Politics
More than 70 Million Americans Are on Medicaid. This Is Where They Live.
In the stretch of rural Kentucky that borders West Virginia, voters reliably send Republicans to Congress. Representative Hal Rogers, who represents the area, did not even face a Democratic challenger in 2024. More than 40 percent of the population there relies on Medicaid, the public health insurance plan for low-income Americans.
In eastern Louisiana, where Representative Julia Letlow, a Republican, was elected in 2024 by a wide margin, about one-third of the population is enrolled in the program.
Share of population enrolled in Medicaid
Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming have not adopted the Affordable Care Act’s Medicaid expansion.
The New York Times
And in California’s Central Valley, Republicans control a district where two-thirds of the population is on Medicaid, one of the highest rates in the nation, according to an analysis of federal enrollment data by the Center on Budget and Policy Priorities, a liberal think tank.
Some of those places could bear the brunt of steep Medicaid cuts that are expected to be central to Republicans’ budget plans. The budget passed on Tuesday night by House Republicans directs Energy and Commerce, the committee that oversees Medicaid, to cut spending by $880 billion over the next decade, which would amount to an 11 percent reduction in the program’s planned spending.
In its 60 years, Medicaid has swelled from a small program that provided medical care to poor Americans receiving cash assistance to the largest source of public insurance. It covers 72 million Americans, about one-fifth of the population. It pays for about half of all nursing care in the United States, and 40 percent of all births.
The program has grown especially quickly over the last 15 years, as millions joined through the expansion of the Affordable Care Act to cover healthy adults who earn less than 138 percent of the federal poverty line, about $21,597 for an individual and $36,777 for a family of three. The rolls swelled again during the coronavirus pandemic, when Medicaid extended emergency coverage to millions.
Republicans have not yet specified what policy changes they would make to Medicaid. Options discussed include requiring enrollees to be employed, or dialing down funding for the Affordable Care Act’s expansion, which made millions of adults eligible for coverage. A work requirement would be expected to cut Medicaid spending by about $100 billion over the next decade, as those unable to comply — or to file the correct paperwork showing their employment — would lose coverage.
In a statement, Representative Rogers of Kentucky described claims his party would gut the program as “lies promoted by House Democrats.”
“We are on a mission to cut waste, fraud and abuse of taxpayer dollars, so that we can protect the future of programs like Medicaid for years to come,” he said.
Medicaid enrollment rates, by congressional district
Large cuts to Medicaid would likely hit dense urban areas that tend to vote for Democrats. The congressional district that covers part of the Bronx in New York, for example, has one of the highest Medicaid enrollment rates in the country, with the program covering 67 percent of the people who live there. A district that covers part of Los Angeles has more than half its residents enrolled in the program.
Of the 10 congressional districts with the highest share of residents enrolled in Medicaid, nine are held by Democratic legislators.
Medicaid enrollment
David Valadao
Ritchie Torres
Jim Costa
Sydney Kamlager-Dove
Raul Ruiz
Adam Gray
Alexandria Ocasio-Cortez
Jimmy Gomez
Luz Rivas
Adriano Espaillat
Note: Margin of victory not shown for representatives who faced another member of the same party on the November ballot.
Districts with the highest Medicaid enrollment rates
District
Representative
Margin
Calif. 22nd
68%
R+7
N.Y. 15th
67%
D+55
Calif. 21st
61%
D+5
Calif. 37th
56%
D+57
Calif. 25th
55%
D+13
Calif. 13th
55%
D+0.09
N.Y. 14th
53%
D+38
Calif. 34th
53%
D
Calif. 29th
52%
D+40
N.Y. 13th
52%
D+67
There are also pockets of the country that rely significantly on the program where voters favor Republicans. Of the 218 seats Republicans control in Congress, 26 are in districts where Medicaid covers more than 30 percent of the population, according to a New York Times analysis of federal enrollment data.
All 26 of those representatives voted in favor of the House budget this week.
Medicaid enrollment
David Valadao
Jay Obernolte
Hal Rogers
R
Uncontested Doug LaMalfa
Cliff Bentz
Dan Newhouse
Nick Begich
Nicole Malliotakis
Julia Letlow
Clay Higgins
Vince Fong
Mike Johnson
Note: Margin of victory not shown for Republican representatives who faced another Republican on the November ballot.
