By Chris Matthews

Republicans could be preparing to add more than $5 trillion in new debt to avoid painful healthcare cuts.

Congressional Republicans and President Donald Trump are hurtling toward a collision over tax reform, exposing a growing ideological rift over healthcare spending that could threaten the president's legislative agenda in its entirety.

At the center of the fight: whether Medicaid cuts will be used to finance an extension of Trump-era tax cuts.

"Medicaid is a tremendously difficult issue for Republicans," said Henrietta Treyz, director of economic policy at Veda Partners.