In a rare move, Japan's ruling coalition on Tuesday endorsed a revision to the draft budget for the next fiscal year that will require fresh lower house approval, as Prime Minister Shigeru Ishiba shelved a hike in medical costs due to opposition and patient resistance.

The ruling camp wants the budget, totaling 115.20 trillion yen, to be enacted in time for the start of fiscal 2025 in April, but Ishiba faces increasing challenges in parliament following revelations that he handed out gift vouchers to new ruling party lawmakers.

The voucher issue, which emerged after Ishiba's decision to reverse the government plan to ask patients to shoulder more of their medical expenses, has led the opposition camp to turn the heat up on the coalition government at a time when it is struggling with low approval ratings.

The revision approved by the Liberal Democratic Party and the Komeito party does not change the total size of the budget.

Scrapping the hike in medical costs will cost 10.5 billion yen, but the government will cover the amount by reducing reserve funds earmarked for emergency spending by the same amount.

The revised budget draft will first be sent to the House of Councillors and then again to the House of Representatives, where the ruling camp no longer holds majority control. It will the first time under the postwar Constitution for a budget to be enacted after being revised following lower house approval.

Opposition parties have been stepping up pressure on Ishiba to fully explain himself over his distribution of gift vouchers worth 100,000 yen each to 15 new lower house members in early March when they met over dinner.

Ishiba, who heads the LDP, has maintained that the practice does not pose legal problems, though he has acknowledged that it was out of sync with public sentiment. Opposition parties have been urging him to testify before the parliament's political ethics committee.

"There are many people who are resentful" of the prime minister's voucher-giving, Komeito Secretary General Makoto Nishida told a press conference. He took issue with the LDP's "complacency" in a meeting with his counterpart Hiroshi Moriyama earlier in the day.