The nonpartisan Congressional Budget Office (CBO) estimated that the Republican budget bill under consideration would trigger about $500 billion in automatic cuts to Medicare, the program that provides health insurance to around 68 million older adults and people with disabilities.

Some $500 billion in cuts to Medicare could be avoided if Congress instructs the White House budget office to disregard the reconciliation package’s debt impact.

Medicaid has become a key hot button topic in the sweeping tax and spending cuts bill that House Republicans are scrambling to pass as soon as this week.