Context:

President Donald Trump and Republican leaders are applying intense pressure on GOP holdouts to pass a significant multi-trillion-dollar bill, despite internal party divisions. The primary contention arises from disagreements over Medicaid cuts and state and local tax deductions, with moderates and hardliners clashing over the Senate's changes to the House's original proposal. Senate Majority Leader John Thune and Speaker Mike Johnson are involved in high-stakes negotiations to address these issues, stressing the importance of passing the bill by July 4th. Despite the pressure, some Republicans are advocating for a conference committee to resolve differences, which would delay the bill's passage. The GOP is generally united on several key tenets of the bill, but concerns about the deficit and Medicaid cuts remain significant obstacles to consensus.

Dive Deeper:

• President Trump and Republican leaders are urging quick passage of a sweeping agenda, but face resistance from GOP members concerned about deep Medicaid cuts and changes to the House's original bill.

• Key GOP figures, including Senate Majority Leader John Thune and Speaker Mike Johnson, are working to reconcile differences between moderates and hardliners in their party, as well as between the House and Senate versions of the bill.

• The contentious bill includes provisions to extend Trump's 2017 tax cuts and impose new work requirements on social safety nets, while also addressing funding for the Pentagon and border security, but how to finance these initiatives remains debated.

• A notable point of contention involves the state and local tax deduction limits, with New York Republicans demanding higher deductions than those proposed by the Senate, risking further intra-party conflict.

• Despite Trump's push for a July 4th deadline, some Republicans, including Rep. Nicole Malliotakis, are advocating for a more deliberate approach, potentially involving a conference committee to align the House and Senate versions.

• The Medicaid cuts proposed by the Senate are a significant sticking point, with centrist Republicans opposing them due to their potential impact on rural hospitals and Medicaid providers, while hardliners demand even deeper cuts.

• If Trump and Senate GOP leaders concede to the demands of Medicaid cut opponents, the bill's cost could increase significantly, risking further backlash from fiscal conservatives within the party.