The order is based on a "most favored nation" pricing model, which is similar to a policy Trump pushed in his first administration.

Today Medicaid provides health coverage for 71m Americans, 20m more than 15 years ago. The Affordable Care Act fuelled the growth, allowing states to cover more people. But it has also supercharged the price of the programme: in 2023 it cost $880bn,

House Republicans want to impose work requirements on some Medicaid recipients up to 64 years old and impose more costs on some beneficiaries to help pay for President Donald Trump’s planned sweeping tax package.