Senate Republicans have unveiled a sweeping plan to overhaul the Medicaid program, with changes policy analysts warn could lead to even greater coverage losses and pain for hospital systems than the aggressive proposal passed by the House of Representatives last month.

Republicans must overcome intraparty divides to get legislation to Trump’s desk by July 4 target.

Republican leaders are aiming for quick negotiations over needed changes to the newly unveiled Senate tax bill which lacks the votes to secure majorities in both chambers as written.