Recently, House Republicans approved the broad outline of their major legislation for this year, which includes $4.5 trillion in tax cuts and $2 trillion in spending cuts. To get there, the Energy and Commerce Committee was charged with finding $880 billion in cuts — something would be impossible to do without slashing Medicaid, now the single-largest health insurance program in the US.

But some House Republicans are wary of voting for Medicaid cuts, forcing the White House and congressional leadership to scramble. President Donald Trump has so far sworn off major cuts to the program.

Between Medicaid’s expansion under the Affordable Care Act and the two major economic downturns in the past 20 years — the Great Recession and the economic downturn following the start of the Covid-19 pandemic — an increasing number of........

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