In this Vox article, Dylan Scott explores the conundrum facing House Republicans as they attempt to balance a massive legislative plan—featuring $4.5 trillion in tax cuts and $2 trillion in spending cuts—with the controversial prospect of slashing Medicaid. Despite Medicaid being the largest health insurance program due to its expansion under the Affordable Care Act and subsequent economic downturns, its immense popularity cuts across party lines, even among many Republican voters. A recent KFF poll underscores this sentiment, with 42 percent of Americans supporting increases in Medicaid spending and only 17 percent favoring cuts. In response to widespread public backing for Medicaid, President Trump has steered the conversation away from direct cuts by proclaiming, "We're not going to touch it. Now, we are going to look for fraud." Yet, critics argue that this pivot toward investigating “fraud, waste, and abuse” is more a political maneuver than a reflection of actual financial misconduct, setting the stage for a heated legislative and public debate over Medicaid's future.

• Legislative Dilemma: House Republicans plan $4.5 trillion in tax cuts and $2 trillion in spending cuts, with $880 billion in cuts possibly coming from Medicaid.
• Medicaid’s Importance: Expanded under the Affordable Care Act and bolstered during economic downturns, Medicaid is now the largest health insurance program in the US.
• Public Support: A KFF poll reveals that while 42 percent of Americans support raising Medicaid spending, only 17 percent favor cuts, with even conservative voters leaning towards keeping or increasing funding.
• Republican Strategy: In light of popular support, the GOP is shifting the narrative from direct cuts to targeting "fraud, waste, and abuse," as evidenced by President Trump's statement.
• Political Implications: The debate highlights the tension between fiscal conservatism and the broad public reliance on Medicaid, potentially reshaping the GOP’s legislative path as Congress finalizes the budget.
• Upcoming Battle: With the Senate yet to formulate its own budget resolution, the fate of Medicaid hinges on whether the GOP can successfully rebrand cuts without alienating its growing base of low-income voters.
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