Programs projected to prevent thousands of deaths and even more illnesses are on the chopping block, while Republicans propose handing $4.5 million to millionaires and billionaires.

Around a dozen House Republicans are uneasy about the prospect of voting for their party’s budget proposal over potential cuts to Medicaid, according to several people familiar with the conversations.

Deep Medicaid cuts will rattle America’s health care system along with state and local budgets. Forbes contributor Dr. Arthur Kellermann says “if Trump’s Medicaid cuts happen, healthcare costs will rise and access to care will decline for everyone—including you.”