POLITICO Nightly: How the Republican megabill goes after state Medicaid

By Joanne Kenen Activists protest proposed cuts to Medicaid on Capitol Hill on May 21, 2025 in Washington. | Tasos Katopodis/Getty Images from People's Action Institute CASH IS KING — As recently as last summer, more states were increasing health coverage for immigrants , regardless of their legal status. But under the “One Big Beautiful Bill” now wending its way through Congress, those days could soon be over. Health coverage is expensive. And the mood in the country is not particularly invested in funding such programs these days. The House Republican tax and spending bill would levy very harsh financial penalties on states that provided health coverage to undocumented people — even though they are spending their own money, not federal dollars. It is extraordinarily unusual, perhaps unprecedented, for the federal government to forbid a state from spending its own money on health (except on abortion, and there are attempts to limit some care for trans people). The states aren’t putting undocumented immigrants into Medicaid, which is a joint state-federal venture, but rather into similar but separate state programs. Right now, the federal government is paying 90 percent of the cost of Medicaid expansion under the Affordable Care Act. That’s a higher match than it pays for traditional Medicaid. Those matching formulas vary by state but tend to run from about 50 to 75 percent , according to a recent analysis from the Commonwealth Fund. The House reconciliation bill — which leadership is still seeking to pass late tonight or Thursday — says states that continue to cover undocumented people would get cut from 90 to 80 percent. That’s a drop that shifts a huge financial burden onto states covering their own low-income U.S. citizens under the ACA. *****TRUMP LIES!***** During the 2024 campaign, President Donald Trump lambasted those programs and said his Democratic opponent Kamala Harris was “putting these illegal immigrants onto Social Security, onto Medicare, and she’s going to destroy those programs, and the people are going to have to pay.” (Undocumented immigrants are not eligible to receive Social Security or Medicare, although many do pay into the system through taxes .) Republicans in the House are now attempting to enact his vision. Hardliners in fact want deeper and faster cuts to Medicaid and other social programs. Whatever finally makes it through the House then has to pass the Senate, where there are stricter rules about what can or cannot be included in a budget reconciliation bill. Whatever eventually becomes law is also certain to end up in the courts, partly because of the wording of the landmark 2012 Supreme Court case that upheld the Affordable Care Act but reshaped its Medicaid provisions. Pretty much every big health policy change now leads to a big court fight. For now, though, the House has been increasing the scope and size of its attempts at stripping coverage for undocumented immigrants. The blueprint that passed the House Energy and Commerce Committee last week would have affected 14 states (all but Utah voted for Harris). But the bill language was then quietly modified, potentially stripping coverage not just from undocumented adults — but also for pregnant people and for kids in 34 states, red and blue, including Washington D.C. And that second population is made up of people who are in the U.S. legally, stressed Shelby Gonzales, an immigration expert at the Center on Budget and Policy Priorities. “States will find the costs prohibitive,” said Gonzales. “It would encourage them to end this coverage — or make it very difficult for them to continue.” The health policy research organization KFF estimated it could shift $153 billion in costs to those 34 states over a decade. Advocates for covering more immigrants argue that even though up-front costs are high, not covering them and having them end up in emergency rooms with more advanced and serious conditions is even more expensive in the long run. Everyone ends up paying indirectly for those visits, and communities are less healthy overall when people don’t get appropriate care at the right time, said Tanya Broder of the National Immigration Law Center. So far, governors of most affected states have remained mum on what they’d do should those cuts go into effect. It doesn’t behoove state leaders to speak up on sensitive topics when nobody knows what the final measure will say or how soon it will go into effect. Some, like Washington’s new Democratic governor Bob Ferguson, have kept immigrant coverage in budgets but acknowledged that things could change, said Lee Che Leong, senior policy advocate at the Northwest Health law Advocates. The exception is California, where Democratic Gov. Gavin Newsom recently proposed charging a $100 a month premium for undocumented adults who are covered — and freezing new enrollment starting in 2026. (Even before this GOP proposal emerged, several other states had capped or paused immigrant enrollment given budgetary pressures.) Despite the arguments of the advocates, covering immigrants is often a tough sell. People who are not citizens can’t vote their gratitude come election time. But people who don’t want their tax dollars spent on undocumented people can certainly vote their displeasure. Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com . Or contact tonight’s author on X (formerly known as Twitter) at @JoanneKenen .   A fresh chapter for Playbook — same mission, new momentum. Jack Blanchard sets the scene. Dasha Burns brings the inside scoops. Adam Wren takes Washington into the weekend. Playbook delivers must-know reporting with style, clarity, and serious scoops. Subscribe now —and don’t miss a beat.     What'd I Miss? ****QATARI PLANE SCAM!***** — Trump administration accepts Qatari jet for Air Force One: The United States has officially accepted a controversial luxury jet from Qatar for use as Air Force One, according to the Pentagon, despite concerns from lawmakers and MAGA allies about the financial and ethical implications. The $400 million jet will likely cost taxpayers hundreds of millions of dollars to bring it up to presidential standards, including a security sweep of the entire aircraft and costly upgrades to ensure secure communications. excerpt:  Defense Secretary Pete Hegseth accepted the Boeing 747 “in accordance with all federal rules and regulations,” Pentagon spokesperson Sean Parnell said in a statement. “The Department of Defense will work to ensure proper security measures and functional-mission requirements are considered for an aircraft used to transport the president of the United States.” President Donald Trump has billed the jet as a cost-saving stopgap due to massive delays in the Air Force’s effort to replace the current fleet with two Boeing planes. But Trump’s interest in the jet has worried lawmakers in both parties, who have stressed the security risks and ethical ramifications of the president accepting a foreign-owned aircraft as a gift. “It still sounds like a pretty bad idea to have a foreign government outfitting the most highly sensitive plane in the U.S. arsenal,” Sen. Chris Murphy (D-Conn.), a senior member of the Senate Foreign Relations Committee, said in an interview. Murphy, who has teed up a resolution to challenge the deal, could give new momentum to the congressional pushback. “This sounds like a question Congress should debate,” he said. Trump has suggested keeping the plane at his presidential library after he leaves office, which Murphy called “fundamentally corrupt.” ABC News first reported the administration’s acceptance of the jet. It’s not clear how soon the Air Force, which is tasked with reconfiguring the Qatar plane, can upgrade the jet and put into service. But contractor L3 Harris Technologies will work on the electronics at the Texas facility, according to two people familiar with the issue, who like others, were granted anonymity to discuss internal matters. A spokesperson for the company declined to comment. The Air Force and Boeing have been working on delivering two new Air Force One aircraft but a series of issues, including cracks in the fuselage and slow going on wiring and other critical updates to the commercial 747, have pushed the delivery date to 2027 at the earliest. And that’s only then if some requirements are relaxed. The plane, which Trump first toured in February when it made a stop near his Florida golf club, has sat in San Antonio, Texas for weeks, according to one defense official and flight tracking apps, where it is likely undergoing some preliminary assessments and work. Just adding secure communication is “a big lift all by itself,” said a former defense official who worked on the Air Force One program. “Then you’ve got life support for the President. You take a medical suite with him when he goes, food service that lasts for the length of the trip and you’ve got some things that are there to protect the president from a range of possible threats.” All of those upgrades “can’t be done in a few months or even a year,” the person said, even under the most rushed scenario. “This isn’t going to be a ‘free’ plane, as the president has said.” And Trump will likely continue to face bipartisan backlash. Sen. Josh Hawley (R-Mo.) said the deal sends the wrong message given the Gulf monarchy’s history of harboring extremists. “We love it that Qatar wants to be friends with the United States again,” Hawley said. “But they could start by quitting harboring and promoting Islamic terrorists who want to kill Americans at every turn.” Qatari Prime Minister Sheikh Mohammed bin Abdulrahman Al-Thani on Tuesday defended the gift, calling it “a normal thing that happens between allies.” The subject even came up in the in the Oval Office on Wednesday during a televised meeting between Trump and South African president Cyril Ramaphosa, who apologized that he didn’t have a plane to give the president. “I wish you did. I’d take it,” Trump said. “If your country offered the United States Air Force a plane, I would take it.” ****TRUMP LIES & NATIONAL EMBARASSMENT!