Republican districts with highest Medicaid enrollment rates
District
Representative
Republican Margin
Calif. 22nd
68%
R+7
Calif. 23rd
47%
R+20
Ky. 5th
44%
Calif. 1st
42%
R+31
Ore. 2nd
40%
R+31
Wash. 4th
38%
R
Alaska At-Large
36%
R+2
N.Y. 11th
34%
R+28
La. 5th
34%
R
La. 3rd
34%
R
Calif. 20th
33%
R
La. 4th
33%
R
Their districts are scattered across the country, from Alaska to West Virginia. The list includes the Louisiana district held by Speaker Mike Johnson, where 33 percent of residents are enrolled. All are in states that participate in the Medicaid expansion. Republicans have considered scaling back funding for that program, which would save the federal government about $500 billion over the next decade — but also leave people in many states without coverage.
While President Trump has repeatedly said over the last week he would not cut Medicaid, Republican legislators don’t have many options for looking for those cuts elsewhere. Some have already expressed concern about cuts to the program. Last week, seven Republican members of the Congressional Hispanic Conference sent Speaker Johnson a letter warning that “slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities.”
As the second Trump administration has gotten underway, health care has not been a top issue for the president’s voters. It ranked as the fifth-most-important issue to them in a January poll from The New York Times and Ipsos, behind immigration, the economy, inflation and taxes.
In January, Michael Perry, a founder of the polling firm PerryUndem, conducted three focus groups with Medicaid enrollees who voted for President Trump, noting that most did not list health care among their top voting issues.
When he brought up the idea that Republicans were exploring cuts to Medicare, some said they did not think the president would ultimately cut their health coverage because he would want to avoid a backlash. But other voters, he said, expressed concern. “They liked Medicaid, said it made a difference in their lives,” Mr. Perry said. “It wasn’t hard for them to put their finger on what Medicaid had done.”
Politics
House Republicans push Johnson to go to war with Senate over SAVE Act
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Several House Republicans are pushing Speaker Mike Johnson, R-La., to go to war with the Senate GOP over an election security bill that has little chance of passing the upper chamber under current circumstances.
House GOP leaders convened a lawmaker-only call on Sunday in the wake of a massive military operation against Iran launched by the U.S. and Israel.
After leaders briefed House Republicans on how the chamber would respond to the ongoing conflict — including a vote on ending Democrats’ weeks-long government shutdown targeting the Department of Homeland Security (DHS) — Fox News Digital was told that several lawmakers raised concerns about the Senate not yet taking up the Safeguarding American Voter Eligiblity (SAVE America) Act. Among other provisions, the act would require voters in federal elections to produce valid ID and proof of citizenship.
Rep. Derrick Van Orden, R-Wis., was among those pushing the House to reject any bills from the Senate until the measure was taken up, telling Johnson according to multiple sources on the call, “If we don’t get this done, or at least show that we’ve got some backbone, we’re done. The midterms are over.”
Speaker of the House Mike Johnson, R-La., pauses for questions from reporters as he arrives for an early closed-door Republican Conference meeting at the Capitol in Washington, Tuesday, Feb. 3, 2026. (J. Scott Applewhite/AP Photo)
At least three other House Republicans shared similar concerns. Sources on the call said Rep. Brandon Gill, R-Texas, argued that GOP voters were “not enthused” heading into November and that “the single biggest thing” to turn that around would be forcing the Senate to pass the SAVE America Act.
The SAVE America Act passed the House last month with support from all Republicans and just one Democrat, Rep. Henry Cuellar, D-Texas.
JEFFRIES ACCUSES REPUBLICANS OF ‘VOTER SUPPRESSION’ OVER BILL REQUIRING VOTER ID, PROOF OF CITIZENSHIP
Republicans have pointed out on multiple occasions that voter ID measures have bipartisan support across multiple public polls and surveys. But Democrats have dismissed the legislation as an attempt at voter suppression ahead of the 2026 midterms.
Senate Majority Leader John Thune speaks at a press conference with other members of Senate Republican leadership following a policy luncheon in Washington, D.C. on Oct. 28, 2025. (Nathan Posner/Anadolu via Getty Images)
The legislation would require 60 votes in the Senate to break filibuster, which it’s likely not to get given Democrats’ near-uniform opposition. But House Republicans have pressured Senate Majority Leader John Thune to use a mechanism known as a standing filibuster to circumvent that — which Thune has signaled opposition to, given the vast amount of time it would take up in the Senate and potential unintended consequences in the amendment process.
