Medicaid is set to become a key issue in the battle over control of Congress in next year’s midterm elections now that President Trump’s "big, beautiful bill" has passed.

Congress passed the largest Medicaid cuts in the program’s 60-year history through the GOP’s megabill right before the July 4th holiday, a $1 trillion reduction that's projected to push more than 12 million low-income individuals off their health insurance over the next decade.

Republicans argue the moves are necessary to address waste and fraud in the program, ensuring that "able-bodied" adults aren’t taking advantage of the system.

But with 1 in 5 Americans enrolled in Medicaid, Democrats hope this massive slash spells political poison for Republicans in the midterms. GOP holdouts voiced concerns along these lines leading up to the vote. Sen. Thom Tillis (R-N.C.), who voted against the bill and won't be seeking reelection, reportedly told Senate Majority Leader John Thune (R-S.D.) that the Medicaid cuts could cost Republicans control of both the House and Senate.

Heading into the 2026 election cycle, Republicans will have to get ahead of Democratic messaging on health coverage.

“The key here for Republicans going into the midterms is to clearly go on offense and define the debate around Medicaid in particular today, not tomorrow, not next month, not in the fall, not next year. They need to do it in a unified and aggressive way today, because Americans' public opinion is on [the] Republican side,” Kristin Davison, partner at the GOP consulting firm Axiom Strategies, told The Hill.

She pointed to polling that showed most Americans — 62 percent, per polling from earlier this year — are in favor of measures like adding work requirements to Medicaid.

The legislation makes a wide range of changes to Medicaid, though the Senate’s parliamentarian struck some more extensive ones for being noncompliant with Senate rules.

The law is set to require Medicare beneficiaries to prove for the........

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