Republican infighting over Medicaid work requirements and raising the state and local taxes cap is threatening to derail the “one big beautiful” reconciliation bill. There are currently enough Republican detractors to sink the bill’s markup in the Budget Committee on Friday.

Republican leaders intend to accelerate new work requirements under Medicaid as they scramble to secure the support of GOP holdouts for President Trump’s “big, beautiful bill.” House

Millions of Americans are at risk of losing access to Medicaid under the proposed legislation, which passed the House Energy and Commerce Committee (HECC). Representative Brett Guthrie, a Kentucky Republican and chair of the HECC, insisted that the changes will "strengthen and sustain" Medicaid for the future, calling them "common sense."