The U.S. House of Representatives, with a slim Republican majority, is in a big puzzle over members’ own conflicting views of a reconciliation package that would represent the nation’s budget framework.

The Republican majority is trying to find $1.5 trillion in spending cuts to help offset the cost of extending President Donald Trump’s 2017 tax cuts.

One focus is Medicaid , the joint federal and state program for health insurance and medical services, traditionally for poor, elderly and disabled Americans but more recently also for the working class.

The House Energy and Commerce Committee has an instruction to cut a minimum of $880 billion in spending. One of the biggest programs under the committee’s authority is Medicaid.

That committee is lined up to lay possibilities on the table starting next week.

House leadership has aimed to pass the reconciliation package by Memorial Day.

If that happens, Senator Shelley Moore Capito said discussions are active for what would occur next. Administration officials have been aiming to get the reconciliation package passed by July 4.

“We want to do a pro growth policy here to that we saw in the late teens under President Trump the first time. We want to keep that momentum and get that momentum restarted in this economy,” Capito said.

“That part of it, I think, is very complicated, but I think it is moving forward.”

A major question is what might happen with Medicaid.

More than a half million West Virginians are supported by the program, according to a state budget overview for the West Virginia Department of Human Services. That’s just under a third of all West Virginia residents.

HOPPY KERCHEVAL: Medicaid cuts would hit WV harder than most states.

Capito described her approach as cautious.

“I’ve talked at length to West Virginians, to the hospitals, to the nursing homes, to the state Medicaid office, to understand how fully this this can impact West Virginia,” Capito said in response to a question by reporter Steven Allen Adams of the Ogden Newspapers.

“I’m not interested in cutting anybody’s benefit, but I am interested in making sure that we get rid of the fraud, that we make sure that we have a work requirement , that we make sure have accountability, and those are money savings in Medicaid.”

The Department of Health and Human Services estimated a combined total of more than $100 billion in improper payments in both Medicare and Medicaid in fiscal 2023.

Improper payments, as defined by government analysts, are not solely due to fraud — but they can also include errors or missing documentation.

Cuts to Medicaid would affect West Virginia significantly, said Leslie Dach, founder of the national non-profit Protect Our Care.

“These are people who are working, who have disabled children, who count on Medicaid for their health care, and this would be taken away from them,” Dach said on MetroNews Talkline.

“So, you know, the estimates are that if you cut $880 billion out of Medicaid, you’re going to have as much as, depending on how they do it, as much as 20 or 30 million people losing their health care in America.”

He said “that has ripple effects, of course, on all of these families, but also in rural hospitals that depend on Medicaid to pay their bills and to stay in business. And so it’s going to decimate lives if it happens.”