The Republican speaker’s decision underscored the resistance in his party to politically painful reductions to the program, and drew a backlash from the hard right, which is demanding deep cuts.

WASHINGTON ― Some of Republicans’ top ideas for reducing Medicaid spending would cut enrollment by millions, according to a new report by the Congressional Budget Office. The analysis comes as no surprise but nevertheless could make it harder for House Speaker Mike Johnson (R-La.

Work requirements remain on the table but Congress will not cut the matching rate for the Affordable Care Act expansion or impose per capita limits on states.