House Republicans rammed through their budget blueprint late Tuesday after U.S. President Donald Trump intervened to pressure wavering members to vote for the resolution, which jumpstarts the process of enacting sweeping cuts to Medicaid and other programs to finance trillions of dollars in proposed tax cuts primarily for the rich.

Just one Republican—Rep. Thomas Massie of Kentucky—joined every House Democrat in voting against the resolution, which sets the stage for $880 billion in Medicaid cuts and $230 billion in cuts to the Supplemental Nutrition Assistance Program (SNAP).

“Today, Republicans are cheering the passage of their extreme budget resolution that betrays the middle class,” Rep. Brendan Boyle (D-Pa.), the top Democrat on the House Budget Committee, said in a statement following Tuesday’s vote. “Their bill will impose pain and suffering on tens of millions of hardworking Americans—cutting Medicaid and the Affordable Care Act, all to fund extravagant giveaways for billionaires like Elon Musk.”

Rep. Pramila Jayapal (D-Wash.) added in a social media post late Tuesday that “99% of House Republicans just voted to gut Medicaid so they can lower taxes for the richest 1%.”

“They’re showing you exactly who they’re working for,” Jayapal wrote.

“House Republicans have ignored the demands of their constituents and instead chosen to side with their billionaire donors and party leadership to advance an extreme budget bill to give trillions in tax benefits to wealthy elites at the expense of workers and families.”

In the lead-up to the vote, House Speaker Mike Johnson (R-La.) and other Republicans attempted to dodge backlash over their push for Medicaid cuts by saying the budget resolution doesn’t contain the word Medicaid or explicitly recommend cuts to SNAP.

That is highly misleading. The resolution instructs the House Energy and Commerce Committee to “submit changes in laws within its jurisdiction to reduce the deficit by not less than” $880 billion over the next decade. That panel has jurisdiction over Medicaid, which Republicans have repeatedly targeted in public and private discussions, with one leaked GOP document floating over $2 trillion in cuts to the program.

Republicans also rejected numerous Democratic amendments that would have prevented Medicaid and SNAP cuts in the upcoming budget reconciliation process as their resolution moved through committees.

“House Republicans have ignored the demands of their constituents and instead chosen to side with their billionaire donors and party leadership to advance an extreme budget bill to give trillions in tax benefits to wealthy elites at the expense of workers and families back home,” said David Kass, executive director of Americans for Tax Fairness. “Don’t buy Republican representatives’ spin—this was far from a procedural vote with no consequences. This budget bill will strip healthcare, nutrition services, and education programs from millions of working and middle-class Americans to fund Trump’s $5 trillion in tax giveaways to billionaires and big business.”

Roll Callnoted that passage of the budget resolution marks just “the first step toward passing the mammoth reconciliation bill that House Republicans are seeking to enact Trump’s agenda.”

“The plan remains at odds with that of Senate Republicans, who are pursuing their own slimmer budget blueprint focused on border security and defense, while deferring tax legislation until later in the year,” the outlet added.

Sharon Parrott, president of the Center on Budget and Policy Priorities, said in a statement that “both the House and Senate budgets significantly miss the mark on what should be their basic goals: lowering costs, increasing opportunity, and responsibly addressing our nation’s long-term priorities, including reducing future economic risks associated with high deficits.”

“But the enormity of program cuts called for by the House budget stands as a singular threat to the well-being of people in every state, city, and rural community, threatening to take away their health coverage, make healthcare more expensive, and make it harder to afford food and college,” said Parrott. “The quick math on the House budget shows a stark equation: The cost of extending tax cuts for households with incomes in the top 1%—$1.1 trillion through 2034—equals roughly the same amount as the proposed potential cuts for health coverage under Medicaid and food assistance under the Supplemental Nutrition Assistance Program.”

“The House Republican budget’s path of higher costs for families, more people without health coverage, increased poverty and hardship, and higher debt—all in service to tax cuts for the wealthy and profitable business interests—is the wrong direction for our nation,” Parrott added. “It is also directly at odds with the recent election in which so many people expressed concern about their ability to afford food, housing, healthcare, and other necessities—and at odds with the promises made to them by President Trump.”