Legislation heads to House for final vote as concerns mount over deficit and Medicaid cuts
The U.S. Senate on Tuesday passed President Donald Trump’s far-reaching tax and spending bill, a sweeping legislative package that cements several of his top policy priorities—while adding an estimated $3.3 trillion to the national debt over the next decade.
The bill, which now returns to the House of Representatives for final approval, is a major pillar of Trump’s 2024 agenda. The president has called on lawmakers to send it to his desk by July 4, aiming to sign it into law on Independence Day.
Despite holding narrow majorities in both chambers, Republicans have struggled to advance the 940-page bill, which includes permanent tax cuts, deep spending shifts, and structural changes to key social programs. With Democrats uniformly opposed, the GOP could afford to lose only three votes in each chamber.
In the Senate, the bill passed 51–50, with Vice President JD Vance casting the tie-breaking vote after only three Republicans broke ranks. The House, where Republicans hold a 220–212 majority, is expected to face another razor-thin vote. The earlier House version passed in May by just two votes.
Fiscal Concerns and Internal GOP Pushback
Some Republicans remain uneasy, particularly over the Senate’s revisions, which the Congressional Budget Office (CBO) says would increase the federal deficit by $800 billion more than the House version. The conservative House Freedom Caucus slammed the changes, warning the Senate’s version adds $651 billion to the deficit—excluding interest costs, which could nearly double the total.
“This isn’t fiscal responsibility,” the caucus posted online. “It’s not what we agreed to.”
Moderate Republicans have also voiced reservations, especially about sharp cuts to Medicaid.
“I can’t support a final bill that guts critical funding streams our hospitals depend on,” said Rep. David Valadao (R-Calif.), during weekend deliberations.
Still, House Republicans are expected to face intense pressure from Trump to fall in line.
What’s in the “One Big Beautiful Bill Act”
Nicknamed the “One Big Beautiful Bill Act,” the legislation locks in Trump’s 2017 personal and corporate tax cuts, set to expire at year’s end. It also introduces new tax breaks for tipped workers, overtime pay, and seniors—core pledges of Trump’s re-election platform.
Beyond tax reform, the bill devotes tens of billions to Trump’s hardline immigration policies and eliminates many of President Joe Biden’s climate and green energy initiatives.
The package would also tighten eligibility for food stamps and healthcare programs like Medicaid, moves the CBO says could shift more financial burden onto lower-income Americans.
The CBO projects the bill would push the national debt to $36.2 trillion by 2035. Economists warn this could dampen long-term growth, hike interest rates, and limit public investment—impacts likely to be felt most by younger generations.
To prevent a fiscal crisis, the bill raises the U.S. borrowing limit by $5 trillion, averting a debt ceiling standoff that could have rattled global markets. However, bond markets remain cautious, with investors increasingly wary of U.S. deficits.
Republican Fault Lines: SALT, Medicaid, Medicare
Despite broad GOP support for the bill’s overall goals, disagreements persist. Republicans from high-tax states like New York, California, and New Jersey are demanding relief from the federal cap on state and local tax (SALT) deductions.
Meanwhile, lawmakers from rural districts have raised concerns that changes to Medicaid could reduce access to healthcare services in already underserved areas. On the far-right, some are pushing for deeper Medicare cuts to curb the bill’s fiscal footprint.
Trump has been quick to rebuke critics within his own party, using his Truth Social platform to shame dissenters and excluding them from recent White House briefings. Few Republicans have openly challenged him since his return to office in January.
One of the few to do so—Senator Thom Tillis of North Carolina—announced this week he will not seek re-election in 2026.
