House Republicans can afford just a few ‘no’ votes to overhaul Medicaid. 64 of them represent high-enrollment districts

As part of their effort to pass a massive tax, immigration and spending cuts package, House Republicans are eyeing plans to shave billions from the federal budget. Some of those cuts could affect Medicaid and the related Children’s Health Insurance Program.

As part of their effort to pass a massive tax, immigration and spending cuts package, House Republicans are eyeing plans to shave billions from the federal budget. Some of those cuts could affect Medicaid and the related Children’s Health Insurance Program, which nearly 80 million children, senior citizens, people with disabilities, parents and adults without dependents rely on for critical care. Most US adults say they don’t want to see decreases in Medicaid spending, according to a recent KFF poll. It’s not clear yet what changes, if any, would be made to the programs. Those decisions will be made in meetings on Capitol Hill, but Republican lawmakers voted to pass a budget blueprint in April that gave the House Energy and Commerce Committee instructions to shave $880 billion in funding from programs in the committee’s jurisdiction. Medicaid is one of those programs. GOP leaders have said they want to eliminate waste, fraud and abuse. It’s uncertain, however, whether Republican lawmakers could achieve the topline level of cuts that have been proposed without affecting benefits. More than 60 House Republicans represent districts with higher-than-average Medicaid enrollment, according to a CNN analysis of Medicaid enrollment data and 2024 election results. While most Republican districts aren’t heavily reliant on the program, Speaker Mike Johnson’s historically tight margin in the House means that he can only afford a handful of Republican “no” votes to pass any changes to Medicaid without Democrats’ help.