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.

G.O.P. lawmakers from swing districts face tough votes as soon as next week, when key House panels are scheduled to consider legislation that would cut popular programs to pay for President Trump’s agenda.