House Republicans passed a new budget resolution in a razor-thin vote that puts the GOP on a path to enact President Donald Trump’s ambitious fiscal agenda, including deep tax cuts and significant reductions in spending on health programs like Medicaid.

In theory, the budget, which kicks off the process of passing an extension of tax cuts enacted in 2017 and up to $2 trillion in spending cuts meant to partly offset them, could become law without significant cuts to Medicaid. But it won’t be easy.

President Donald Trump called on Congress to make his expiring 2017 tax cuts permanent just hours after House Republicans squeaked through a tax-and-spending plan paving the way for a temporary extension through deep cuts in safety-net programs such as Medicaid.