More than a dozen Republican state legislators warned U.S. Rep. Tom Emmer and other Minnesota party members in Congress against making deep Medicaid cuts, writing in a pointed letter that "this is contrary to how we Republicans respect the aged and the vulnerable."

"Just to emphasize what you already know, Medicaid includes services and care for the seniors and those with disabilities, not just health care for the poor. Additionally, nearly 50% of all Medicaid enrollees are children," reads the letter signed by six GOP state senators and eight Republicans in the Minnesota House and sent last week.

"Given some of the large numbers coming out of Washington, we are concerned that there is no practical way to accommodate some of the proposed massive reductions and still provide the kind of care these vulnerable people require," the letter continues.

Their warning comes as U.S. House Republicans eye a budget package that includes $4.5 trillion in tax breaks and $2 trillion in spending cuts to government programs. Federal Medicaid cuts could worsen Minnesota's already turbulent budget outlook; the state is projected to face a $5.1 billion deficit in the 2028-2029 fiscal cycle.

The federal government is projected to spend roughly $11.3 billion on Minnesota's Medicaid program in the current budget year, according to state reports.

"Drastic reductions to Medicaid funding have the potential to impact the 1.4 million people we serve and place incredible pressure on our overall state budget," the state legislators wrote to Emmer and his fellow GOP House members, Pete Stauber, Michelle Fischbach and Brad Finstad.

Representatives for Emmer, Stauber, Fischbach and Finstad did not respond to requests for comment Tuesday.

State Sen. Jim Abeler, R-Anoka, was the lead author of the letter. In an interview, Abeler noted that DFL Gov. Tim Walz has also proposed lowering state spending on Medicaid waivers that support people with disabilities. Walz has argued the cutbacks are needed to address the future projected deficit.

"There's a double punch coming here," Abeler said of possible spending cuts at both the state and federal levels.

He said he hopes Republicans in Congress will ultimately take a thoughtful approach to Medicaid spending. As discussions continue at both levels of government, Abeler said lawmakers need to find innovative ways to do more with less.

"This makes you go back to the drawing board … about how to focus on who really needs it," Abeler said. "Sometimes a crisis pushes us to greater innovation and actually more effective service."

Sen. Carla Nelson, R-Rochester, also signed the letter. But she said in a brief interview Tuesday that, "I don't anticipate cuts from the federal government in those programs."

Democratic U.S. Rep. Betty McCollum shared the GOP legislators' letter in a post on X Monday.

"It's wrong to cut Medicaid — a healthcare lifeline for over a million Minnesota seniors, disabled, and children — to give more tax breaks to billionaires like Elon Musk," she wrote.

Staff writers Briana Bierschbach and Walker Orenstein contributed to this report.