Republicans’ big plan to cut taxes, fund border security and defense spending and fulfill all the key parts of President Donald Trump’s domestic agenda will rely on deep cuts to Medicaid. But Republicans are risking a massive political backlash by cutting a program many of their constituents rely on.

Republicans are proposing deep cuts to Medicaid to finance tax cuts and other priorities. Pushback is coming not only from Democrats, but also from hospitals that rely on revenue from the program.

For Representative David Valadao of California and other Republicans whose constituents depend on Medicaid, a vote for their party’s budget could be politically fatal. President Trump’s agenda hangs in the balance.