PHOENIX (AZFamily/AP) — Former Republican Gov. Jan Brewer is urging members of Arizona’s congressional delegation to leave Medicaid alone. In a written opinion piece, she wrote that cuts to Medicaid could cost Arizona $2 billion and leave thousands of people at risk.

“I hope our (congressional) delegation remembers what’s at stake. This isn’t about politics. It’s about people,” said Brewer, who expanded Medicaid more than a decade ago. It was one of her administration’s signature achievements.

When it comes to Medicaid , Rep. Juan Ciscomani is telling fellow Republicans he won’t support steep cuts that could hit thousands of residents in his Arizona district — “my neighbors, people my kids go to school with” — who depend on it.

As GOP leaders draft President Donald Trump’s “big, beautiful bill” of some $4.5 trillion in tax breaks and $1.5 trillion in spending cuts by Memorial Day, dozens of Republicans from contested congressional districts have positioned themselves at the center of the negotiating table.

While it’s often the most conservative members of the House Freedom Caucus driving the legislative agenda — and they are demanding as much as $2 trillion in cuts — it’s the more centrist-leaning conservatives who could sink the bill. They have been hauled into meetings with Trump at the White House, some have journeyed to his Mar-a-Lago estate in Florida, and many are huddling almost daily with House Speaker Mike Johnson .

Ciscomani, in his second term, signed onto a letter with Republican Rep. Don Bacon from Nebraska and others warning House Republican leadership he cannot support a bill that includes “any reduction in Medicaid coverage for vulnerable populations.”

“Our point is that we understand the need for reform,” Ciscomani said. “But anything that goes beyond that and starts jeopardizing rural hospitals in my district and their existence overall, then we’re running into an area where it will be very difficult to move forward. I think it’s very important they know that.”

Democrats track the vote with an eye on next year’s midterms

Democrats are also applying political pressure in Ciscomani’s district and beyond. As Republicans decline to hold town halls on the advice of their leaders, Democrats are stepping in to warn constituents about what could happen to programs they rely on for health coverage and to put food on the table.

Democratic Sens. Mark Kelly of Arizona and Cory Booker of New Jersey visited Ciscomani’s Tucson-based district last month to offer harsh condemnations.

Kelly asked how many in the room were represented by Ciscomani, and then he warned about how scores of residents in the district could lose their health care coverage.

“And for what? It is so Donald Trump could give a big, giant tax cut to the wealthiest Americans. It is not fair,” Kelly said.

Booker, fresh off his 25-hour speech on the Senate floor, was even more pointed, saying just three House Republicans have to change their mind to upend the GOP’s effort in the House, with its narrow majority.

“I believe one of them has to be in this district right here,” Booker said. “Either he changes his mind or this district changes congresspeople. It’s as simple as that.”

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