() Analysts say Republicans cannot reach their budget goals without cutting Medicaid, even as President Donald Trump has said he will leave the program alone.

Republicans have a goal of cutting at least $1.5 trillion in spending over the next ten years to pay for Trump’s proposed tax cuts and the cost of finding and deporting immigrants at the numbers he has demanded.

What have Trump, Republicans said about cutting Medicaid?

House Speaker Mike Johnson said the cuts in the House’s budget proposal, which directed the energy and commerce committee to cut spending by $880 billion in areas under its purview, can be made by cutting out waste and fraud and tightening eligibility requirements.

Trump has also repeatedly said he will not cut Social Security, Medicare or Medicaid for those currently relying on it. The three programs together accounted for nearly half of the federal spending in the last fiscal year.

Can the budget be cut without hurting Medicaid?

But the Congressional Budget Office, an independent agency, said it would be impossible to meet those goals without cuts to Medicare, Medicaid and the Children’s Health Insurance Program (Chip).

The CBO assessment was requested by Rep. Frank Pallone, D-N.J., and Rep. Brandon Boye, D-Penn. The report stresses that there is no way to make the cuts demanded without significant cuts to Medicaid.

What is Medicaid?

Medicare is a joint federal and state program that covers health insurance costs for those with limited resources. Many seniors use it along with Medicare, as Medicaid covers things like nursing home care and personal care services that are not covered by Medicare.

Medicaid is the largest health insurance program in the country based on enrollment numbers, and an increasing number of Americans have enrolled due to expansion of the program in some states and due to economic downturns that have made more people eligible for the program.

The program covers around 70 million people, which amounts to one in five Americans. That’s more than the 66 million seniors covered by Medicare.

How do Americans feel about Medicaid?

Polling from Kaiser Family Foundation found 53% of Americans said they or a family member have used Medicaid and 96% said it was somewhat or very important to their community. Only 17% of respondents said it should be cut.

As Republicans have gained more support from low-income voters, they face having to balance a desire for budget cuts and the fact that their voters rely on entitlement programs like Medicaid. Broken down by party affiliation, the KFF poll found that among Republicans, only a third wanted cuts to Medicaid.

Is there fraud in Medicaid?

Republicans have said they will only cut fraud from Medicaid, but it’s not clear what that would mean and how much money it would actually save.

Information has circulated online saying the Department of Government Efficiency (DOGE) subcommittee found $2.7 trillion in improper Medicaid payments but that is false.

The $2.7 trillion number comes from reports issued by the U.S. Government Accountability Office. The reports were issued in March and June of 2024, before Trump was elected. They found $2.7 trillion of “improper” government payments since 2003.

Improper was defined as payments that shouldn’t have been made or were made for incorrect amounts. The reports covered not just Medicaid, but Medicare and other federal programs, including the Supplemental Nutrition Assistance Program (SNAP).

The payments weren’t necessarily fraud either, with the GAO determining that while some may have been fraudulent, there were also other reasons, including simple administrative errors.

What would Medicaid cuts mean for Americans?

It’s not clear what specific cuts would be made to Medicaid because nothing has been officially proposed. But there are some specific strategies that could be used to reduce spending.

The government could cut federal funding to states, which would then have to tighten eligibility requirements that would make fewer people eligible for health insurance. Those no longer covered would have to find insurance on their own or go without.

Decreased federal funding could also result in caps on coverage, a reduction of services and reduced reimbursement rates. In areas, including rural areas, where the population heavily relies on Medicaid, significant reimbursement cuts could lead to the closure of hospitals and other health care facilities that would impact everyone, not just those who are on Medicaid.

Republicans could also restrict eligibility by instituting work requirements, which have historically resulted in thousands of people getting erroneously removed from Medicaid even though they were working.