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So a menu of deeper cuts is currently being debated and familiar health-care fights have returned.
目前正在討論一系列進一步削減的措施，熟悉的醫保之爭又重新出現。
One likely change would require Medicaid recipients to work—or have a good excuse not to, with Mr Johnson rightly saying that "work is good for you, you find dignity in work".
一項可能的變化是要求醫療補助計劃的受益人工作——或者有充分的理由不工作，約翰遜正確地說“工作對你有好處，你會在工作中找到尊嚴”。
However, just 8% of working-age, able-bodied Medicaid recipients are unemployed without an excuse.
然而，只有8%的適齡、身體健全的醫補計劃受益人是無緣無故失業的。
Cutting that sliver off is unlikely to save much: $100 billion over ten years, according to House Republicans' own estimates. There would still be an impact on policy, though.
根據眾議院共和黨人的估計，削減這一部分不太可能節省太多：十年內節省1000億美元。不過，這仍然會對政策產生影響。
When Arkansas imposed work requirements for Medicaid under Mr Trump's first administration,
在特朗普第一屆政府領導下，阿肯色州對醫補計劃施加工作要求時，
more than 18,000 people lost coverage largely because they were unaware or confused about how to fill out the paperwork.
超過18000人失去了保險，主要是因為他們不知道或不清楚如何填寫文件。
To find bigger cuts, House Republicans would have to get more wonky.
為了找到更大的削減，眾議院共和黨人必須更加深入細節。
The federal government matches states' Medicaid spending at different rates according to the type of patient.
聯邦政府根據患者的類型以不同的費率匹配各州的醫療補助支出。
One sweetener to encourage states to expand the programme was to match every dollar spent on new recipients with $9 from Washington.
鼓勵各州擴大該計劃的一個好處是，每花費一美元給新受助人，華盛頓就會提供9美元作為配套資金。
One of the most aggressive cuts would lower this to meet the match-rate for the original population of Medicaid.
最激進的削減措施之一就是降低這一比例，以達到醫療補助計劃原始人口的匹配率。
House Republicans reckon this would save $561 billion over ten years, and it is the preferred option of Brian Blase, who advised Mr Trump on health care during the transition.
眾議院共和黨人認為，這將在十年內節省5610億美元，這是布賴恩·布萊斯(Brian Blase)的首選方案，他在過渡期間為特朗普提供醫療保健建議。
He says it would "protect Medicaid for those who it was meant to serve". The impact would be large.
他說，這將“保護醫療補助計劃，使其服務對象受益”。影響將是巨大的。
A dozen states, including New Hampshire, have trigger laws that swiftly roll back Medicaid expansion if the federal match-rate is reduced, leaving over 4 million adults without coverage, according to KFF.
據KFF稱，包括新罕布什爾州在內的十幾個州已經制定了觸發法，如果聯邦匹配率降低，將迅速撤銷醫補計劃的擴張，導致400多萬成年人得不到保障。
Of those 12 states, eight voted for Mr Trump in the 2024 election. Many would have little time to respond.
在這12個州中，有8個州在2024 年大選中投票支持特朗普。許多人幾乎沒有時間做出反應。
Arkansas' expansion would undo Medicaid expansion within four months of a federal funding drop.
阿肯色州的擴張將在聯邦資金減少后四個月內取消醫療補助計劃的擴張。
It's the "nuclear scenario", says Camille Richoux of Arkansas Advocates, which campaigns to protect Medicaid in the state.
阿肯色州倡導者組織的卡米爾·里喬克斯(Camille Richoux)表示，這是“核方案”，該組織致力于保護該州的醫療補助計劃。
Other states could also repeal expansion when forced to stump up more cash. If every state followed suit, 20 million people would lose health insurance.
其他州在被迫籌集更多資金時也可能取消擴張計劃。如果每個州都效仿，2000萬人將失去醫療保險。
Another option would establish a limit on annual Medicaid spending per person. But if that were implemented, governors would face some cross voters.
另一種選擇是設定人均醫療補助年度支出限額。但如果實施這一限制，州長將面臨一些反對投票。
In one way or another, each of these plans involves sending less money to states.
無論如何，這些計劃都涉及減少向各州發放的資金。
Mr Blase explains that "states can maintain the exact same programmes, they just would need to spend more of their own money".
布萊斯解釋說，“各州可以維持完全相同的計劃，只是需要花更多的錢”。
Trigger laws could be repealed, he says; states "can make those trade-offs".
他說，觸發法可能會被廢除；各州“可以做出這些權衡”。
Those states might well be the most effective campaigners against any Medicaid cuts, says Tom Scully, who ran Medicaid under George W. Bush and faced his own struggles to reform it.
曾在喬治·W·布什政府下領導醫療補助計劃并面臨改革困難的湯姆·斯卡利(Tom Scully)表示，這些州可能是反對削減醫療補助計劃的最有效的活動家。
Congressmen "talk about a lot—until the first Republican governor figures out and goes 'Holy cow! You can't do this'," he says.
他說，國會議員“談論了很多——直到第一位共和黨州長明白過來并說‘天哪！你不能這樣做’”。
They will be backed up by powerful health-care lobbies. Campaigners have a useful advantage.
他們將得到強大的醫療保健游說團體的支持。活動家擁有一個有用的優勢。
Gone are the days when enraged constituents filled town halls to complain about Obamacare.
憤怒的選民涌入市政廳抱怨奧巴馬醫改的日子已經一去不復返了。
Instead, three-quarters of Americans have a favourable view of Medicaid, including a majority of Republicans.
相反，四分之三的美國人對醫療補助持積極態度，包括大多數共和黨人。
