Justice voted for the megabill last week, despite his concerns over some of its Medicaid provisions — and after warning Republicans “cannot cut into the bone.” Steep cuts, he said, would cost the GOP voters and lead the party to “awaken to [being in the] minority.”

States and rural health advocacy groups are sounding the alarm that Congress’ slashing of Medicaid will devastate already financially fragile rural hospitals. One analysis estimates more than 300 hospitals could be at risk of closing under the Republican measure to slash about $1 trillion in Medicaid funding over ten years.