Voice of America will receive feeds from a pro-Trump network, administration says.

Ms. Lake, who in recent years mounted unsuccessful campaigns for governor and senator in Arizona, said OAN had offered to provide free news reports to Voice of America and another American-supported division, the Office of Cuba Broadcasting. In a statement on social media, she called the arrangement “an enormous benefit to the American taxpayer.”

“I don’t have editorial control over the content of VOA and OCB programming, but I can ensure our outlets have reliable and credible options as they work to craft their reporting and news programs,” said Ms. Lake, using acronyms for Voice of America and the Office of Cuba Broadcasting.

Patsy Widakuswara, a former Voice of America White House bureau chief who was placed on leave, said she was concerned by the development.

“We’ve worked so hard to build trust for our brand,” she said. “This is 83 years of good journalism that’s going to be destroyed.”

Voice of America was created in 1942 to combat Nazi propaganda, and has long brought news to corners of the globe where reliable journalism is scarce.

In March, Mr. Trump issued an executive order to dismantle the U.S. Agency for Global Media, the congressionally chartered agency that oversees Voice of America, effectively shuttering the news outlet. The president accused the broadcaster of harboring bias against him and branded it the “voice of radical America.” Voice of America’s roughly 1,300 workers were sent home.

The broadcaster’s journalists then sued, saying that Mr. Trump was not authorized to withdraw funding that had been approved by Congress.

A federal judge in Washington sided with the reporters, ordering the Trump administration to bring back programming.

An appeals panel seemed to complicate the matter over the weekend, reversing parts of the lower court’s order that required the Trump administration to restore funding. But the panel left the requirement that Voice of America revive programming.

It is not clear how many Voice of America reporters will return after the court decisions.

“Some have already returned,” Ms. Lake said in an email Tuesday evening. “Some will be returning in the future.”

She declined to comment further.

About 15 employees have been reinstated in recent days, said Ms. Widakuswara, who was not one of them.

Grant Turner, who served as chief executive of Voice of America’s parent agency during the first Trump administration, said that moves to add OAN content would violate a statutory requirement that the broadcaster be “accurate, objective, and comprehensive.”

He predicted that the OAN content would not land well with foreign audiences, either.

“They know what real fake news sounds like,” Mr. Turner said of Voice of America’s listeners, adding, “They want something that’s genuine.”

Several members of the “Les Misérables” cast are planning to boycott the performance, according to a person familiar with the situation who was granted anonymity because the discussions were considered confidential. The cast was given the option not to perform as word spread that Mr. Trump planned to attend, the person said. The boycott was reported earlier by CNN.

Richard Grenell, whom Mr. Trump appointed as president of the Kennedy Center, said the center had not heard of any boycott.

“Any performer who isn’t professional enough to perform for patrons of all backgrounds, regardless of political affiliation, won’t be welcomed,” he said in a statement. “In fact, we think it would be important to out those vapid and intolerant artists to ensure producers know who they shouldn’t hire — and that the public knows which shows have political litmus tests to sit in the audience.”

He added: “The Kennedy Center wants to be a place where people of all political stripes sit next to each other and never ask who someone voted for but instead enjoys a performance together.”

The White House did not immediately respond to requests for comment. Bond Theatrical, the agency overseeing the “Les Misérables” tour, issued a brief statement which did not address the question of performers opting out of the gala but said that the show would be performed “throughout our engagement at the Kennedy Center.”

Mr. Trump’s takeover of the Kennedy Center, and his decision to purge its previously bipartisan board of Biden appointees, have prompted an outcry among many artists. Several prominent figures, including the actress Issa Rae and the musician Rhiannon Giddens, have canceled engagements at the center in protest. The musical “Hamilton” scrapped a planned tour there next year.

Mr. Trump is expected to take part in a fund-raiser before the performance of “Les Misérables” on June 11. An invitation offered a gold sponsorship level for $2 million, and a silver sponsorship for $100,000; both come with photo opportunities with Mr. Trump. “Les Misérables” is set to run at the Kennedy Center through mid-July.

Mr. Trump is a fan of Broadway musicals of the 1980s, including “Les Misérables,” “Cats” and “Phantom of the Opera.”

When the president visited the center in March, he opened a board meeting with a question: Which musical is best, “Phantom of the Opera” or “Les Misérables”?

