Exclusive – Sen. Joni Ernst: Senate Version of the One Big Beautiful Bill Must Protect Medicaid Coverage for Rural Red State Trump Voters

The Senate must amend the House-passed President Trump’s One Big Beautiful Bill (OBBB) to root out waste, fraud, and abuse while protecting healthcare benefits for Americans, Sen. Joni Ernst (R-IO) explained on The Alex Marlow Show.

President Donald Trump’s reconciliation bill is “an opportunity to be very aggressive about getting rid of the waste in the federal government,” Ernst told host Alex Marlow, giving “assurances” that rural Trump voters who are eligible for Medicaid will have their healthcare protected.

The House successfully passed Trump’s OBBB early Thursday morning after a marathon series of negotiations leading up to the vote. The chamber passed the legislation days ahead of its self-imposed Memorial Day deadline.

The Senate has its own deadline of the Fourth of July to pass the bill and is expected to work from the House’s framework as it makes its own changes to this vehicle for Trump’s legislative agenda.

“We can take what the House has brought to us, and we appreciate their hard work, but we should be aggressive, and then we can come together and work out these differences,” Ernst said.

Reforming and reinforcing the integrity of Medicaid and other programs created to help vulnerable Americans should be a critical component in Senate negotiations, she explained.

“I do think we need to take another look at Medicaid and the fraud that is in Medicaid — those that are ineligible for Medicaid. We need to scrutinize that even more so than the House did,” Ernst told Marlow.

“I think we need to look at where we are with SNAP,” she added in reference to the Supplemental Nutrition Assistance Program, commonly known as food stamps.

“These programs were initially started for the populations that are most vulnerable here in the United States,” she said, adding that unfortunately “we have many individuals that have taken advantage of this.”

Ernst explained that she wants to use the reconciliation bill to begin repairing that damage to these programs from the Biden administration’s lax oversight.

“There were Biden rules that were put into place that made it very easy to receive these types of benefits, very difficult to dis-enroll those people when they did better, when they got a job. They still remained on Medicaid rolls,” Ernst told Marlow. “So, we need to go back and take a look at those rules.”

Marlow noted that some red state Republicans – “particularly rural Republicans” like the voters Ernst represents in Iowa – are concerned that they could lose their healthcare coverage as a result of the OBBB. Ernst said “we can give those assurances” that those voters would not lose their health care if Republicans laser focused on Medicaid eligibility “going back to those that are truly eligible for the program.”

Republicans understand the seriousness of the issue and will make sure they get it right, she noted.

Ernst told Marlow that she does not want the Senate to “rush through the bill.”

“We’ll miss a lot and have unintended consequences if we move too quickly,” she explained. “But I do think that we need to take our time in scrutinizing those populations that are eligible and those that would not be eligible.”

Ernst singled out work requirements for able-bodied adults without dependents as a key measure from the House bill that should be retained and strengthened.

“There’s no reason that a 30-year-old man, even in Iowa, that’s not disabled and has no dependents, there’s no reason that individual should not be working,” she proclaimed. “And believe me, the work requirement is a pretty low bar.”

Ernst stressed that Republicans want to demonstrate “empathy” and “care for our constituencies.”

“That’s extremely important to all of us,” she said. “But at the same time, we have to recognize that we are on a trajectory as the United States to get to a point where if we don’t start focusing on our vulnerable populations and putting others back out into the workforce making them ineligible — again, an able bodied adult with no dependents — we will continue to add to our national debt. We’re sitting at $36 trillion, and we won’t be able to sustain [it].”
“What we don’t want to see is Medicaid, Medicare, Social Security failing in the future because we refused to do our jobs today,” she stressed.

By strengthening Medicaid, the program will better serve those for whom it was created while ensuring the program remains healthy for Americans long into the future, she noted.

“And again, we’re not cutting benefits for anyone that the program was intended for. What we are doing is tightening it up to make sure that we can continue delivering on those benefits for the people that it was intended to benefit,” she said.

Congress might never get this opportunity again and must make the most of Trump’s enthusiasm for moving quickly and boldly, she explained.

“President Trump is the only one so far during my time in the Senate, probably since I was a child with Ronald Reagan, where we have seen a true opportunity to make a real difference in the way we exact federal government,” Ernst said.