House Republicans signaled they’re going full steam ahead on significant changes to Medicaid, despite pressure from Democrats and even some moderates in their party.

The suggested overhauls to the program, which provides health care for lower-income Americans and those with disabilities, are part of an effort to slash federal spending and hit the House GOP’s goal of cutting $2 trillion over a decade from the federal budget.

“I support any plan that helps Medicaid be sustainable. And the current trajectory of Medicaid is not,” said Florida Republican Rep. Byron Donalds, who recently declared he’s running for governor of Florida — a state with millions of Medicaid recipients.

“Medicaid is supposed to be for people who are disabled, for children, for single parents with multiple kids. That’s what Medicaid is for. And if we continue down this line where it just becomes a bigger and bigger portfolio of beneficiaries, the federal government is not going to be able to afford the match,” Donalds added.

In a letter to Speaker Mike Johnson, moderate Republican members of the Congressional Hispanic Conference warned “slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities.”

Asked what he would say to Republican colleagues who are worried cuts to Medicaid will have a serious impact on lower income Americans, Donalds replied, “I think some of that is, quite frankly, fear-based. We know the Democrats are already running ads about Medicaid and about how what we’re trying to do is damaging to people and it’s just simply not true.”

Some GOP members have floated adding new work requirements to the program and capping the amount of money states receive to run their Medicaid programs — a pitch that could drastically reduce the number of people on Medicaid and limit the funding available for beneficiaries.

“I don’t consider that a cut,” Rep. Ralph Norman, R-S.C., said about work requirements. “I don’t consider block-granting to the states a cut. The Democrats are using that but it’s just not right.”

The exact plan is still unclear. Approving the House budget blueprint Tuesday night was just the first step in a months-long budgeting process that could stretch into the summer.

“We’re very early in this process,” New York Rep. Nicole Malliotakis, a moderate who represents a Staten Island district with a significant number of Medicaid recipients, said.

“Maybe you should wait until we actually do the work and highlight what we’re going to do,” she said.

Republicans also believe they can achieve a significant amount of their spending cuts by targeting fraud in Medicaid and Medicare. But eliminating all fraud and waste would likely only chip away at Republicans’ goal.

Asked about that approach, Malliotakis said, “There’s about $50 billion a year in fraud, just within the Medicaid program.”

But whether Republicans can get to the kinds of numbers they’re talking about by just eliminating fraud, Malliotakis said, “Well, yes. Within the health care. You’re going to look at that, you’re going to look at the loopholes the states have put in place.

Meanwhile, Democrats are pouncing.

An internal Democratic Congressional Campaign Committee memo first obtained by ABC News shows Democrats aim to make Medicaid cuts “politically perilous for House Republicans” in the November 2026 midterm elections.

“Rather than delivering on their campaign promises to lower the high cost of living, [Republicans] are poised to pass an extreme budget scheme that would decimate affordable health care and take food off the tables of millions of American families,” the memo reads.