Mr. Trump, who as a young man dreamed of becoming a theater producer, told the board that he had been informed that Broadway shows sell the best at the Kennedy Center, and pledged to present many of them, according to a recording of the board meeting that was obtained by The New York Times. And he praised musical theater performers.

“When you go to watch ‘Les Miz,’ when you go to watch ‘Phantom of the Opera,’ you know how great some of the talent is,” he said. “I’ve always said, no pop star has a voice like what you’re just hearing. I’ve always said they are, to me, the greatest talents. And that’s all they want to do. They don’t want to make movies. They don’t want to do anything. They just want to do eight shows a week, with a Wednesday matinee, right? And they’re tremendously talented people.”

While Mr. Trump’s vision for the Kennedy Center is still taking shape, he appears eager to fix up the building, which opened in 1971. A House committee approved a budget proposal last week that called for allocating $257 million to the Kennedy Center for capital repairs and other expenses, roughly six times the amount it usually receives from the government. The funding was requested by Mr. Trump, according to a statement by the committee.

But it was unclear whether the announcement would assuage researchers, advocates and parents, who reacted with alarm last month when Mr. Kennedy and Dr. Jay Bhattacharya, the director of the National Institutes of Health, floated — and then walked back — the idea of an autism registry for research. Many feared privacy violations.

In Illinois on Wednesday, Governor JB Pritzker, a Democrat, issued an executive order aimed at protecting the privacy rights of state residents with autism. His office said he made the move in response to “rising national concerns about efforts to create federal autism registries or databases without clear legal safeguards or accountability.”

Mr. Kennedy’s intense focus on autism stems from his insistence, despite evidence otherwise, that vaccines are to blame for the rapid rise in autism diagnoses in the United States. The Centers for Disease Control and Prevention recently reported that about 1 in 31, or 3.2 percent, of American eight-year-olds have received a diagnosis.

For the new database, the health department said it would take steps to ensure the privacy of medical data. But it is not clear precisely what kind of research will be conducted. Mr. Kennedy said in the announcement that his department would use the platform “to uncover the root causes of autism and other chronic diseases.”

Some experts were skeptical.

“It’s the registry without the word ‘registry’ in it,” said David Mandell, a professor of psychiatry and longtime autism researcher at the University of Pennsylvania. He said that some of his research had relied on Medicaid data, which had been difficult to access, and that on one level he welcomed the announcement.

But he also expressed concern that the data would be “misused or misappropriated,” or steered toward vaccine studies.

“We are creating a tool, and tools can be used for good and for evil,” Dr. Mandell said. “I know a lot of researchers — and I like to think of myself as one — who have used this kind of tool for good. And I’m really concerned that that’s not what happens.”

In outlining the government’s research priorities, the announcement appeared contradictory. While Mr. Kennedy focused on root causes, the health department said that studies would focus on autism diagnosis trends; the effectiveness of medical and behavioral treatments; the economic burden on families and health care systems; and access to care and “disparities by demographics and geography.”

Given the Trump administration’s assault on “diversity, equity and inclusion” initiatives, the last priority might appear surprising. But some of Dr. Bhattacharya’s previous research, from his tenure as a medical economist at Stanford University, focused on health care disparities, and he recently told reporters that he believed it was appropriate to examine how diseases affect different populations.

“Concern for the health of minority populations is not the same thing as D.E.I.,” Dr. Bhattacharya said in an interview after Mr. Kennedy announced he was taking action against petroleum-based food dyes.

Jill Escher, the president of the National Council on Severe Autism and a parent of two adult children with autism, said that she is of two minds about Mr. Kennedy’s announcement. On the one hand, she said, she agreed “one hundred percent with the administration that it is incredibly urgent to find more answers about autism.”

But she said that she was concerned Mr. Kennedy’s approach was “a lot of dart throwing without hypothesis building.” Given that scientists have been studying autism for at least three decades, she said, she preferred a more systematic approach in which the Department of Health and Human Services identified the most pressing questions and developed a research agenda to answer them.

The disorder takes many forms, but is usually marked by a blend of social and communication problems and repetitive behaviors. Some people with severe autism are nonverbal and have intellectual disabilities; others on the autism spectrum simply struggle with social cues. Many researchers believe that a complicated array of factors, including genetics and possibly fetal exposures in utero, are responsible for autism.

