major policy differences, but that if it slips past Memorial Day it would be wrapped “shortly thereafter.”

Still, Carter said Tuesday at the American Hospital Association’s conference in Washington, “I’m very confident, first of all, we can get this done … [and] that we’re going to get it done in a timely fashion. Certainly we’re going to get it done before July 4.”

Carter, a former pharmacist, also revealed that the text of bipartisan legislation targeting the business practices of pharmacy benefit managers, or PBMs, to lower drug prices is currently on tap for inclusion in the Energy and Commerce Committee’s portion of the Trump agenda bill. Carter had previously said that commercial market overhauls may not qualify for the budget reconciliation process given the Senate’s stringent rules, but changes impacting government programs like Medicaid could qualify. On Tuesday, he said Republicans are planning to include some of those provisions in the package. 

“What we’re going to do is eliminate spread pricing in Medicaid,” Carter said, referring to the policy that would prohibit PBMs from charging Medicaid more for a prescription drug than is paid to a pharmacy that dispenses the medication.

But Republicans have struggled to reach agreement over how to obtain enough savings to reach the House Energy and Commerce Committee’s target of $880 billion in spending cuts for the megabill. Democrats and some Republicans have warned that major cuts to Medicaid could threaten health care access for millions of Americans.

“What we’re trying to do is to see where we can cut waste, fraud and abuse of Medicaid, where we can stabilize that program and make it sustainable for the most vulnerable in our population, those who it was intended for in the first place,” Carter said.

Carter also hinted, as he has previously, that he might be interested in running against Sen. Jon Ossoff (D-Ga.) in the 2026 Georgia Senate race.

“Right now, I’m concentrating on making sure we get through this reconciliation process as chair of the health subcommittee and representing people with the first congressional district, but I want to do what’s best for our state,” Carter said. “And I believe that God has a plan, and he’ll make sure that that plan is followed.”

Ben Leonard contributed to this report.

Democratic appropriators infuriated by the Trump administration’s disregard for Congress’ power of the purse are getting their first chance to cross examine the secretaries who have aided the president’s slashing.

Treasury Secretary Scott Bessent, DHS Secretary Kristi Noem and Agriculture Secretary Brooke Rollins are hitting the Hill Tuesday to testify on their portions of President Donald Trump’s fiscal 2026 budget request. VA Secretary Doug Collins is also likely to face sharp budget questions when he appears before Senate Veterans’ Affairs Tuesday.

Democrats will push hard for answers on why Trump is unilaterally cutting congressionally approved funding — and why he’s proposing another $163 billion in nondefense cuts going forward.

“Appropriations laws are not suggestions,” Rep. Lauren Underwood, the top Democrat on the Homeland Security subcommittee, told POLITICO of the warning she’ll deliver to Noem. Here’s where things could get testy Tuesday:

The looming X-date: Expect lawmakers to press Bessent on when the Treasury Department believes Congress will have to act on the debt limit (unless Treasury drops that news before his 10 a.m. hearing). Bessent and House Republicans will need Democrats’ support to raise the debt limit if the X-date comes before the GOP can pass its party-line megabill.

Noem will have to defend Trump’s immigration policies: The president’s budget called for a 65 percent increase in funding for border security and Immigration and Customs Enforcement.

Noem is almost certain to face scrutiny over disaster aid, with the Trump administration on track to run out of cash for FEMA this summer. The secretary plans to tell lawmakers that the agency “needs to be both reformed and reimagined,” while privately telling officials she wants FEMA to end its role in funding long-term rebuilding efforts and helping communities with disaster preparation.

But Congress will want to know whether the Trump administration has plans to fund existing disaster aid needs — and when it plans to make a formal request, kicking off what could be a contentious funding fight.

On the Senate side, expect Rollins to get questions on funding freezes and tariffs’ impact on U.S. farmers. Meanwhile, Democrats are expected to slam Collins over plans to cut tens of thousands of jobs at the VA. All in all, expect a preview of what other Cabinet secretaries will face as they parade up to the Hill for their budget hearings in the coming weeks.

What else we’re watching:

— D.C. funding fix: Speaker Mike Johnson said Monday the House will vote “as quickly as possible” on fixing D.C.’s $1 billion funding shortfall. But he also suggested it’s taking a back seat to resolving Republicans’ megabill problems. “We’re not delaying this for some political purpose or any intentionality,” Johnson told reporters Monday. “It’s just a matter of schedule.”

— Crypto bill changes: Senate Majority Leader John Thune said Monday he is open to amending landmark cryptocurrency legislation that GOP leaders hope to pass in the coming weeks. This comes as Republicans scramble to negotiate changes that would win over enough Democrats to overcome a filibuster.

— Sports executives on the Hill: Senate Commerce is meeting Tuesday to discuss how the rise in digital platforms is changing the way Americans watch sports. “Catching your favorite team on TV shouldn’t feel like solving a puzzle,” said Chair Ted Cruz. “Games that used to be free or easy to find are now scattered across pricey apps and exclusive deals.” Executives from the NBA, MLB and NHL are all scheduled to testify. According to Cruz, the NFL declined to send a representative.

Jordain Carney, Jasper Goodman, Meredith Lee Hill, Jennifer Scholtes and Katherine Tully-McManus contributed to this report.