**** — Trump puts South Africa’s president on the defensive over unproven ‘genocide’ claims: President Donald Trump turned down the lights in the Oval Office and turned the tables on South Africa’s president , playing a video of Black activists calling for seizing the land of white farmers and showing gravestones that he offered as proof of a “genocide.” Cyril Ramaphosa, whose initial remarks offered warm praise for Trump in an effort to “reset” the relationship, said that the speeches by “a small minority party” were “not government policy” and that he was unfamiliar with the images of the graves. excerpt:  While Trump and former Fox News Channel host Tucker Carlson have pushed the narrative of Afrikaner persecution for several years, there is no evidence of a genocide. While some white farmers have been murdered, those cases account for less than one percent of the country’s 27,000 murders annually. Additionally, the president’s claims of land seizures are exaggerated. While Ramaphosa signed a law earlier this year laying out circumstances in which the state can seize land for public purposes, most landowners are compensated. As Trump continued to insist that “when they kill the white farmer, nothing happens,” Ramaphosa attempted to counter, acknowledging that “there is criminality in our country” and making clear he was willing to talk about the president’s concerns. “People who do get killed, unfortunately, through criminal activity, are not only white people. The majority of them are Black people,” Ramaphosa said. Ramaphosa, who requested Wednesday’s White House visit to reset relations and wanted to focus mostly on trade, suggested that the conversation would be more productive without the press in the room. But Trump did not dismiss the contingent of journalists from the Oval, instead taking another question and continuing his broadside. “You’re taking people’s land away from them,” Trump continued. “We’re not,” replied Ramaphosa, who called on his minister of agriculture, a white man from an opposition party, to back him up. The minister, John Henry Steenhuisen, noted that the Black politicians shown in the video exhorting violence against white farmers were from “opposition minority parties” that his and Ramaphosa’s coalitions joined together to block from power. ***BRAIN DEAD INCOMPETENT JD VANCE!*** Vice President JD Vance, seated on a couch beside Trump, then interjected with a question for Ramaphosa. “So you denounce that type of language in the video?” he asked. “Oh yes, we’ve always done so,” Ramaphosa responded. “We are completely opposed to that.” ***TRUMP HAS ENCOURAGED VIOLENCE!**** But Trump wouldn’t relent, asking Ramaphosa why those opposition leaders were allowed to go free after speech that encouraged violence. “Why wouldn’t you arrest that man?” Trump said “He said: ‘Kill the white farmers!’” ***NAZI MUSK BROUGHT RACISM & WHITE SUPREMACY WITH HIM FROM SOUTH AFRICA! HIS $$$ ORIGINATED FROM EXPLOITATION OF BLACKS IN SOUTH AFRICA!*** At one point, Trump referenced Elon Musk, the South Africa-born billionaire and informal adviser who stood to his left behind the sofa. But the Tesla, Starlink and SpaceX CEO did not speak. ***TRUMP DEFYING COURT ORDERS! ILLEGAL DEPORTATIONS! LACK OF DUE PROCESS! WORTH READING IN ITS ENTIRETY! **** — Trump admin deportation flight to South Sudan violated court order, judge rules: The Trump administration “unquestionably” violated a court order when it abruptly deported seven men to South Sudan , a federal judge ruled today, suggesting that administration officials may have committed criminal contempt. The rebuke from U.S. District Judge Brian Murphy is the latest episode in an intensifying clash between the administration and the judiciary over President Donald Trump’s campaign to carry out rapid deportations while evading court oversight. excerpts:  Three federal judges have now castigated the administration for circumventing, or outright defying, court orders that have sought to block or reverse aspects of Trump’s deportation agenda. And several others — including a majority of the Supreme Court — have scolded the administration for attempting to violate immigrants’ due process rights. At a court hearing Wednesday, Murphy accused immigration officials of defying his earlier directives to provide “meaningful” due process to people whom the administration is trying to deport to countries where they have no ties and could face violence. “It was impossible for these people to have a meaningful opportunity to object to their transfer to South Sudan,” said Murphy, a Biden appointee. Last month, Murphy barred the Trump administration from deporting people to so-called “third-party countries,” rather than their countries of origin, without first giving them a meaningful chance to challenge their deportation on the basis that they might be killed or tortured there. Despite that ruling, the administration on Tuesday morning gathered detainees who were being held in immigration custody in Texas and put them on a plane to be deported. The men were told they