In bringing the issue to the fore, Mr. Kennedy has delighted some in the autism community. But many were infuriated by his remarks at a news conference last month, when he asserted that the disorder is preventable (experts say there is no evidence of this), and insisted that autism “destroys” families.

Critics said he only added to the stigma around the disorder.

In his announcement on Wednesday, Mr. Kennedy said that the platform would begin as a “pilot research program” aimed at autism, but would eventually be available to researchers studying other chronic conditions.

Dr. Means, a wellness influencer who earned a medical degree from Stanford and frequently casts doubt on the American medical system, is the co-author of “Good Energy,” a book about chronic illness. The book, which she wrote with her brother, argues that metabolic dysfunction is at the root of a chronic disease epidemic. Dr. Means has pointed to rising rates of infertility, obesity, diabetes, depression and other conditions as signs that the United States is undergoing a health crisis, and pointed at environmental factors and the food system as possible culprits.

Her brother, Calley Means, is a top adviser to Mr. Kennedy, and the siblings have been prominent supporters of Mr. Kennedy’s policy efforts. They became especially popular among conservatives after they appeared on Tucker Carlson’s podcast last August, and Mr. Trump and Joe Rogan discussed them in October on Mr. Rogan’s podcast.

When Mr. Kennedy was sworn in as the new health secretary, Dr. Means wrote on X that he “has a vision for the future that aligns with what I want for my family, future children, and the world.”

Dr. Means’s website says she earned her bachelor’s and medical degrees from Stanford University before dropping out of her residency program in surgery. She is the co-founder of Levels, a digital health company that uses continuous glucose monitoring to help track metabolic health.

Mr. Trump said Dr. Nesheiwat, a former Fox News contributor, would work with Mr. Kennedy “in another capacity” at the health and human services department.

Dr. Nesheiwat was scheduled to appear before the Senate health committee on Thursday, but her nomination ran into trouble on two fronts. Laura Loomer, a conservative activist whom Mr. Trump has listened to on other personnel matters, called for a new surgeon general nominee, arguing Dr. Nesheiwat “is not ideologically aligned” with the president. Reports have also raised questions about the veracity of Dr. Nesheiwat’s résumé.

She is the sister-in-law of Michael Waltz, who served as Mr. Trump’s national security adviser until last week. The president said he would nominate Mr. Waltz to be the ambassador to the United Nations.

Dani Blum contributed reporting from New York.

He also implied that the Chinese had been the ones to request trade talks, contradicting statements by China that the two sides were meeting at the request of the Americans. “I think they ought to go back and study their files,” the president said.

Scott Bessent, the Treasury secretary, and Jamieson Greer, the United States trade representative, plan to meet with Chinese officials on Saturday and Sunday in Geneva to discuss trade and economic matters. The countries have been locked in a standoff. High tariffs have been hurting businesses in both countries, but neither government has wanted to look like it is conceding to the other by requesting a meeting.

Chinese officials say they have little clarity from the U.S. side about which policy changes could mollify Mr. Trump, and it is unclear whether the two countries will strike any kind of trade deal.

On Wednesday, Mr. Trump said China would need to “stop fentanyl from coming in,” and he blamed former President Joseph R. Biden Jr. for not upholding an agreement that Mr. Trump signed with China during his first term.

Mr. Trump spoke from the Oval Office as he swore in David Perdue, the new ambassador to China. A former senator from Georgia, Mr. Perdue is also a former chief executive of Reebok and Dollar General, and the business community has viewed him as someone who could be a moderating force on the U.S.-China relationship.

“I picked him a long time ago but it just happened to come due on a pretty important date,” the president said.

Melania Trump vanishes from view for weeks at a time, holing up in Trump Tower in Manhattan or in Florida, where she can lie low at Mar-a-Lago. Administration officials say she is at the White House more often than the public knows, but when exactly, and for how long, these officials will not (or perhaps cannot) say for certain.

It’s like having Greta Garbo as first lady.

Mrs. Trump is expected to reappear in the capital on Thursday to unveil a postage stamp honoring Barbara Bush, the former first lady, and to attend a ceremony for military mothers. But two people with knowledge of Mrs. Trump’s schedule said she had spent fewer than 14 days at the White House since her husband was inaugurated 108 days ago. Others say even that is a generous estimate. Officials in the East Wing and West Wing declined multiple requests for comment for this article.

That the first lady’s whereabouts is among the most sensitive of subjects in this White House only adds to the intrigue.

