Senate Republicans are taking Medicaid cuts even further than their House counterparts with legislation that targets hospital payments.

Senate Republicans say they are looking for ways to safeguard rural hospitals from proposed cuts to a key Medicaid funding method.

The Senate’s deep cuts to Medicaid in the tax and spending megabill are setting off alarm bells among some Republicans, complicating leadership’s effort to get the legislation passed by July 4. It seeks to clamp down on two tactics states use to boost Medicaid funding to hospitals: state-directed payments and Medicaid provider taxes.