The Senate Republicans’ stalled effort to repeal the Affordable Care Act is not the only profound threat to our health care system. If Gov. Scott Walker gets his wish, Wisconsin will be the first state that requires adults without children to undergo drug testing if they want to receive Medicaid. Other states could follow his plan.

This would tie lifesaving health care benefits to government procedures that force people to submit to degrading invasions of privacy. Of all the ways to help Americans with drug problems, threatening their Medicaid eligibility is among the worst options.

Much attention has rightly focused on the Senate bill to reduce federal Medicaid spending by as much as $772 billion over the next decade, which would result in 20 million fewer enrollees. But budget cuts are not the only way to weaken Medicaid and limit access to health care.

Indeed, President Trump’s insistence on giving “our great state governors the resources and flexibility they need with Medicaid” does just that. While flexibility has at times allowed some states to expand services, others like Arizona, Kentucky and Maine are now attempting to impose conditions, such as time limits or work requirements, that would shrink the program. Because these reforms are more palatable than draconian cuts, they can easily slip beneath the radar and quietly imperil Medicaid’s long-term viability.