“We haven’t seen such a low-profile first lady since Bess Truman, and that’s going way back in living human memory, nearly 80 years ago,” said Katherine Jellison, a historian at Ohio University whose research has focused on first ladies. She said that, like Mrs. Trump, Mrs. Truman spent much of her time running back to “her home base whenever she had the chance.” (In Mrs. Truman’s case, that was Independence, Mo.)

“She just kind of liked her own private world,” Ms. Jellison said.

The same is true of this first lady. She has hired staff to work for her in the East Wing, but she rarely goes into the office. Even regulars at Mar-a-Lago say they don’t often see Mrs. Trump around the premises.

Every marriage has its highs and lows, but as with so many other things, the Trumps are in a league of their own. In the span of just a few months last year, the couple endured a public trial about his philandering, two assassination attempts and a presidential campaign.

The trial, which concerned hush money Donald J. Trump paid to a porn star, made for an especially challenging moment for the couple, two people with knowledge of their dynamic said. Mrs. Trump kept well away from the courthouse in Lower Manhattan and from the campaign that kicked into high gear in the weeks that followed.

The attempted assassination of her husband over the summer — and a subsequent incident in which a gunman got close to Mr. Trump on one of his golf courses — deeply spooked a woman who was already worried about her family’s safety and had been for years, according to two people familiar with her thinking. The first time President Trump was inaugurated, in 2017, she was concerned about even getting out of the car to walk in the parade.

At the White House this time around, Mr. Trump has taken to performing some duties that typically would fall to a first lady. She’s not the one carefully selecting light fixtures for the White House residence, redesigning the Rose Garden, greeting tour groups in the East Wing or hosting receptions for Women’s History Month. He is.

It has been a decade since husband and wife rode that golden escalator down into national political life together. Now, he has come to a moment in which he finds himself flush with power and self-confidence like never before. And yet, as he expands, she shrinks.

Mr. and Mrs. Trump do share one common approach to public office, though. They both know how to make money from the exposure. In January, Mrs. Trump launched her own cryptocurrency token. “You can buy $MELANIA now,” she wrote on social media the day before her husband’s second inauguration.

And then there is the deal she struck with Amazon, reported to have been about $40 million, for a documentary offering a “behind the scenes” look at her life as first lady.

What might that show? It’s hard to say, exactly.

‘You serve the country’

Mrs. Trump waited for months to move into the White House last time. But that was because her son was just 10, and his mother took the time she needed to arrange his schooling and the transition to a new city. Back then, Mrs. Trump’s parents were omnipresent at the White House as she learned to navigate the role. Mrs. Trump’s mother, Amalija Knavs, died in January 2024. These days, Mrs. Trump spends a lot of time with her father, Viktor.

Barron Trump is 19 now. He is finishing his freshman year at New York University and is increasingly independent. Still, there is a part of Mrs. Trump that remains attached to the protective maternal role she has in his life, people around her say.

“You know, I feel that as children, we have them until they are like 18, 19 years old,” Mrs. Trump told Fox News in a rare interview she gave in January before the inauguration. “We teach them. We guide them. And then we give them the wings to fly.”

She was asked where she planned to spend most of her time this term.

“I will be in the White House,” she answered. “And, you know, when I need to be in New York, I will be in New York. When I need to be in Palm Beach, I will be in Palm Beach. But my first priority is, you know, to be a mom, to be a first lady, to be a wife. And once we are in on Jan. 20, you serve the country.”

Because Mrs. Trump is seldom seen or heard from, the times when she does appear provide a glimpse of how she sees her role. Some of her choices have been in line with traditional first lady duties — up to a point.

She stood alongside her husband to preside over the White House Easter Egg Roll last month, but even that raised ethical and legal concerns after it was revealed that corporate sponsors were allowed to contribute. (All money raised was to go to the White House Historical Association, a private nonprofit educational organization founded by Jacqueline Kennedy in 1961.)

On April 1, she spoke at the State Department for the International Women of Courage awards, the first time she had been seen in public in Washington in weeks.

At the White House, the first lady has hired her own staff in the East Wing. But what to do when the boss doesn’t come into the office? “We were honored to welcome these curious, young gardeners to the White House this past week!” reads the caption of one recent video posted to the “FLOTUS” Instagram page.

But FLOTUS herself does not appear in the video. It’s not clear if she was even there.

