House Republicans seem to be pulling back on some, but not all, of the big cuts to the Medicaid program in their large tax cut bill. They are facing opposition from more moderate Republican lawmakers who don't want to end the almost free healthcare for the people they represent.

According to a recent report from the nonpartisan Congressional Budget Office, it is estimated that millions of Americans would lose Medicaid coverage under the various cost-saving proposals currently under consideration by Republicans. House Republicans are reportedly seeking to identify up to $1.5 trillion in cuts across federal health, food stamp, and other programs to counterbalance the anticipated $4.5 trillion loss in revenue from tax breaks.

"According to the CBO report, each of those options would lead to a decline in Medicaid enrollment and a rise in the number of uninsured individuals."

The results ignited new doubts about House Speaker Mike Johnson’s capacity to approve what President Donald Trump terms his “significant, impressive bill” by a deadline he set for himself by Memorial Day.

Legislators are expressing mounting apprehension, especially given the rising economic unease concerning Trump’s actions, such as the trade conflict which is potentially leading to increased costs, shortages of goods, and unemployment across the country. A significant element of the proposal is the Republican Party's primary aim to prolong tax reductions, initially implemented in 2017, that are due to end in the near future. However, they intend to implement expenditure reductions in other areas to help cover the costs and restrain the ongoing increase in national debt and budgetary shortfalls.

This week, Johnson has been meeting privately in the Speaker's office at the Capitol with different groups of Republicans, especially the more moderate ones from important election areas in the country. These Republicans are saying that big budget cuts would really hurt their areas.

Democrats, who had commissioned the CBO report, swiftly seized on the findings.

According to Representative Frank Pallone, this analysis from the Congressional Budget Office supports their long-held view that Republican plans for Medicaid would cause millions of people to lose their healthcare. He asked for the analysis with Senator Ron Wyden.

Late Tuesday evening, Republican lawmakers leaving a meeting suggested that Speaker Johnson and the GOP leadership were abandoning some of the most contested alterations to the federal matching fund rates for Medicaid provided to states.

Representative Jeff Van Drew, a Republican from New Jersey, stated that the planned changes to Medicaid would not happen.

Republican Representative Nick LaLota of New York pointed out that Trump has publicly stated his opposition to Medicaid reductions, suggesting that the prevailing Republican strategy now centres on targeting other aspects of Medicaid for spending cuts.

LaLota proposed, among other suggestions, implementing work obligations for Medicaid recipients, necessitating twice-yearly eligibility verification rather than annual checks, and prohibiting aid to immigrants residing in the U.S. without lawful status.

However, the more traditional Republicans, particularly those in the House Freedom Caucus, are demanding more substantial reductions as they strive to curb the rapidly increasing deficits caused by the tax concessions.

Medicaid, a collaborative initiative overseen by individual states and the federal administration, currently extends coverage to 71 million adults.

Republicans are exploring a range of possibilities to decrease federal expenditure on the program, such as diminishing the portion the federal government contributes to enrollees' healthcare costs – which in some instances reaches 90%.

Lawmakers are also contemplating implementing a per capita spending limit for federal outlays on Medicaid enrollees, although this proposition appears to be garnering less legislative backing.

The CBO projected that although these reforms would yield substantial cost reductions, they would also lead to approximately ten million individuals losing their Medicaid coverage.

It appears they are no longer under consideration.

However, Republicans are still considering other suggested adjustments to Medicaid, such as implementing fresh constraints on state taxes imposed on healthcare providers. These taxes currently lead to increased federal government payments. While this could generate billions in savings, the report indicates it might also lead to around 8 million individuals losing their coverage.