The president has said his administration “won’t touch” entitlement programs. Past efforts to do so have backfired on Trump and other politicians.

Around a dozen House Republicans are uneasy about the prospect of voting for their party’s budget proposal over potential cuts to Medicaid, according to several people familiar with the conversations.

Programs projected to prevent thousands of deaths and even more illnesses are on the chopping block, while Republicans propose handing $4.5 trillion to millionaires and billionaires.

The Senate plan, passed last week, does not include Medicaid cuts. The Senate budget resolution omits tax policy but sets the spending agenda to enact Trump’s border, defense and energy policies, punting negotiations on tax policy to a later date and breaking up the spending plan into two separate measures.

Republican House Speaker Mike Johnson has ruled out some of the deepest cuts to Medicaid as concerns bubble up across the GOP, from the president to state leaders.