Film crews have been spotted around Mrs. Trump lately. But for the most part, the Amazon documentary about her life is, like its subject, shrouded in mystery. Documentary filmmakers and Hollywood executives say that the $40 million that Amazon is reported to have paid for the documentary, which Mrs. Trump is executive producing, is tens of millions of dollars more than what such projects would ordinarily fetch. Amazon declined multiple requests for comment for this article, as did the film’s director, Brett Ratner.

Just as Mrs. Trump’s presence can make for an interesting sight, so too can her absence.

When the first tour group was led through the East Wing, it was Mr. Trump who popped up to surprise them. “The first lady worked very hard in making it perfect,” he told the group. But she was not there.

During the first Trump term, Mrs. Trump replanted and restored the Rose Garden. This term, the president plans to pave over it to turn it into a patio so he can entertain al fresco. Mrs. Trump was initially bothered by her husband’s plan, according to two people briefed on the matter. She has since been assured the rose bushes themselves will be left alone.

She also came around to the idea of the ballroom that he is adamant about building at the White House — once she was told the construction wouldn’t take place too close to the residence.

One person who has known Mrs. Trump for a long time is Paolo Zampolli, a former modeling agent from Italy who first spotted her in Milan in the 1990s. The Trumps say it was Mr. Zampolli who introduced them for the first time, in 1998, at the Kit Kat Club in Manhattan. He refers to Mrs. Trump reverently as “the lady.” Any persnickety questions about the lady’s absence in Washington, he said, were unfounded. “She loves the White House,” he insisted, “and she loves the role of serving as our first lady.”

When the president makes his big swing through the Middle East next week, to Saudi Arabia, Qatar and the United Arab Emirates, the first lady is not expected to go with him.

But she did accompany him to Vatican City for Pope Francis’ funeral.

When they landed back in Newark on a Saturday afternoon, it was Mrs. Trump’s 55th birthday. The president gave her a kiss on the cheek. She got into a car, he climbed into Marine One, and they went their separate ways.

“Everyone is welcome to come and see this incredible event,” Vice President JD Vance said. “But when the time is up, they’ll have to go home. Otherwise, they’ll have to talk to Secretary Noem,” he added, referring to Kristi Noem, the homeland security secretary, another member of the panel.

Ms. Noem, speaking next, did not pick up Mr. Vance’s refrain. But Sean Duffy, the Transportation Secretary, soon echoed his sentiments.

“Go on a road trip. See America,” he said to potential visitors. But in the next breath, he added: “Don’t overstay your visa. Don’t stay too long.”

The blunt warnings to tourists not to overstay their visas is in keeping with the Trump administration’s approach to foreigners over the last few months, which has included not only deporting immigrants illegally present in the United States, but also efforts to expel or turn away some authorized to be in the country.

The aggressive posture has prompted many countries to issue travel advisories, warning their citizens to be wary when traveling to the United States.

It is not clear whether the Trump administration’s approach to foreign visitors will affect the tourism boom a World Cup typically brings.

The World Cup, a quadrennial event in which national soccer teams from across the globe compete for large cash prizes, a gold trophy and international bragging rights, draws in millions of spectators. In 2022, when Qatar hosted the competition, 3.4 million people attended the games, according to FIFA, with more than a million of those traveling from abroad.

Nearly a dozen U.S. cities and metropolitan areas stand to benefit from the influx of visitors by hosting games next year: Atlanta, Boston, Dallas, Houston, Kansas City, Los Angeles, Miami, New York/New Jersey, Philadelphia, Seattle and the San Francisco Bay Area. The World Cup final will take place in MetLife Stadium, home to New York’s two N.F.L. teams, the Giants and the Jets.

Canada will host games in Toronto and Vancouver, while Mexico will host games in Guadalajara, Mexico City and Monterrey.

Mr. Trump indicated during the task force’s meeting on Tuesday that he was keenly aware of the World Cup’s economic potential, noting that “these events, if done properly, make a tremendous amount of money and prestige.” He signaled that he would support congressional efforts to budget $625 million for enhanced security around the games, of which there will be more than in past competitions: The 2026 World Cup will include 48 teams, up from 32. Seventy-eight of the 104 games will be in the United States.

Mr. Trump himself did not offer any admonitions to would-be visitors, but had a stern warning when asked whether pro-Palestinian protesters might have difficulty attending.

