House Republicans signaled they’re going full steam ahead on significant changes to Medicaid, despite pressure from Democrats and even some moderates in their party.

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.

It might be hard to get super interested in the back and forth of the budget bills bouncing around Capitol Hill, but they could have huge consequences for Americans’ everyday lives.