were being sent to South Sudan, one of the most dangerous and war-torn nations on Earth. They were given only about 12 hours notice of the deportations and no ability to consult with their lawyers. South Sudan, a landlocked country in East Africa, is plagued by a food shortage, ethnic conflict and violent crime. The State Department strongly recommends that Americans avoid traveling there. Despite notifying the deportees that South Sudan was their destination, Homeland Security officials subsequently declined to say whether the plane had arrived there or had landed in an alternate destination while Murphy considered whether to order the plane’s return. A police spokesperson in South Sudan, Maj. Gen. James Monday Enoka, told the Associated Press Wednesday that no migrants had arrived in the country. Enoka said any arriving deportees would be investigated and “re-deported to their correct country” if found not to be South Sudanese, AP added. The hasty deportations fell far short of the due process requirements in Murphy’s April ruling, the judge said Wednesday. “I believe it to be obviously insufficient,” Murphy said, even as he acknowledged that his April ruling did not set a specific amount of advance notice before proceeding with third-country deportations. The hearing took place as the deported men apparently sat on the plane after it had landed. The judge on Tuesday issued an emergency order that they not be discharged from U.S. custody without his permission. Lawyers for the men asked Murphy to order the plane returned to the United States. But the judge did not go that far. Late Wednesday, after the hearing ended, he expanded on the Tuesday emergency order, saying that the Department of Homeland Security must interview each of the deported men to determine whether they have “reasonable fear” of torture or death in South Sudan. DHS may conduct those interviews either abroad or in the United States, but officials must maintain custody of the men throughout the process, Murphy ruled. And if their fear is deemed credible, the government must seek to reopen their deportation proceedings in immigration court, likely requiring the deportees’ return to the United States. Citing the violation of his April ruling, Murphy also expanded his broader block on deportations to third-party countries, specifying that people targeted for deportation to such countries must have at least 10 days to raise fears of torture. Under the international Convention Against Torture, immigrants are protected from being deported to countries where they are likely to face torture. ***INTERESTING REPRESENTATIVE! RIP GERRY CONNOLLY!*** — Northern Virginia Rep. Gerry Connolly dies at 75: Gerry Connolly, a longtime Democratic member of Congress from Northern Virginia known for his advocacy of the federal workforce, died today. He was 75 years old. `The longtime lawmaker’s death was announced by his family via a statement from his congressional office.  ***PARKING LOT LAWYER ALINA HABBA:  Her words: “Somebody said to me, ‘Alina, would you rather be smart or pretty?’ And I said, ‘Oh, easy, pretty. You can fake being smart!”  REMEMBER WHEN SHE LOST A NEW YORK TRUMP CASE BECAUSE SHE WAS "TOO BUSY" TO LOOK UP NEW YORK STATUTES?**** — Judge criticizes DOJ for ‘worrisome’ and ‘embarrassing’ blunders in arrest of New Jersey mayor at ICE facility: The “hasty arrest” and swift dismissal of a trespassing charge against Mayor Ras Baraka “suggests a worrisome misstep” by interim U.S. Attorney for New Jersey Alina Habba, a federal judge said this afternoon. U.S. Magistrate Judge André M. Espinosa granted what he called the “embarrassing retraction” of the misdemeanor charge following a May 9 incident at an Immigration and Customs Enforcement facility in Newark that unfolded in a tussle between federal authorities and three members of Congress and resulted in the arrest of the city’s Democratic mayor, who is also running for governor. excerpt:  U.S. Magistrate Judge André M. Espinosa granted what he called the “embarrassing retraction” of the misdemeanor charge following a May 9 incident at an Immigration and Customs Enforcement facility in Newark that unfolded in a tussle between federal authorities and three members of Congress and resulted in the arrest of the city’s Democratic mayor, who is also running for governor. Espinosa said an arrest is a “severe” step, not part of an investigation, and he said prosecutors must not try to secure convictions at all cost, satisfy public clamor or advance political agendas. “Your office must operate with a higher standard than that,” he said. Habba was not present for the 1 p.m. virtual hearing for Baraka, though she did phone in to a morning hearing for Rep. LaMonica McIver (D-N.J.), who was charged earlier this week with two counts of assault for actions that happened during the same incident. McIver was allowed to appear virtually from Washington because Congress is in session. Her case is being handled by federal Magistrate Judge Stacey Adams in Newark. Habba may still be considering action against the two other members who were present at the ICE facility when Baraka was arrested — Reps. Bonnie Watson Coleman and Rob Menendez, both New Jersey Democrats.   