“I think people are allowed to protest,” he said. “You have to do it in a reasonable manner — not necessarily friendly but reasonable — otherwise Pam will come after you and you’re going to have a big problem,” he added, referring to Pam Bondi, the attorney general. Ms. Bondi was present at the meeting, but did not address reporters.

The Trump administration has been trying to deport a number of foreign nationals, including at least one green card holder, who participated in pro-Palestinian activism on campus, as part of a crackdown that has inspired widespread debate about First Amendment rights. But displays of Palestinian solidarity are common at World Cup games.

In the 2022 World Cup, members of Morocco’s team held up Palestinian flags as they celebrated their victory over Spain. Fans unfurled giant banners featuring the Palestinian flag and the words “Free Palestine” during games between Tunisia and Australia and the Netherlands and Qatar. And pro-Palestinian chants were commonplace at many matches.

Ms. Noem said that her department had already started processing travel documents and visa applications for a new FIFA-sponsored competition of club teams, which will be played in the United States this summer. She said that event would be a precursor for the 2026 World Cup, and that the administration would put “all hands on deck to make sure this goes smoothly.”

Mr. Trump has entrusted stewardship of the 2026 World Cup to Andrew Giuliani, the son of Rudolph W. Giuliani, the former mayor of New York City who previously served as a lawyer for Mr. Trump. The president named the younger Giuliani the task force’s executive director on Tuesday.

Andrew Giuliani was a special assistant and an assistant director of the White House’s Office of Public Liaison during Mr. Trump’s first term. His history as a professional golfer has earned him accolades from Mr. Trump.

Mr. Johnson also suggested he was leaning against another way of reducing spending on Medicaid, by changing the way the federal government pays states — currently by providing a percentage of beneficiaries’ medical bills — to a flat fee per person.

“I think we’re ruling that out as well, but stay tuned,” the speaker said.

The retreat was an acknowledgment that many House Republicans viewed the ideas — both of which would create large state budget shortfalls — as politically toxic. It also underscored how difficult it will be for Mr. Johnson’s conference to find Medicaid cuts that hit the spending targets Republicans set for themselves and also win enough votes to pass.

Ultraconservative Republicans quickly vented their opposition, in a public reminder that Mr. Johnson’s efforts to stave off a revolt of mainstream lawmakers could cost him crucial support from his right flank. That could doom Mr. Trump’s vast tax and spending cut plan in the House, where the speaker can afford to lose fewer than a handful of votes.

“Well - I haven’t ruled it out,” Representative Chip Roy, Republican of Texas, declared on social media after Mr. Johnson’s comments on Tuesday night about abandoning the idea of cutting back on federal payments for some Medicaid beneficiaries. “It’s necessary to stop robbing from the vulnerable to fund the able-bodied.”

And as if to drive home the point of Mr. Johnson’s challenging balancing act, a group of 32 conservatives sent him a letter on Wednesday insisting that they would support the reconciliation bill only if it does not add to the deficit. That means that if Republicans fail to come up with enough spending cuts, they would also have to accept a smaller tax cut to compensate.

“The deficit reduction target must be met with real, enforceable spending cuts — not budget gimmicks,” they wrote in the letter, led by Representative Lloyd K. Smucker of Pennsylvania, a member of the Ways and Means Committee.

House Republicans are laboring to identify roughly $2 trillion in spending cuts to help offset both the 2017 tax cuts they want to extend and the new tax cuts they want to pass in their reconciliation bill. The biggest challenge so far has centered on the Medicaid program, which provides health insurance to 72 million poor and disabled Americans.

The House budget plan calls for $880 billion in cuts from the committee that oversees the program, a target that would be difficult to achieve without substantial changes. If House Republicans cannot agree on policies that comply with the instructions, the entire package could be doomed.

Abruptly reducing federal funding for the program by paying less in the 40 states and the District of Columbia that have expanded Medicaid under Obamacare would have saved an estimated $710 billion over a decade, according to new estimates released by the Congressional Budget Office on Wednesday.

That would have cut funding to state governments, which would have been left with difficult choices. Nine states have passed laws that would cause them to automatically drop coverage for the expansion population if federal funding declines, and three others have provisions that would force an immediate legislative review.

Other states would need to make up the money in some other way — by cutting benefits or payments to medical providers, raising taxes or cutting other state functions. As a result of those changes, the budget office estimated that the policy would cause 5.5 million Americans to lose their Medicaid coverage and 2.4 million Americans to become uninsured.

