President Trump’s vow to keep Medicaid intact is colliding headlong into the Republicans’ strategy to extend their 2017 tax cuts, complicating the GOP effort to secure a major policy win in the early months of Trump’s second term.

Trump on Wednesday endorsed the House Republicans’ plan to move “one big beautiful bill,” combining immigration and energy policies with $4.5 trillion in tax cuts. A large part of that cost, according to the GOP’s budget blueprint, would be offset by reductions in Medicaid spending.

Yet hours earlier, the president had vowed to preserve Medicare and Medicaid in their current form. Republicans, he suggested, would find the budget savings for the tax cuts elsewhere.

“Medicare, Medicaid — none of that stuff is going to be touched,” Trump said in a prime-time interview with Sean Hannity of Fox News. “We don’t have to.”

Trump’s promise clashes directly with the House GOP’s budget plan, which seeks as much as $880 billion in Medicaid cuts over the next decade. That figure is by far the biggest chunk of the $2 trillion in cuts Republicans are seeking across all federal programs to help pay for the loss of revenue from their proposed tax cuts. Those offsets are seen as crucial to the success of the larger legislative package because conservative deficit hawks — whose votes will be........

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