The House-approved budget bill includes proposals for significant spending cuts to Medicaid and new work requirements.

The White House needs nearly every Republican to vote for the bill, but two distinct factions have their doubts.

It would impose work requirements for low-income adults to receive Medicaid health insurance and increase them for food assistance as well as cut funding for services like birth control to the nation’s biggest abortion provider. Supporters of the bill say the moves will save money, root out waste and encourage personal responsibility.