The massive budget bill that Senate Republicans are debating pays for some of its tax cuts by slashing hundreds of billions of dollars in Medicaid spending. The latest report from the non-partisan Congressional Budget Office estimates nearly 12 million people will lose health insurance if the Senate version of the bill becomes law. Trump insists the cuts come from eliminating waste, fraud and abuse. Democrats have said they break Trump's promise not to touch Medicaid — and over the weekend, Republican Senator Thom Tillis of North Carolina agreed. "What do I tell 663,000 people in two years or three years when President Trump breaks his promise by pushing them off of Medicaid because the funding's not there anymore?" We asked Sarah Jane Tribble, the chief rural correspondent for KFF Health News, what the cuts will mean for rural residents of states like North Carolina — and the hospitals that serve them.For sponsor-free episodes of Consider This, sign up for Consider This+ via Apple Podcasts or at plus.npr.org. Email us at [email protected] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy