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.

The House budget bill that passed does not include specific policies, and targeted spending cuts are too big to achieve without cutting Medicaid.

After a roller-coaster night in the House, Congress now moves to negotiations as the Senate continues to push for two bills and the House argues for one.