The Obamacare expansion extended health benefits to poor, childless adults without disabilities, a population that many Republican lawmakers consider less worthy of resources than other populations Medicaid serves, such as poor children, pregnant women and Americans who live in nursing homes. But other Republicans see this population as a core constituency, as working-class voters have become a growing component of the party’s electoral coalition.

Some conservatives like Mr. Roy have argued that uniting around cutting the Affordable Care Act, a program their party detests, should be the bare minimum for Republicans looking to raise revenue for Mr. Trump’s agenda.

“I’ve got a bunch of my colleagues running around saying, ‘Well, we can’t touch Medicaid,’” Mr. Roy said in a speech on the House floor. “Why can’t we? Medicaid was expanded under Obamacare, which we all opposed, and the Medicaid expansion was a big reason why we opposed it.”

But many of Mr. Roy’s colleagues, especially those in politically competitive seats, do not agree. The cuts would be particularly damaging in wealthier Democratic-led states, such as California and New York, where Republicans have been elected in districts where many constituents use Medicaid.

“I will never support cuts to Medicaid, Medicare or Social Security that are not specifically aimed at reducing waste, fraud or abuse,” said Representative Jeff Van Drew, Republican of New Jersey.

But without any such cuts, Republicans are left with a dwindling set of options that would allow them to meet their $880 billion target. Medicaid reforms with broad support across the caucus, such as requiring beneficiaries to prove they are employed in order to keep their benefits, would not reduce spending by nearly as much.

Another option under consideration, limiting taxes on hospitals and other complex financing maneuvers that states use to increase federal spending on the program, would tend to disadvantage states led by Republicans. The budget office estimated it would reduce the deficit by around $668 billion and cause 3.9 million more people to become uninsured.

Mr. Trump has also recently expressed a reluctance to make any major cuts to Medicaid, and has repeated several times that the program should not be “touched.” A White House official said Mr. Trump was pushing for stronger discounts on prescription drugs used in Medicaid, an alternative that would avoid some of the political pitfalls but may not save enough to comply with the budget language.

One option, to limit the way states use a tax loophole to increase federal spending on Medicaid, would save $668 billion but cause 3.9 million Americans to go without health insurance.

Another option, which would lower federal spending on Medicaid beneficiaries who are part of the Obamacare expansion of the program, would save the government $710 billion over a decade, but cause 2.4 million people to become uninsured.

But after a meeting with centrist Republican lawmakers on Tuesday, Speaker Mike Johnson said he had ruled out cutting the funding formula for working-age adults who are covered under the Affordable Care Act expansion.

The budget office released the estimates Wednesday in a letter to Democratic lawmakers in the Senate Finance and House Energy and Commerce committees, who had requested them from the office.

The budget blueprint passed by Republican majorities in both chambers asks the House committee that oversees Medicaid — which provides health coverage to around 72 million Americans who are poor or disabled — to find $880 billion in cuts, a difficult target to meet without including major program changes.

The analysis considered a few other policy options: One would change the structure of Medicaid from one in which the program pays for beneficiary medical bills to one in which states received a fixed payment for each person. This option would reduce the deficit by $662 billion, and lead to 2.9 million people without insurance.

Another proposal, which would allow states to require more paperwork from beneficiaries to sign up and stay enrolled, would save $162 billion and cause 600,000 people to be uninsured.

In every scenario, the reductions in Medicaid enrollment are larger than the projected increases in the number of people without insurance, because the budget office assumes some people currently covered by Medicaid would get insurance another way.

The analysis did not include one option Republicans seem to agree on: a policy that would require certain Medicaid beneficiaries to prove they are working a minimum number of hours in order to receive benefits. A previous budget office estimate suggested such a policy could reduce federal spending by around $100 billion, but that policy would probably overlap with the others, meaning the totals cannot be added together.

All of the budget office calculations assume states would respond to changes in federal policy by making changes to their own programs. The budget office said some states would stop covering those now covered under the Affordable Care Act expansion. Others would reduce benefits or payments to medical providers. Some would make changes to other parts of their state budgets to make up the difference.

Democratic leaders used the estimates to assail the Republican plan.

