WASHINGTON (TNND) — Speaker of the House Mike Johnson told reporters Tuesday they shouldn't doubt his conference's ability to use the budget reconciliation process to pass a massive legislative package implementing key elements of President Donald Trump's agenda by his self-imposed deadline of Memorial Day. The problem is, Republicans can't agree on how they'll pay for what they've called "one big beautiful bill."

"This is about balancing preferences. I mean, no one's gonna be surprised. Everybody knows where the touch points are on the final details of the final analysis," Johnson said.

In February, the House Energy and Commerce Committee, which has jurisdiction over Medicaid, the Children's Health Insurance Program and parts of the Affordable Care Act, was tasked by the House Budget Committee to find at least $880 billion in spending cuts.

The prospect of cutting health care benefits on which their constituents rely has sparked pushback from many moderate Republicans. Rep. Don Bacon, R-Neb., for instance, said he won't support more than $500 billion in Medicaid cuts.

"We're trying to do this very carefully. But I wanted to tell our leadership that if you are going to cut above this, you're going to have to persuade about 20 of us, or maybe more, that it's not going to affect the quality of healthcare for individuals who need it, or hospitals," Bacon said.

A group of anxious Republicans met with Johnson Tuesday night to discuss the issue.

On Wednesday, the non-partisan Congressional Budget Office released an analysis requested by Democrats of several Medicaid spending cuts Republicans have considered. It found the effects of these cuts would lead to millions of Americans losing health insurance.

According to the CBO, some of the ways states would respond to the proposed Medicaid spending cuts are reducing payments to health care providers, limiting optional benefits and reducing overall Medicaid enrollment.

“Republicans continue to use smoke and mirrors to try to trick Americans into thinking they aren’t going to hurt anybody when they proceed with this reckless plan, but fighting reality is an uphill battle," said Sen. Ron Wyden, D-Ore., who serves as ranking member on the Senate Finance Committee and requested the CBO analysis along with House Energy and Commerce Ranking Member Frank Pallone Jr., D-N.J.

To complicate matters further for House Republican Leadership, on Tuesday afternoon, 32 of the most conservative members of their conference sent them a letter demanding that the reconciliation bill does not add to the deficit.

The terms they laid out, under current terms, would require $2 trillion in spending cuts.

"The House reconciliation instructions are binding. They set a floor for savings, not a ceiling. We must hold that line on fiscal discipline to put the country back on a sustainable path," the letter said.

Maya MacGuineas, president of the Committee for a Responsible Federal Budget, said House Republicans have shown more fiscal discipline than their Senate counterparts in this reconciliation process but is still "deeply concerned" about where the bill is headed.

"Both the House and Senate have come up with plans to pass tax cuts and defense and border security spending increases without requiring equal amounts of offsets," MacGuineas said. "They would allow $3 to $7 trillion in new debt, making it one of the largest deficit increases in history, while relying on unrealistic economic growth assumptions and budget gimmicks to paper over the extent of the additional borrowing."