The sweeping Republican tax-cut bill includes new requirements that are projected to remove millions from the Medicaid program.

House Speaker Mike Johnson (R-LA) said on Sunday that the 4.8 million people estimated to lose Medicaid coverage will not lose their healthcare “unless they choose to do so.” Republicans have been criticized for Medicaid cuts in the “big beautiful bill” that seeks to fund President Donald Trump‘s tax cuts.

House Republicans narrowly passed Trump’s tax bill, featuring $625 billion in Medicaid cuts with work requirements. Speaker Mike Johnson called the Medicaid changes “commonsense” and said millions won’t lose coverage unless they choose.