Cut through policy complexity and turn intelligence into action with POLITICO’s Policy Intelligence Assistant —a new suite of tools designed to save you time and demonstrate your impact more easily than ever—available only to Pro subscribers. Save hours, uncover critical insights instantly, and stay ahead of the next big shift. Power your strategy today— learn more .     AROUND THE WORLD Members of the judicial police work near the body of Andrii Portnov, an adviser to former Ukrainian president Viktor Yanukovych, after Portnov was shot outside a school in Madrid, Spain on May 21, 2025. | Paul White/AP INVESTIGATION LAUNCHED — Spanish police are investigating the death of Andrii Portnov, 51, a powerful Ukrainian former politician, who was living in Spain. Portnov was shot dead by several unknown attackers on a street in Pozuelo de Alarcón, a town in the Madrid province of Spain, the Spanish Interior Ministry confirmed to POLITICO. “Official sources confirm that the victim was shot several times as he was getting into a vehicle. Several people shot him in the back and head and then fled the scene into a wooded area,” the ministry’s press service said. Portnov was one of the key functionaries of Ukraine’s pro-Russian fugitive former President Viktor Yanukovych. In 2021, he was sanctioned by the United States over allegations of high-profile corruption, particularly in the judiciary. PEDDLING INFLUENCE — A bombshell report from the French authorities alleges that organizations with links to the Muslim Brotherhood have been attempting to influence European Union institutions through “significant lobbying activities.” A version of the document seen by POLITICO before its official publication says the Islamist group’s supposed ideological allies sought to push Brussels to criminalize blasphemy and promote a “singular” vision of religious freedom that clashes with France’s strict model of a secular state that protects both freedom of religion and freedom from religion. The European Parliament and MEPs were “particularly targeted,” the report said. The French Ministry of the Interior was expected to release a sanitized version of the document, which would not include the names of sources which could be endangered by its release and mentions of ongoing legal cases, today after it was discussed during a national security council meeting today chaired by French President Emmanuel Macron. Following the meeting, Macron’s office said the report would be released by the end of the week. ‘FANCY BEAR’ ATTACKS — Eleven Western countries have accused a notorious Russian military intelligence hacking group of targeting defense, transport and tech firms involved in helping Ukraine . The United States, the United Kingdom, Germany, the Czech Republic, Poland, Australia, Canada, Denmark, Estonia, France and the Netherlands released a joint statement today on the Russian state-sponsored campaign, which targeted organizations involved in the “coordination, transport, and delivery of foreign assistance to Ukraine.” The countries said Unit 26165 of the Russian military intelligence service — known in the cybersecurity world as "Fancy Bear" — had carried out the campaign for more than two years using a variety of tactics including targeted scam emails and stolen passwords. Russian hackers involved in the campaign have gone after government organizations and private companies in the defense, transport, maritime, air traffic management and IT sectors, they said. Nightly Number $365 million The amount of money slated for solar projects in Puerto Rico that will be diverted to improve the island’s power grid , the Department of Energy announced today. The money had been set aside for that purpose under the administration of former President Joe Biden. RADAR SWEEP PEACE AND QUIET — When the pandemic forced people to live and work in their homes, our desire for quiet grew. People became more frustrated when their upstairs neighbor stomped around or dropped something. Now, a Japanese company is pressing mute on city living with its soundproof apartments. Livlan manages about 900 units in and around Tokyo, made soundproof by creating “a room inside a room” with gypsum boards. Since 2020, the company’s waitlist has grown from about 200 to over 6,000 people, reflecting the popularity of quiet spaces and products cropping up around the globe, writes Marika Katanuma for Bloomberg. Parting Image On this date in 1992: First Lady Barbara Bush laughs and chats with Louisiana State University students as they receive their doctorate degrees in Baton Rouge, La. Bush was given an honorary degree of Doctor of Humane Letters and spoke to the graduates at the spring commencement ceremonies. | Bill Haber/AP Did someone forward this email to you?  Sign up here .   Follow us on X Charlie Mahtesian @PoliticoCharlie Calder McHugh @calder_mchugh   Follow us

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