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.

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.

Democratic Leader Hakeem Jeffries called the proposal the “largest Medicaid cut in American history,” warning it could devastate millions, especially in New York, where 7 million residents rely on the program. Experts caution that reductions in federal Medicaid funding could destabilize state budgets, affecting other services.