The divide between Republicans and Democrats over the future of Medicaid was well encapsulated this week by two of Houston's congressional members during an all-night rumble that resulted in one Democrat calling U.S. Rep. Dan Crenshaw “a jerk.”

Crenshaw and U.S. Rep. Lizzie Fletcher, D-Houston, are both members of the House Energy & Commerce Committee that advanced a plan that will either save Medicaid or imperil it, depending on which party had the microphone. While Fletcher and Crenshaw, R-Houston, didn’t directly combat each other, they outlined each party's view on what will happen to the popular health care program if Congress makes cuts to it as part of the “big beautiful bill” President Donald Trump wants from Congress this summer.

Crenshaw and other Republicans acknowledged their bill could kick 7.6 million people off Medicaid but insisted it’s aimed at fraud and abuse, undocumented immigrants and able-bodied Americans who aren’t willing to work.

“We’re not here to cut the Medicaid lifeline for the neediest Americans. That’s just a lie,” Crenshaw said as he started his remarks around 3 a.m.

At one point he looked at a crowd of Medicaid recipients with disabilities who had filled the hearing room in Washington, D.C., and accused Democrats of using them to scare the public about benefit cuts.

“If I could roll two eyes I would," Crenshaw, who wears an eye patch because of a combat injury from his time as a Navy SEAL, said as Democrats objected to him claiming they were lying about the issue. U.S. Rep. Nanette Barragán, D-Calif., could be heard a short time later responding on the microphone, “He’s being a jerk.”

The bill would impose work requirements to receive Medicaid for able-bodied adults aged 19 to 64 without dependents, demanding they work or volunteer at least 80 hours a month or show they are looking for work. It includes exceptions for pregnant women and short-term hardships.

Benefits for people with disabilities, children, and the truly needy, Crenshaw said repeatedly, are not going to be cut.

But that is where Fletcher took issue later in the hearing. While the bill doesn’t directly cut benefits for those recipients, she said it could indirectly affect their health care because of rules the GOP is adding to the program.

Under the GOP bill, there would be more frequent eligibility verifications, something Fletcher said Texas tested out in 2003. And more recently after the pandemic she said the state made family resubmit eligibility documents. It resulted in more than 900,000 kids who were eligible for Medicaid to lose coverage, often for procedural reasons like not getting paperwork filed or the state mishandling the documents.

The former oil and gas attorney said Congress should learn the lessons from that and ensure the eligible recipients aren't dropped simply because of mounds of red tape.

“Let’s not make the law that was so bad in Texas the law of the land across the country,” Fletcher said.

The Republican bill also limits access to a tax loophole that Texas and other states have used to tap extra Medicaid dollars for hospitals and medical providers. Texas hospitals would still be able to use so-called provider taxes to access higher federal reimbursements, but they couldn't be expanded, even as healthcare expenses continue to rise.

Other Democrats warned that means more strain on hospitals and clinics to provide care, which ultimately could mean to more of those facilities closing or discontinuing care for the needy, including those in the room whom Crenshaw said wouldn't lose coverage.

Democrats have argued that while Republicans insist they are going after waste fraud and abuse, all of the changes to Medicaid in the legislation could lead to 14 million people lose health care, including because of reduced subsidies for people insured through the Affordable Care Act.

Crenshaw, 41, and Fletcher, 50, were both elected to Congress in 2018 from Houston. Crenshaw represents the 2nd District, which includes areas around Spring, Kingwood and The Woodlands. Fletcher's 7th Congressional District runs from Rice University west to just over the Fort Bend County line.

View this article in the Houston Chronicle.