House Republicans are under increasing pressure to spell out exactly how they plan to fund President Trump’s domestic policy initiatives, and a major debate is looming over whether to cut Medicaid benefits. Medicaid has become a central target as the GOP looks for ways to make room in the budget for an extension of Trump’s tax cuts, but the issue is deeply divisive within the party.
Conservatives are pushing hard for steep Medicaid reductions, arguing that cuts are necessary to control federal spending. However, moderates have made it clear they will not support any plan that rolls back benefits for millions of vulnerable Americans who rely on the program for health coverage. More than 70 million people across the country depend on Medicaid, making it one of the most politically sensitive programs in the federal budget.
“We won’t vote for something that takes away benefits from seniors, disabled and vulnerable people that we represent who rely on Medicaid,” said Rep. Nicole Malliotakis, one of a dozen moderate and vulnerable Republicans who recently sent a warning letter to House leadership. These moderates have expressed serious concerns that any plan targeting Medicaid could backfire, alienating key voters just ahead of the 2026 midterm elections.
The stakes will rise further on May 7, when the House Energy and Commerce Committee plans to mark up its portion of the sweeping reconciliation bill. The committee, which oversees Medicaid, has been tasked with finding $880 billion in savings a figure that, according to the Congressional Budget Office, cannot realistically be reached without cutting Medicaid.
Trump has made expanding his domestic agenda a cornerstone of his second term, but pushing for Medicaid cuts could hurt the very Americans who form the core of his voter base. Many low-income, elderly, and rural voters who helped elect him would be among the hardest hit by any reductions. If Trump continues down this path, it risks undermining the economic security of the people he promised to champion and it could deal a serious blow to his political support at a critical time.
Trump and Republican leaders face a critical choice: protect essential benefits for millions of Americans, or risk a political backlash that could ultimately hurt not just vulnerable families, but the future of the Trump agenda itself.