“This analysis from the nonpartisan, independent C.B.O. is straightforward: The Republican plan for health care means benefit cuts and terminated health insurance for millions of Americans who count on Medicaid,” said Senator Ron Wyden of Oregon, the ranking member of the Finance Committee.

It was developed by Conor Fennessy, a staff member in Elon Musk’s Department of Government Efficiency, according to two people with direct knowledge of the plan. Similar lists of grant eliminations are being developed in other parts of the Department of the Interior, according to the two people, who requested anonymity for fear of retribution.

At the National Park Service, the DOGE plan proposes eliminating Scientists in Parks, a popular program that places students and early-career scientists at natural and historic landmarks to help protect ecosystems.

Also on the chopping block: a $67,000 climate resiliency study on lands surrounding the Golden Gate National Recreation Area; a $223,000 study of the impact of climate change on Alaska’s glaciers; watershed protection efforts across the country; and a $220,000 project to protect the Louisiana State University “campus mounds,” two dome-shaped structures created by Native Americans thousands of years ago.

The reason given for shuttering those programs, according to the document, is “Climate change/Sustainability,” indicating they were singled out because they touch on an issue the Trump administration has opposed addressing.

Others are listed for potential elimination because of “D.E.I.,” or diversity, equity and inclusion, which the Trump administration also opposes.

Grants for termination listed as D.E.I. include funding $462,000 worth of improvements at a park in Washington State to better accommodate children with disabilities, and $198,000 to the Santa Monica Mountains Fund, a nonprofit group, to mentor college students.

Also on the list, a $58,000 grant to the State Historical Society of Colorado to survey properties associated with gay and transgender history for possible nominations to the National Register of Historic Places.

The Trump administration listed its reason for canceling the grant as: “LGBQ.”

Elizabeth Peace, a spokeswoman for the Interior Department, declined to comment on specific grant eliminations. She said in a statement that the agency was committed to fiscal responsibility.

“We are eliminating wasteful programs, cutting unnecessary costs and ensuring every dollar serves a clear purpose,” Ms. Peace said. She added, “By streamlining operations and focusing resources on conservation, responsible energy development and public land protection, we are prioritizing taxpayers while upholding our mission.”

Kristen Brengel, senior vice president of government affairs for the National Parks Conservation Association, a nonprofit group that advocates on behalf of parks, said the agency was saving very little money while losing a wealth of knowledge and expertise.

“It’s penny-wise and pound-foolish,” she said. “It’s amazing when you look at the dollars on all of these projects at how much the Park Service is accomplishing with so little money.”

Ms. Brengel said cuts to climate change studies would hurt the park-visiting public.

“The research that goes on in national parks is essential for how we’re assessing the conditions of our land, air and water in the country,” she said, adding, “This isn’t about the politics of climate change, it’s about public safety and public health.”

The possibility of grant terminations comes as the Trump administration is planning deep cuts at the Department of Interior. The agency, which manages more than 500 million acres of public lands across the United States, could see its budget cut by roughly 30.5 percent, or $5.1 billion.

It also is undergoing a reorganization that has raised concerns among Democrats on Capitol Hill.

In April, Interior Secretary Doug Burgum signed an order that critics said hands broad decision-making authority over the agency to DOGE.

In it, he assigned the job of overseeing the department’s budget, human resources, contracting, federal financial assistance, and information technology to the agency’s assistant secretary for policy, management and budget. The authority of that position was delegated to Tyler Hassen, a former member of DOGE, in March.

Senator Martin Heinrich of New Mexico, the top Democrat on the Senate Committee on Energy and Natural Resources, sent a letter to Mr. Burgum on Wednesday calling the delegation of responsibilities “extremely troubling” and seeking answers about Mr. Hassen’s role.

“Delegating sweeping authorities and responsibilities to a non-Senate confirmed person in violation of the Vacancies Reform Act is baffling and extremely troubling,” Mr. Heinrich said.

He asked for details on Mr. Hassen’s role as well as information about grants that have been terminated and employees who have left the agency amid DOGE efforts to cut the size of the federal work force.

The Vacancies Reform Act is a law that Congress passed in 1998 that governs who can serve temporarily in positions that require presidential appointment and Senate confirmation.

Ms. Peace said the agency did not comment on congressional letters. But she said Mr. Burgum’s order ensured “that President Donald J. Trump’s executive order to restore accountability to the American public is carried out.”

She said the agency would “continue to prioritize retaining first responders, parks services and energy production employees.”