In theory, the budget, which kicks off the process of passing an extension of tax cuts enacted in 2017 and up to $2 trillion in spending cuts meant to partly offset them, could become law without significant cuts to Medicaid. But it won’t be easy.

Pennsylvania faces billions in Medicaid and other health funding cuts, which could force tens of thousands out of programs, under a budget resolution approved by Congressional Republicans, according to opposition groups.

The possibility of Medicaid cuts has become a headache for the most vulnerable Republicans in Congress — and has handed Democrats a potent issue ahead of 2026 elections.