At the same time, their moderate counterparts desire greater tax relief for those states with higher state and local tax systems and more generous assurances for Medicaid coverage. Meanwhile, Democrats have been left on the sidelines,

House Speaker Mike Johnson’s push to pass a sweeping tax and spending bill — the centerpiece of President Donald Trump’s agenda — is running into trouble, as the Louisiana Republican attempts to paper over divisions in his conference over growing deficits, cuts to Medicaid and contentious tax provisions.

The vote is a significant, but not fatal, setback to the legislation that President Donald Trump hopes will define his second term.