For months, more than a dozen Hill Republicans have been sounding the alarm about the steep Medicaid cuts in President Donald Trump's sprawling agenda package, which is now just hours away from becoming law. North Carolina Sen. Thom Tillis called cuts to Medicaid "inescapable." Missouri Sen. Josh Hawley called Republicans' targeting of Medicaid "a mistake." Nebraska Rep. Don Bacon, who once declared he wouldn't support anything with over $500 billion in cuts, said he reluctantly supported the Senate's nearly $1 trillion in cuts because of other tax breaks in the bill. Now, Democrats are turning those precise GOP warnings into the centerpiece of their strategy to seize control of Congress in the midterms next November. "It's 2018 all over again," said Rep. Jared Golden of Maine, a Democrat who holds one of his party's toughest, most Trump-friendly swing seats. "I'm not gonna predict the future but I think today was a pretty bad vote for them," Golden told CNN, adding that he did not consider voting for the GOP bill, despite billions for border security and military funding. "I would never vote for these Medicaid cuts. Never." Recent polling so far shows Republicans have a tough sales job ahead of them, with53 percent of votersopposing the bill in a Quinnipiac University poll from June. But the GOP plans to hit back, armed with their own argument that Democrats stood in the way of broadly popular tax breaks for many Americans, billions more for border security and additional support for American troops. They argue that Democrats are vastly exaggerating the cuts to Medicaid, most of which come from work requirements largely targeted at able-bodied adults without dependents who don't work or attend school 80 hours a month. Speaker Mike Johnson described the bill as the "most comprehensive, complicated piece of legislation" in recent memory, and "arguably in the top two or three in the history of the Congress." Trump praised the legislation at an event in Iowa on Thursday and suggested using Democrats' opposition to it on the campaign trail. New York Republican Rep. Nicole Malliotakis offered an emphatic defense of the legislation while calling Democratic critics "liars" and accusing them of "fearmongering." And she argued for the new Medicaid work requirements by saying, "Nobody loses benefits if they choose." But Democrats insist they have a far more potent message. "We will look back on election night last November, on what just happened this week, culminating with this vote today, as the beginning of the House majority for Democrats," Rep. Brendan Boyle of Pennsylvania told CNN. "There's nothing more effective than a member of Congress saying things in their own words about how bad this bill is," added California Rep. Ami Bera, who is heavily involved in the Democrats' campaign operation. He pointed to Republicans like Rep. David Valadao, whose rural California district is heavily reliant on state and government aid. Roughly two-thirds of people in his district get their health insurance from Medicaid. "This is really a bad vote for David," Bera said. The bill cuts nearly $1 trillion over a decade from Medicaid, which has seen its costs balloon since an Obama-era expansion of that program across 40 states. Roughly 12 million people could lose health insurance by 2034 because of the changes to Medicaid and the Affordable Care Act under the bill, according to the Congressional Budget Office. Some of the starkest impacts won't be felt for years, and the bill's work requirements won't take effect until the end of 2026. Ahead of its final passage, the "big, beautiful bill" was already the subject of anintenselobbying campaign, with more than $35 million spent on advertisements in June in an attempt to sway members and their constituents. Those ad wars are continuing, as outside groups and dark money networks on both sides prepare large advertising campaigns for the coming weeks and months in a race to define the sprawling legislation. "After this vote, every time you wait longer at a doctor's office or get a higher utility bill in the mail, it's gonna have a 'brought to you by MAGA' disclaimer to go along with it," said Jesse Ferguson, a Democratic strategist who has worked on House races. A collection of Democratic outside groups – including Save My Care, Protect Our Jobs, Unrig Our Economy and others – areset to spendseveral million dollarsbetween the beginning of July and the end of the year, according to data from the ad tracking firm AdImpact, targeting about a dozen key seats. Many were on the air throughout June and have continued launching new attack spots amid the legislative wrangling this week. Demonstrating the reactive posture, Unrig Our Economy launched a new spot following Thursday's vote, targeting GOP Rep. Juan Ciscomani, from Arizona's competitive 6th Congressional District, linking criticism of his vote to the July 4 holiday deadline. "While Americans are celebrating our country with family, friends, and fireworks, Republicans in Congress just passed the largest cut to Medicaid in history,"the ad says, singling out Ciscomani. House Majority Forward, a nonprofit affiliated with House Democratic leadership, is creating ads to hit multiple vulnerable Republicans later this month, including Reps. Scott Perry in central Pennsylvania, Tom Barrett in southern Michigan and Derrick Van Orden in western Wisconsin, according to a person familiar with the plans. "You can be sure that HMP will use their own words against them in our ads next