As Republican leaders draft President Donald Trump’s big bill of $4.5 trillion in tax breaks and $1.5 trillion in spending cuts, dozens of more moderate Republicans from contested congressional districts have positioned themselves at the center of the negotiating table.

GOP lawmakers in swing districts insist they will not vote for any proposal that strips benefits, placing them at odds with more conservative lawmakers looking to secure deep cuts in spending.

Republicans will have to find a way make up for hundreds of billions in potential Medicaid cuts that leaders appeared to rule out Tuesday.