President Donald Trump's bill is working its way through Congress. (Tasos Katopodis/Getty Images)
The Senate released the nearly 1,000-page bill minutes before midnight on Friday night.
It makes some notable modifications to the House's version of the bill – which passed that chamber by just one vote in May – particularly on Medicaid and green energy credits.
Among their issues is the difference in provider tax rates and state-directed payments, both of which states use to help fund their share of Medicaid costs.
Representative Young Kim, a Republican from California, has concerns about Medicaid provisions in the bill. (Photo by Ting Shen-Pool/Getty Images)
They said it "undermines the balanced approach taken to craft the Medicaid provisions in H.R. 1—particularly regarding provider taxes and state-directed payments."
"The Senate version treats expansion and non-expansion states unfairly, fails to preserve existing state programs, and imposes stricter limits that do not give hospitals sufficient time to adjust to new budgetary constraints or to identify alternative funding sources," the letter read.
To offset Senate Republicans' concerns about their chamber's proposed limits on state-directed payments and provider tax rates, the Senate Finance Committee included a $25 billion rural hospital fund in their legislation.
It was enough to sway Sen. Josh Hawley, R-Mo., who told reporters on Saturday that he would support the bill after expressing earlier concern about the Medicaid provisions' impact on rural hospitals.
But in the House, sources are signaling to Fox News Digital that moderate Republicans could still need convincing if the bill passes the Senate this weekend.
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Moderates are reaching out to Speaker of the House Mike Johnson, R-La., with concerns. (Nathan Posner/Anadolu via Getty Images)
It could pose problems for House GOP leaders given their thin three-vote majority, though it's worth noting that the legislation could still change before it reaches the lower chamber.
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But one senior House GOP aide told Fox News Digital they believe the moderates will ultimately fall in line, even if the text doesn't change.
"Moderate Republicans can plead and beg with House leadership all they want – the reforms to Medicaid made in the Senate are here to stay," the senior aide said. "And ultimately, these lawmakers will roll over and vote for the ‘Big, Beautiful Bill’ because the wrath of President Trump is far worse than a lower provider tax."
Fox News Digital reached out to Speaker Mike Johnson's office for comment.
For his part, Johnson, R-La., has publicly urged the Senate on multiple occasions to change the bill as little as possible – given the fragile unity that must be struck in the House to pass it.
Elizabeth Elkind is a politics reporter for Fox News Digital leading coverage of the House of Representatives. Previous digital bylines seen at Daily Mail and CBS News.
Follow on Twitter at @liz_elkind and send tips to elizabeth.elkind@fox.com
https://www.foxnews.com/politics/scoop-blue-state-republican-could-oppose-trump-tax-bill-over-medicaid-changes