Which takes longer: electing a new pope or finalizing the House’s reconciliation bill? We’re about to find out, as Republicans hunker down for a string of marathon mark-up sessions that could decide the fate of the president’s “one, big, beautiful bill.” “Are we going to see a puff of white smoke above the Capitol by the end of [this] week?” Family Research Council President Tony Perkins joked. While there’s nothing House Speaker Mike Johnson (R-La.) would like better, a lot of obstacles still stand in the GOP’s way.

Members on both sides have been sifting through hundreds of pages of the draft language that’s being debated this week in the Ways & Means, Energy & Commerce, and Agriculture Committees. In a normal situation, mark-ups (which is basically when committees discuss, amend, and vote on any changes in the bill) take a few hours. But reconciliation is anything but normal. Back in 2021, when Democrats were wading through Joe Biden’s so-called “Build Back Better” legislation, the back-and-forth in Ways & Means alone took a grueling 35 hours, stretched into four days.

Some of the hot-button issues include the debt ceiling increase, Medicaid reforms, an extension of the Trump tax cuts; tax relief on tips, overtime, and car loan interest; the states’ share of the Supplemental Nutrition Assistance Program (SNAP); state and local tax (SALT), deduction caps; and a slew of overhauls to Biden’s expensive legacy on things like student loan forgiveness and green energy credits. For social conservatives, all eyes are on defunding Big Abortion (including Planned Parenthood) and ending taxpayer spending on gender transition procedures.

As Johnson reiterated on Saturday’s “This Week on Capitol Hill,” leadership has been clear for decades about its commitment to end the federal gravy train for abortion businesses. “The polling is off the charts,” the speaker pointed out, referring to the near-60% of Americans who “do not want forced taxpayer funding for abortion.” For years, that was a bipartisan principle. Now, as the Democratic Party has become more radicalized, even the Hyde Amendment is objectionable. But that’s not the case across the country. “I think even people who support abortion understand that you cannot force taxpayers to fund it,” the speaker reiterated. “And that’s what’s been happening — and we’re going to take care of that problem.”

At least heading into the high-stakes Energy & Commerce mark-up Tuesday, the draft proposal stopped Medicaid from bankrolling mutilating surgeries for minors — a fact that Chairman Brett Guthrie (R-Ky.) touted in a Wall Street Journal op-ed. “The Republican bill also prohibits Medicaid from funding ‘gender reassignment’ surgery for children, instead recommitting the program to essential care for our most vulnerable Americans. The federal government shouldn’t be subsidizing these procedures in any form,” he argued, “and I am proud that we will be protecting all our children from the lasting, harmful effects of these procedures.”

Family Research Council’s Quena González cheered the fact that the GOP is trying to tackle this issue on a broad scale. “It’s exciting that Congress is finally defunding gender transition procedures and abortion providers. This kind of legislation would have been inconceivable just a year ago, prior to President Trump’s election,” he told The Washington Stand. “We are still hoping that Republicans will strengthen the language defunding gender transition procedures so that it applies not just to minors but across the board. Taxpayers should not be funding experimental gender transition procedures for anyone.”

Other major flashpoints — like whether to reform Medicaid and by how much — were at the top of the agenda for both sides of the GOP. Moderates, who’ve argued Republicans can’t kick ineligible people off the Medicaid rolls, seemed to have temporarily won out over conservatives who want to limit the program to its pre-COVID pool of participants — not millions of young, healthy Americans. Part of this whole process, Johnson explained, is “returning to fiscal sanity.” And in the aftermath of COVID, “the federal government went on a spending spree. They expanded Medicaid way beyond its original intent, and they set it on a trajectory to collapse upon itself.” He added, “So many people are on Medicaid who were never intended to be there — able-bodied workers, young men with no dependents, [they’re] on Medicaid. It doesn’t make any sense.”

The only way to make it solvent again is to “shore up the program,” the speaker stressed, “reform it so that it can be sustained. Look, Medicaid is a very important safety net for young pregnant mothers who are single, for example, and the disabled and the elderly and people who genuinely need a hand up sometimes. It’s not meant for young men to sit around on their couches and play video games. So we’re going to get those guys off the program. We’re going to get illegal aliens off the program. We’re going to … get rid of the fraud, waste, and abuse, which cost about $500 billion every 10 years. And we’re going to get this program back under control [adding] work requirements for [capable] people.”

Conservatives like Rep. Chip Roy (R-Texas) see that overhaul as absolutely critical to their support. “Does the bill offer ANY transformative changes on Medicaid or otherwise? Currently — NO,” he warned. “It ignores the policy changes that matter (federal match driving Obamacare-Medicaid explosion to blue states and the able-bodied) — and even the changes it embraces are mainly codification of rules Trump would do anyway, leaving healthcare costs spiraling, fat cats still making lots of money while hard-working Americans are left behind.”

Others are frustrated by the party’s inability (or maybe refusal) to bring America’s debt under control. Senator Rand Paul (R-Ky.) has been particularly perturbed that the House version of the bill would raise the country’s borrowing limit another $4 trillion. (His chamber is proposing $5 trillion.) “This is what’s going to be so disappointing to the American public when they find out that all [that] DOGE was doing,” he said, “which is so good and I compliment and support — [but it] never got translated in because no one had the wherewithal and the guts to say, ‘Let’s don’t raise the debt ceiling that much, let’s raise it a small amount.’” At some point, he urged, “There has to be some conservative movement in the country that says, ‘Enough’s enough,’ no matter what party’s in power. We can’t keep spending $2 trillion more than we take in every year.”

Johnson understands his party’s exasperation, but he also realizes that this is part of a larger process. “Look, we use the analogy all the time. … The U.S. economy is like a giant aircraft carrier. You don’t turn it on a dime. It takes miles of open ocean. And the reconciliation bill is a big first step in that,” but he suggested, it’s not the last. 

While President Trump called the first stab at reconciliation “GREAT,” the speaker will have to juggle 220 other opinions and as many as “20-plus issues” that Roy insisted needed resolution. “It’s a tightrope waltz,” Perkins shook his head. Managing that would be a headache for anyone, he told Johnson, but “I do think that your style has a lot to do with it, in terms of allowing the members to have something that they have complained that they’ve not had … and that is a voice in the process. It’s a slow, deliberative process, [and] I commend you for that.”

Asked what he’s done differently than past speakers, the Louisianan smiled. “I’m sure I’ve prayed as much or more than anyone who’s ever held this gavel,” Johnson said. “No kidding. I mean, that’s a big part of this. You know, we need divine intervention. The challenges are much larger than any of us — individually or even collectively. And we acknowledge that.”

Sure, he admitted, “Some people mock me for it. But I know that God has given our nation another chance. … And we need … God’s ideas and not our own. And that’s helped. A lot is patience. … I mean, look, what I try to model is servant leadership. And I try to empower every member of the House, all the Republicans — who are all my colleagues. I love them all. I know what makes them tick and how they think and what their priorities are and what the dynamics of their districts are. And so we try to just make sure that we can check as many boxes for as many people as we can,” he underscored. “And it takes a lot of time to listen and deliberate and think through and build consensus.”

“I’ve joked, ‘I’m almost more of a mental health counselor than a speaker of the House half the time,” Johnson said. “But you know, that’s what it requires. But I love that. I love working with the people I work with,” he insisted. “The American people have sent some extraordinary folks to Washington to lead in these fateful times, and I’m convinced we’re going to get this job done together.”