Hard-liners' Medicaid letter has ties to GOP think tank

A letter signed by 20 hard-line House Republicans calling for deep cuts to Medicaid in the GOP’s domestic policy megabill appears to be written at least in part by a conservative think tank with ties to top Republican leaders.

Rep. Chip Roy of Texas led the letter and promoted it publicly but digital metadata embedded in a PDF copy circulated inside the House and obtained by POLITICO lists the author as Brian Blase, president of Paragon Health Institute.

Blase served on the White House National Economic Council during President Donald Trump’s first term. He and other conservative health wonks launched Paragon in 2021, and it has rapidly gained influence in GOP policy circles. Former Paragon staffers are now top health aides to Speaker Mike Johnson and President Donald Trump.

According to tax records gathered by InfluenceWatch, Paragon has received seven-figure donations from groups linked to high-profile conservative activists Charles Koch and Leonard Leo.

The push from Roy and his fellow hard-liners to enact massive “structural” reforms across Medicaid comes as centrists and even some more conservative-leaning members have raised concerns about cutting too deeply into the program. Trump is also wary of slashing the program but has signaled he supports some efforts to curb spending.

The letter urges House Republicans to pursue “meaningful” reforms to the safety-net health program: “If the House budget reconciliation package does not include structural Medicaid reform that achieves desired Republican outcomes, we will be setting up massive tax increases and benefit cuts in the future,” Roy & Co. wrote. “For once, Congress should stop procrastinating, using excuses, and finally fulfill the Republican agenda.”

Asked if Blase was in fact the document's author, Paragon spokesperson Anthony Wojtkowiak said in a statement that the group “sent a list of Medicaid reform principles to policymakers.”

“It appears that the excellent letter by Chip Roy and colleagues incorporated some of our ideas,” Wojtkowiak said, noting the group frequently works with lawmakers on policy issues.

A Roy spokesperson did not respond to a request for comment.