President Donald Trump's tax cut and spending bill faces a critical stress test on Wednesday as Republicans in the U.S. House of Representatives try to overcome internal divisions about cuts to the Medicaid health program and tax breaks in high-cost coastal states.

Among the primary sticking points in the negotiations is just how much to slash from the bill. As things stand, the measure's tax breaks total about $4.9tr (£3.7tn), partly paid for by cuts to the healthcare programme known as Medicaid, as well as to green energy tax breaks approved by former President Joe Biden.

The president spoke with House Republicans on Tuesday in what appeared to be part pep rally, part pressure campaign.