Sen. Josh Hawley (R-MO) told reporters Tuesday that President Donald Trump was surprised to learn about a Medicaid rule change that could harm rural hospitals and made clear he did not know about it.

Hawley said he spoke directly with Trump. The Missouri senator has become the most prominent Republican voice pushing back against cuts to the low-income health care program during negotiations over the One Big Beautiful Bill.

“Just had a great talk with President Trump about the Big Beautiful Bill,” Hawley wrote this month on X. “He said again, NO MEDICAID BENEFIT CUTS.”

Hawley’s stance places him at odds with fiscal hawks in the Senate who support the House-passed bill’s effort to slash $880 billion from the program by tightening eligibility standards and increasing reporting requirements. While the bill targets what lawmakers call waste, fraud, and abuse,” critics argue the changes could still lead to coverage losses, especially in rural areas where Medicaid serves a significant share of the population.

Trump, according to Hawley, agrees and was unaware of certain provisions in the bill affecting rural hospitals. With Medicaid now a defining issue for many working-class voters in the GOP base, Hawley is pushing Republicans to realign with the party’s new political reality.



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