Ronald Reagan and his fellow Republicans once invoked what they referred to as “welfare queens” as they made the case for reining in social spending in the 1970s and 1980s, painting a picture of unscrupulous women bilking the system to finance a sumptuous lifestyle.

Now as they try to justify cuts to Medicaid, congressional Republicans are focused on a different deadbeat poster child: the shiftless male video gamer who lazes around the house attached to his console while getting free health care that should go to more deserving people.

The imagery has changed, but the political tactic from the G.O.P. remains the same. By making broad generalizations about the types of people who could inappropriately benefit from federal benefits, they make the idea of cutting back seem virtuous rather than stingy.

With a new, restrictive work requirement for Medicaid and other cost-cutting measures emerging as main points of contention in the political debate over their sweeping domestic policy bill, Republicans have sought to play down the potential fallout for Americans who rely on the health care program for the poor. They say no one who truly merits help will lose benefits.

To bolster their case, they assert that ridding the Medicaid rolls of slackers and undocumented immigrants who should not be getting taxpayer help will shave off billions of dollars without touching benefits for those in need. Their message is that the necessary savings can be achieved by going after the old standbys of waste, fraud and abuse.

“You don’t want able-bodied workers on a program that is intended, for example, for single mothers with two small children who is just trying to make it,” Speaker Mike Johnson said on CNN in February as he began laying the groundwork for the Medicaid cuts. “That’s what Medicaid is for, not for 29-year-old males sitting on their couches playing video games.”