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.

Work requirements remain on the table but Congress will not cut the matching rate for the Affordable Care Act expansion or impose per capita limits on states.

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.