President Donald Trump's fellow Republicans in the U.S. Congress are weighing steep cuts to the Medicaid health program as part of a wide-ranging budget package that also would cut taxes and raise spending on defense and border security.

Republicans worried about losing their slim House majority next year are struggling with how to achieve Medicaid savings as even more Americans rely on the program.

By Sarah Kliff Margot Sanger-Katz and Alicia Parlapiano Reporting from Washington For months, Republicans have been trying to figure out how to reduce Medicaid spending to help enact President Trump’s domestic agenda.