“Republican primary voters in the House Freedom Caucus (HFC) congressional districts have a message for their Republican congressmen: cut health care to pay for tax cuts and pay a political penalty or cut prescription drug prices and win their enthusiastic support,” said the new polling memo shared with Secrets Friday.

“Republicans can also right-size Medicaid while still giving working-age adults a way to afford health insurance that helps rather than hurts them politically in a contested primary,” added Tony Fabrizio and Bob Ward.

The duo polled in 32 House districts where Republicans face close midterm election votes. What they found was that voters are ready to dump any candidate or incumbent who moves to threaten healthcare directly.

The warning was blunt and easy to understand: “In these districts, which were tied in the 2024 elections and now have the Republican behind by four points, voters from across the political spectrum oppose making straight cuts to healthcare programs to pay for tax cuts. Medicaid cuts to pay for tax cuts are opposed by three-quarters of voters, including a majority of Trump voters. A majority of voters also oppose eliminating the healthcare tax credits that allow working families to afford premiums for people who purchase coverage directly through healthcare.gov or state exchanges.”

The House-approved “big, beautiful bill” doesn’t call for “straight” cuts but could lead to requiring able-bodied recipients to earn coverage. And the Congressional Budget Office has warned that if the bill boosts the deficit, cuts to social programs will follow.

The pollsters said that Republicans in the districts are already about four points behind, which could surge to 21 if healthcare is cut.

“If a Republican candidate voted to cut Medicaid to pay for tax cuts, they would lose by 21-points, a net 17-point slide in support from the initial generic congressional ballot. A Republican who supported the elimination of the tax credit would erode ballot support by net 10-points, losing by 14-points. If the Democrats successfully frame this as taking away people’s healthcare, it is a political loser,” said the memo.

Democrats are already claiming that the “big, beautiful bill” is a threat to healthcare, one of the reasons Trump reportedly told lawmakers earlier this week, “Don’t f*** around with Medicaid.”

Conservatives included measures for work requirements in Medicaid and targeted waste, fraud, and abuse in the program, moves liberals claim will push low-income people out of the healthcare system.

The Senate is working on its own bill and has promised radical changes to the House-approved bill.

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In their memo, the pollsters provided a possible solution: getting the healthcare system to demand drug price cuts. “Support for this policy is both broad and intense. Woe to the Republican who gets into a primary fight over this issue and chooses the side of the pharmaceutical industry over their party base voters. They will get crushed,” the memo said.

“The proposal to lower Rx drug prices for Medicare to no more than what other wealthy nations pay, similar to the Most Favored Nation policy (MFN) just announced by President Trump, is supported by seven-in-10 voters. The political benefit to a Republican candidate adopting this position is significant, shifting the congressional ballot a net 11-points in the Republican’s favor from a 4-point initial deficit to a 7-point advantage over the Democrat. Republicans need to get on board with President Trump’s efforts to end global freeloading and lower Rx drug prices for the United States,” the pollsters said.