Medicaid has become a key hot button topic in the sweeping tax and spending cuts bill that House Republicans are scrambling to pass as soon as this week.

Some $500 billion in cuts to Medicare could be avoided if Congress instructs the White House budget office to disregard the reconciliation package’s debt impact.

The nonpartisan Congressional Budget Office (CBO) estimated that the Republican budget bill under consideration would trigger about $500 billion in automatic cuts to Medicare, the program that provides health insurance to around 68 million older adults and people with disabilities.