A budget proposal released by House Republicans on Tuesday takes a big chunk out of two of skilled nursing’s biggest sources of revenue.

Most notably, the new spending plan, which is labeled as “A Brighter American Future,” aims to upend Medicaid, which pays for about two-thirds of all skilled nursing care, according to the Washington Post. Modifications could include limiting per-capita payments, allowing states to turn Medicaid into block grants, and adding work requirements for some enrollees. All told, coupled with other changes to federal health programs,  those moves would amount to $1.5 trillion in savings, the Post reports.

Meanwhile, Medicare, which pays for about 20% of SNF care, stands to take a $537 billion haircut over the next decade. Proposed changes to the payment program would include giving seniors the chance to enroll in private health plans that compete with Medicare.

The House Budget Committee hopes to pass the plan this week, but it may not make it any further. It is unclear whether the House will even bring the plan up for a vote, the Post writes. While the GOP controls the House and the Senate, the proposal is unlikely to garner support among moderates or any Democrats.

“The 2019 Republican budget scraps any sense of responsibility to the American people and any obligation to being honest,” said Rep. John Yarmuth (D-KY), a member of the Budget Committee. “Its repeal of the Affordable Care Act and extreme cuts to healthcare, retirement security, anti-poverty programs, education, infrastructure, and other critical investments are real and will inflict serious harm on American families.”