year, and we will take back the House in 2026," the group's spokesman, CJ Warnke, said in a statement to CNN. Van Orden, for his part, shrugged off any analysis predicting that millions of people would lose coverage because he doesn't trust the Congressional Budget Office. "The state of Wisconsin is going to get an additional billion dollars a year for our healthcare system. That's why I'm not worried about any of the junk you're talking about with reelection," Van Orden said, adding that he's also getting $500 million for rural healthcare infrastructure. Democrats still have work to do to win the messaging battle against Trump's legislative agenda. Polling conducted on behalf of House Democrats last month showed that few battleground voters knew much about the GOP's massive tax and spending cuts package, which initially passed the House in May, according to PowerPoint slides of the data presented to members, obtained by CNN. In a private meeting to discuss the 2026 midterms, House Democrats brought in an outside pollster who presented internal Democratic polling that showed few voters said they had heard "a lot" about the bill, while larger shares said they had heard "a little" or "not at all." Some Democrats saw the data as a warning sign that their party is struggling to land political hits against the bill. "Don't allow Republicans to define this bill," said one slide in the presentation, which was obtained by CNN. Key Democratic outside groups are already at work fine-tuning the messaging with off-year races in Virginia and New Jersey and the 2026 midterms in mind, aiming to raise voter awareness of the cuts to safety net programs. A research report commissioned by one of those groups, Protect Our Care, and obtained by CNN, showed survey results for ads across 11 battleground districts, aiming for movement among 2024 Trump voters and swing voters and developing content "effective at lowering the job approval of Republican incumbents." "Pairing the Republican effort to cut Medicaid with the simultaneous reduction in taxes on the rich and corporations is an effective way to reduce Republican job approval," the report said. Republicans are readying their own attacks on Democrats for voting against the more popular provisions in Trump's first big legislative priority, emphasizing tax cuts and border security. In a political memo obtained by CNN the day of the House vote, the National Republican Congressional Committee previewed the case it will make, saying that "House Republicans will be relentless in making this vote the defining issue of 2026." "Every Democrat voted to hurt working families and to protect the status quo. This vote is now their political identity, and the NRCC will work every day from now until next November to brand House Democrats with it," the memo says. And Republicans argue that Americans generally support the idea of work requirements for federal safety net programs like Medicaid and SNAP. GOP Rep. Tim Burchett, who represents the Knoxville-area in Tennessee, insisted that the bill would not complicate reelection chances for his colleagues in swing districts. "America understands that things like, if you're able to work, you ought to work. We need to clear up some of the fraudulent behavior so that it provides for those single moms with two kids that are maybe just getting by and it doesn't collapse the system," Burchett said. But North Carolina Rep. Chuck Edwards, a Republican who had raised concerns about the bill and the potential impact of Medicaid cuts, expressed some lingering reservations about the legislation. "No bill is perfect," Edwards said. "I wish I had more time to digest the Senate's version and have one-on-one dialogues back at home, but I believe that we've made some steps in the right direction." Asked about his message to constituents who could lose access to Medicaid under the new policies, Edwards said, "I don't see a situation at this time where anyone that is entitled to Medicaid would be losing it, but I'd be open to hear folks' thoughts and ideas as they might see differently." Meanwhile, Securing American Greatness – a group aligned with Trump's political network and its mountain of funds – and several other Republican outside groups have been on the air amid the legislating, providing support to members in battleground districts. "Congressman Ryan Mackenzie just voted for working family tax cuts that mean higher wages and lower taxes for working families," saysone of the group's ads, running in support of the freshman representative from a swing district in Pennsylvania. The pro-Trump group, which spent nearly $8 million in June, is also at work hitting battleground Democrats over their opposition to the bill. "Congresswoman Marie Gluesenkamp Perez voted for a 22% tax hike on working families," saysanother spottargeting the Washington Democrat coming off two consecutive narrow elections. Matt Gorman, a Republican strategist, laid out the task ahead of Republicans. "This is the culmination of the best two weeks Trump has had since he became president," he said. "Now it's up to the GOP to sell this bill to a base that needs to turn out next November." GOP Rep. Troy Nehls of Texas, asked if he's worried about people losing health care, told reporters with a post-vote victory cigar in his hand: "It's just some Americans, who aren't Americans. Just illegals." CNN's Ali Main, Arlette Saenz and Aileen Graef contributed to this report. For more CNN news and newsletters create an account atCNN.com