It also comes as Congress grapples with the fallout from the strikes on Iran and the need to ensure safety for the U.S. domestically and for service members abroad, both of which will require close coordination between the two chambers.
Johnson told Republicans several times on the Sunday call that he was privately pressuring Thune on the bill but was wary of creating a public rift with his fellow GOP leader, sources said.
HARDLINE CONSERVATIVES DOUBLE DOWN TO SAVE THE SAVE ACT
“If we’re going to go to war against our own party in the Senate, there may be implications to that,” Johnson said at one point, according to people on the call. “So we want to be thoughtful and careful.”
Sen. Mike Lee, R-Utah, talks with a guest during a “Only Citizens Vote Bus Tour” rally in Upper Senate Park to urge Congress to pass the Safeguard American Voter Eligibility (SAVE) Act on Wednesday, Sept. 10, 2025. (Tom Williams/CQ-Roll Call, Inc via Getty Images)
At another point in the call, sources said Rep. Andrew Clyde, R-Ga., suggested pairing a coming vote on DHS funding with the SAVE America Act in order to force the Senate to take it up.
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But both Johnson and House Homeland Security Committee Chairman Andrew Garbarino, R-N.Y., were hesitant about such a move given the enhanced threat environment in the wake of the U.S. operation in Iran.
Both spoke out in favor of the SAVE America Act, people told Fox News Digital, but warned the current situation merited leaving the DHS funding bill on its own in a bid to end the partial shutdown, so the department could fully function as a national security shield.
Politics
Trump justifies Iran attack as Congress and others raise objections
According to President Trump, the United States attacked Iran because the Islamic Republic posed “imminent threats” to the U.S. and its allies, including through its use of terrorist proxies and continued pursuit of nuclear weapons.
“Its menacing activities directly endanger the United States, our troops, our bases overseas and our allies throughout the world,” he said in a recorded statement Saturday.
According to leading Democrats in Congress, Trump’s justification is questionable, especially given his claims of having “completely obliterated” Iran’s nuclear capabilities in separate U.S. bombings last June.
“Everything I have heard from the administration before and after these strikes on Iran confirms this is a war of choice with no strategic endgame,” said Rep. Jim Himes (D-Conn.), ranking Democrat on the House Intelligence Committee and part of a small group of congressional leaders — the Gang of Eight — who were briefed on the operation by Secretary of State Marco Rubio.
That divide is bound to remain an issue politically heading into this year’s midterm elections, and could be a liability for Republicans — especially considering that some in the “America First” wing of the MAGA base were raising their own objections, citing Trump’s 2024 campaign pledges to extricate the U.S. from foreign wars, not start new ones.
The debate echoed a similar if less immediate one around President George W. Bush’s decision to go to war in Iraq following the Sept. 11, 2001, attacks, also based on claims that “weapons of mass destruction” posed an immediate threat. Those claims were later disproved by multiple findings that Iraq had no such arsenal, fueling recriminations from both political parties for years.
The latest divide also intensified unease over Congress ceding its wartime powers to the White House, which for years has assumed sweeping authority to attack foreign adversaries without direct congressional input in the name of addressing terrorism or preventing immediate harm to the nation or its troops.
Even prior to the weekend bombings, Democrats including Sen. Adam Schiff of California were pushing Congress to pass a resolution barring the Trump administration from attacking Iran without explicit congressional authorization.
“President Trump must come to Congress before using military force unless absolutely necessary to defend the United States from an imminent attack,” Sen. Tim Kaine (D-Va.), a member of the armed services and foreign relations committees, said in a statement Thursday.
In justifying the daylight strikes that killed Supreme Leader Ayatollah Ali Khamenei just two days later, Trump accused the Iranian government of having “waged an unending campaign of bloodshed and mass murder” for nearly half a century — including through attacks on U.S. military assets and commercial shipping vessels abroad — and of having “armed, trained and funded terrorist militias” in multiple countries, including Hezbollah and Hamas.
