GOP lawmakers commit to big spending cuts, putting Medicaid under a spotlight – but trimming the low-income health insurance program would be hard

Speaker of the House Mike Johnson addresses the media on Feb. 25, 2025, after the House narrowly passed his budget resolution calling for big spending cuts. Kayla Bartkowski/Getty Images

Efforts by Republicans in Congress to make steep spending cuts have stirred widespread concerns that the federal government may trim expenditures on Medicaid even though President Donald Trump has previously indicated that he’s unwilling to do that. This public health insurance program covers around 72 million people – about 1 in 5 Americans.

The Conversation U.S. asked Paul Shafer and Nicole Huberfeld, Boston University health policy and law professors, to explain why cutting Medicaid spending would be difficult and what the consequences might be.