CHICAGO, Ill. (WTVO) — In a new op-ed in the Chicago Tribune , Illinois Gov. JB Pritzker said up to a million residents of the state will lose health care coverage if funding for Medicaid is cut as part of the Trump administration’s efforts to reduce the size of federal spending.

“President Trump promised he wouldn’t cut Medicaid. But within hours of taking office, he signed executive orders aimed at weakening the Affordable Care Act,” Pritzker wrote. “This week, House Republicans voted to advance a budget that requires $880 billion in funding cuts, much of which must come from the Medicaid program. Trump endorsed that plan.

“It isn’t just Medicaid they are planning to cut,” Pritzker continued. “The Trump administration and House Republicans plan to eliminate tax credits that enable millions of Americans to buy insurance on the health care marketplace.”

“Let me say this plainly: If Trump, Vice President Vance, Elon Musk and congressional Republicans get their way, up to a million Illinoisans will lose health care coverage,” he added.

Last week, President Donald Trump made his position on Medicaid clear: “We’re not going to touch it.”

States and the federal government jointly pay for Medicaid, which offers nearly-free health care coverage for roughly 80 million poor and disabled Americans, including millions of children. It cost $880 billion to operate in 2023.

Republicans, who already have ruled out massive cuts to Social Security and Medicare, are turning their attention to siphoning as much as $880 billion from Medicaid over the next decade to help finance $4.5 trillion in tax cuts.

But as a deadline to avoid a partial government shutdown nears, hesitation is surfacing among Washington’s Republican lawmakers — once reliable critics of lofty government social welfare programs such as Medicaid — who say that deep cuts to the health care program could prove too untenable for people back home.

Trump and Republicans have for years called for lowering government spending on health care, but they have struggled to formulate a serious plan that gains traction. Trump, for example, has spent nearly a decade arguing for an overhaul of the Affordable Care Act. His efforts to repeal the Obama-era national health care law failed during his first term, and in his most recent presidential campaign he offered only “concepts of a plan” to adapt the program.

Republican House Speaker Mike Johnson has ruled out two of the biggest potential cuts: paying fixed, shrunken rates to states for care and changing the calculation for the share of federal dollars that each state receives for Medicaid. Just a few years ago, Johnson spearheaded a report that lobbied for some of those changes during the first Trump administration.

Johnson insisted in a CNN interview that the focus will instead be ferreting out “fraud, waste and abuse” in Medicaid, although it’s unlikely to deliver the savings Republicans seek.

GOP pressure over Medicaid is mounting, with some state party leaders joining the calls to preserve the program. States are already struggling with the growing cost of sicker patients and could be left to cover more if the federal government pulls back. In some states, the federal government picks up over 80%.

Significant changes to Medicaid are still on the table. They have to be for Republicans get the savings they need to pay for tax cuts.

Work requirements, which could save as much as $109 billion over the next decade, seem to have solid support among GOP members, with some individual Republican-led states already moving to implement them