States have long used taxes on hospitals and nursing homes to increase federal matching funds. If Republicans end the tactic, red states could feel the most pain.

House Republicans on the Energy and Commerce Committee this week unveiled a plan to cut more than $880 billion to pay for a significant portion of President Trump’s domestic agenda. After

Missouri Senator Josh Hawley called the cuts to Medicaid "politically suicidal" as many Republicans' voter bases may be threatened by them. House Republicans have proposed legislation with $880 billion in cuts, largely to Medicaid, in order to approve $4.5 trillion in tax breaks.

Texas hospitals are facing a freeze in billions of dollars in federal Medicaid funding under a budget proposal introduced by House Republican leaders Sunday night. Republicans are moving to limit access to a tax loophole that Texas and other states have used to tap extra Medicaid dollars for hospitals and medical providers.

Republicans can save $880 billion over 10 years in Medicaid by block-granting the federal portion, providing maximum state flexibility and expanding Medicare Part D to Medicaid.

WASHINGTON (AP) — House Republicans have unveiled the cost-saving centerpiece of President Donald Trump’s “big, beautiful bill,” at least $880 billion in cuts largely to Medicaid to help cover the cost of $4.5 trillion in tax breaks.

The Congressional Budget Office reviewed the leading proposals from Republicans who are trying to cut the costs of a program that serves roughly 72 million poor and disabled Americans.

Johnson said some controversial proposals to slash Medicaid were off the table for the massive Trump agenda bill, while conservatives pressed him on steep spending cuts.

In a closed-door meeting late Tuesday, Speaker Mike Johnson and GOP leaders sought to assuage moderates’ fears about changes to the health safety-net program to help finance their party-line megabill.