Republicans are scrambling to resolve intense divisions over Medicaid as they hammer out a key piece of their massive bill for President Donald Trump’s agenda.

House Speaker Mike Johnson (R-La.) is staring down a growing rebellion from his centrist wing over cuts to Medicaid in the GOP's "big, beautiful bill." Why it matters: Moderate and swing-district House Republicans are trying to balance their loyalty to Trump with their increasingly imperiled reelection prospects.

As Republican leaders draft President Donald Trump’s big bill of $4.5 trillion in tax breaks and $1.5 trillion in spending cuts, dozens of more moderate Republicans from contested congressional districts have positioned themselves at the center of the negotiating table.

The Republican speaker’s decision underscored the resistance in his party to politically painful reductions to the program, and drew a backlash from the hard right, which is demanding deep cuts.

WASHINGTON ― Some of Republicans’ top ideas for reducing Medicaid spending would cut enrollment by millions, according to a new report by the Congressional Budget Office. The analysis comes as no surprise but nevertheless could make it harder for House Speaker Mike Johnson (R-La.