Governors of both major political parties are warning that a little-noticed regulation proposed by the Trump administration could lead to big cuts in Medicaid. That could reduce access to health care for low-income Americans. The fiscal accountability rule from the Centers for Medicare and Medicaid Services is getting pushback from hospitals, doctors, nursing homes and insurers. Hospitals say it would force cuts of up to $49 billion a year in the program, leaving some vulnerable people without access to medical care. President Donald Trump’s administration says the $600 billion federal-state program needs closer scrutiny to prevent abuses that raise taxpayers’ costs.