Republicans on Tuesday narrowly passed a budget blueprint through the U.S. House of Representatives, with Arizona’s delegation divided along party lines.

The budget renews sweeping tax cuts implemented during President Donald Trump’s first term and it increases funding for the border and the military. To partially offset those new costs, it mandates steep reductions in Medicaid, food assistance and other safety-net programs for the country’s low-earners.

The proposal passed Tuesday with 217 Republican votes and no support from Democrats. It needed 215 votes to pass.

Leading up to the vote, the budget plan had seen pushback from some in the GOP.

Rep. Juan Ciscomani, R-Ariz., was among several swing-district Republicans who signed onto a letter last week voicing concern over the proposal’s possible cuts to health care, food aid and higher education. Ciscomani had yet to publicly take a position in the hours leading up to the vote, writing on Tuesday afternoon that he would “continue to consider all options on the table.”

Ciscomani wound up voting for the package. He wrote in the leadup to the vote: “While we must deliver on our promise to right-size the government, we must also work to protect the vital programs that so many Americans rely on when they hit hard times.”

The proposal drew opposition from fiscal hawks, too, who noted that, on balance, it was expected to add trillions to the United States’ deficit.

“I don’t like the amount of borrowing here,” said Rep. David Schweikert, R-Ariz., a fiscal hawk. But the package “opens up a chance” for his agenda of modernizing government programs to save money, and the tax cuts will make the country’s economy run faster overall, he argued.

“I actually believe there should be more cuts in spending, because I think we can achieve that by modernization,” Schweikert said.

Rep. Eli Crane was still “coming to a final decision” in the hours leading up to the vote, according to his spokesperson Greg Smith, but he eventually voted for it.

Rep. Andy Biggs, a Republican who is running for governor of Arizona, defended the bill as “the trigger to put in place the Trump mandate” and noted that cuts to programs like Medicaid “haven’t been determined yet.”

The budget plan doesn’t directly impose specific cuts, but it lays out guidelines that tell Republicans where to find the money to offset the tax reforms.

Among those guidelines, it directs the House Energy and Commerce Committee, which oversees Medicare and Medicaid, to cut at least $880 billion over 10 years. Meeting that target would be virtually impossible without significant cuts to those programs, and Republicans widely were expected to take aim at Medicaid.

Arizona’s 3 Dems in Congress focus on Medicaid cuts

Medicaid cuts could be felt acutely in Arizona, where the program covers the cost of health care for 2 million of the state’s roughly 7 million residents.

The program pays for health coverage for nearly half of the state’s births, for more than one-third of all Arizona children, and for nearly all the state’s foster care youths, according to research by U.S. Rep. Greg Stanton’s office and Dr. Jodi Carter, a Phoenix pediatrician who is president of the Arizona chapter of the American Academy of Pediatrics.

Arizona’s three Democratic representatives focused on that human toll in their opposition to the bill.

“Trump and Republicans want to rip away your health care with their cruel budget proposal that would cut Medicaid,” Rep. Yassamin Ansari said.

“Their new favorite buzzwords are ‘waste, fraud, and abuse,'” she said. “Translation: cut Medicaid, SNAP, & education funding to pay for tax cuts for billionaires.”

“They wouldn’t be able to see the doctor of their choice. They’d have to seek health care by going to the emergency room,” Stanton said in a filmed statement before the vote.

“It’s bad for people’s health. It’s bad for families. And it’s bad for business, because the health care economy is such an important part of the Arizona economy,” Stanton said.

Rep. Raúl Grijalva, who is in recovery after undergoing treatment for cancer last year, was absent for the vote, but he has argued the Republican tax package disproportionately benefits the wealthy.

Republicans have countered that the spending cuts and tax reforms are better for the country’s economic outlook in the long run.

“Is there a way we can actually do our work here: Where we maximize the prosperity for my two-and-a-half year old, but also the person heading to retirement? To our brothers and sisters who are out there, working their hearts out? There is a way,” Schweikert argued on the House floor before the vote.

“The hardest part is, we’re going to have to do things differently than what we’ve done in the past.”

Other Republicans have argued that the Medicaid cuts would crack down on fraud within the program. Improper Medicaid payments are common but they account for less than one-third of the cuts that the GOP has proposed, according to a report by

Congress’ nonpartisan investigative arm.

USA TODAY’s Riley Beggin and The Arizona Republic’s Stephanie Innes contributed reporting.