WASHINGTON — The Senate Republican health-care bill would achieve a historic convergence of GOP priorities, placing major, permanent caps on Medicaid spending and providing a significant tax cut for wealthy Americans. President Donald Trump and congressional Republicans describe the legislation as fulfilling their promise to repeal the Affordable Care Act, or Obamacare, but key provisions are also aimed at making progress on the GOP’s long-held goal of cutting entitlement spending. The legislation would sharply break with pledges Trump made during the 2016 campaign to block reductions in Medicaid spending and to deliver tax cuts primarily to the middle class. All together, it shows how long-term conservative goals of cutting taxes and entitlement spending have overtaken Trump’s agenda, as the bill faces critical votes in the Senate as soon as next week that could take it to the precipice of becoming law.