President Bush and his conservative allies in Congress thought that they were going to be able to enact massive cuts to Medicaid -- which benefits the poor -- so they can pass more tax cuts for the extremely wealthy. Though he must have been taken aback when the Senate passed the Smith-Bingaman amendment to strip the Medicaid cuts from the budget, Bush certainly knew that the conservative establishment in the House wouldn't let him down. Right? Wrong. The AP's Kevin Freking has the scoop:

President Bush's budget centerpiece to squeeze billions of dollars from spending on health care for the poor ran into jeopardy Thursday as 44 House Republicans signed a letter protesting the cuts.

The lawmakers said reducing Medicaid spending over the next five years by up to $20 billion as approved last month by the House "will negatively impact people who depend on the program and the providers who deliver health care to them."

The cuts would amount to about a 1 percentage point reduction from Medicaid's projected 7 percent-plus growth over the next several years. By law, benefit programs grow automatically to keep pace with factors such as inflation and ever-rising numbers of beneficiaries.

The lawmakers sent the letter to Rep. Jim Nussle, R-Iowa, chairman of the House Budget Committee. Bush in February proposed $8.5 billion in Medicaid cuts. GOP leaders in the House and Senate proposed making the cuts bigger to pay for new tax cut initiatives. The Senate, however, rejected any cuts in Medicaid spending.

The letter does not include a pledge by the 44 GOP lawmakers to vote against the budget should the Medicaid cuts be reinstated. (Much like the Smith-Bingaman amendment, it is highly possible that fainthearted Republicans will go back on their word and support a budget with massive cuts for the poor.) Nevertheless the defection is yet another indication that the Republican coalition -- once as tight as a knot -- is beginning to slip apart at the seams.