House GOP moderates are telling Republican leaders they will not walk the plank and vote for Medicaid cuts in the party’s “big, beautiful bill” only to see the Senate strip them out — their latest warning shot in the effort to enact President Trump’s legislative agenda.

In the past, GOP leaders have corralled the conference around more conservative pieces of legislation to gain leverage over the upper chamber, cajoling centrists to take politically painful votes with hopes that they would help realize a more right-leaning final product. Speaker Mike Johnson (R-La.) deployed the strategy in February during negotiations over the budget resolution, and former Speaker Kevin McCarthy (R-Calif.) did the same amid the debt limit standoff in 2023.

This time around, however, moderates are putting their foot down, making clear that they will not back a more conservative Trump agenda bill that includes poison pill measures — namely drastic changes to Medicaid — as a negotiating tactic.

“That’s the vote we’re trying to avoid,” Rep. Nick LaLota (R-N.Y.) said of the intermediary step. “There is a specific appetite amongst 20-plus Republican members to vote only on something that is real and that could actually become law rather than this more conservative thing that can’t get the vote.”

“The members with whom I most frequently speak do not want to go down that path,” he added of first passing a conservative bill. “We feel like we’ve done that heavy lifting already, and members like me prefer to only vote on a bill that could actually become law.”

Rep. Jeff Van Drew (R-N.J.), a Democrat-turned-Republican, said such a situation would be the “worst” sequence of events.

“The worst scenario of all would be for the House of Representatives to vote for a bill, get it out, and then it goes to the Senate and the president, and they say we’re not doing it, it’s a bad........

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