Trump said that after the U.S. bombed Iran last summer, it had warned Tehran “never to resume” its pursuit of nuclear weapons. “Instead, they attempted to rebuild their nuclear program and to continue developing long-range missiles that can now threaten our very good friends and allies in Europe, our troops stationed overseas, and could soon reach the American homeland,” he said.
Other Republican leaders largely backed the president.
“The United States did not start this conflict, but we will finish it. If you kill or threaten Americans anywhere in the world — as Iran has — then we will hunt you down, and we will kill you,” said Defense Secretary Pete Hegseth.
“Every president has talked about the threat posed by the Iranian regime. President Trump is the one with the courage to take bold, decisive action,” said Atty. Gen. Pam Bondi.
While Iran’s coordination with and sponsorship of groups such as Hezbollah and Hamas are well known, Trump’s claims about Tehran’s ongoing development of nuclear weapons systems are less established — and the administration has provided little evidence to back them up.
Democrats seized on that lack of fresh intelligence in their responses to the attacks, contrasting Trump’s latest statements about imminent threats with his assertion after last year’s bombings that the U.S. had all but eliminated Iran’s nuclear aspirations.
“Let’s be clear: The Iranian regime is horrible. But I have seen no imminent threat to the United States that would justify putting American troops in harm’s way,” said Sen. Mark Warner (D-Va.), vice chairman of the Senate Intelligence Committee and a member of the Gang of Eight. “What is the motivation here? Is it Iran’s nuclear program? Their missiles? Regime change?”
Senate Minority Leader Chuck Schumer (D-N.Y.) said in a statement that the Trump administration “has not provided Congress and the American people with critical details about the scope and immediacy of the threat,” and must do so.
House Minority Leader Hakeem Jeffries (D-N.Y.) said the Trump administration needs congressional authority to wage such attacks barring “exigent circumstances,” and didn’t have it.
“The Trump administration must explain itself to the American people and Congress immediately, provide an ironclad justification for this act of war, clearly define the national security objective and articulate a plan to avoid another costly, prolonged military quagmire in the Middle East,” he said.
After the U.S. military announced Sunday that three U.S. service personnel were killed and five others seriously wounded in the attacks, the demands for a clearer justification and new constraints on Trump only increased.
Rep. Ro Khanna (D-Fremont) said Sunday he is optimistic that Democrats will be unified in trying to pass the war powers resolution, and also that some Republicans will join them, given that the strikes have been unpopular among a portion of the MAGA base.
Rep. Thomas Massie (R-Ky.), who partnered with Khanna to force the release of the Jeffrey Epstein files, has said he will work with him again to push a congressional vote on war with Iran, which he said was “not ‘America First.’”
Benjamin Radd, a political scientist and senior fellow at the UCLA Burkle Center for International Relations, said that whether or not Iran represented an “imminent” threat to the U.S. depends not just on its nuclear capabilities, but on its broader desire and ability to inflict pain on the U.S. and its allies — as was made clear to both the U.S. and Israel after the Hamas attacks on Israel on Oct. 7, 2023, which Iran praised.
“If you are Israel or the United States, that’s imminent,” he said.
What happens next, Radd said, will largely depend on whether remaining Iranian leaders stick to Khamenei’s hard-line policies, or decide to negotiate anew with the U.S. He expects they might do the latter, because “it’s a fundamentalist regime, it’s not a suicidal regime,” and it’s now clear that the U.S. and Israel have the capabilities to take out Iranian leaders, Iran has little ability to defend itself, and China and Russia are not rushing to its aid.
How the strikes are viewed moving forward may also depend on what those leaders decide to do next, said Kevan Harris, an associate professor of sociology who teaches courses on Iran and Middle East politics at the UCLA International Institute.
If the conflict remains relatively contained, it could become a political win for Trump, with questions about the justification falling away. But if it spirals out of control, such questions are likely to only grow, as occurred in Iraq when things started to deteriorate there, he said.
Israel and the U.S. are betting that the conflict will remain manageable, which could turn out to be true, Harris said, but “the problem with war is you never really know what might happen.”
On Sunday, Iran launched retaliatory attacks on Israel and the wider Gulf region. Trump said the campaign against Iran continued “unabated,” though he may be willing to negotiate with the nation’s new leaders. It was unclear when Congress might take up the war powers measure.
Politics
Video: Trump’s War of Choice With Iran
new video loaded: Trump’s War of Choice With Iran
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