WASHINGTON – Americans could seemajor changesto Medicaid, food stamps, border security and taxes under asweeping Republican billthat passed the U.S. House early on May 22. Theproposal, which PresidentDonald Trumphas dubbed the "big, beautiful bill," would enact Trump'smajor campaign promiseslike eliminating taxes on workers' tips and overtime and is likely to be one of the most significant pieces of legislation that will be passed during his second term in the Oval Office. It passed the House 215-214, with all Democrats and two Republicans voting against it after a marathon all-night debate. Republicans had only three votes to spare in theclosely-divided House. More:The winners (and losers) in Trump's 'big beautiful' tax bill As recently as May 20, it wasn't clear House Republicans would be able to get the bill endorsed by Trump across the finish line. A handful of Republicans from primarily Democratic states were holding out on raisinga tax deduction capthat would benefit their constituents, while fiscal conservatives remained concerned about the cost of the legislation, which is expected to addaround $3.3 trillionto the deficit over the next 10 years. The tax plan hasrattled stock marketsin recent days as investors worry about the ballooning debt. Trump met personally with the GOP conference that morning, urging them to stop pushing for more changes andget behind the bill."Failure is simply not an option," House SpeakerMike Johnson, R-Louisiana, said after the meeting. More:Stocks fall, Dow down 800 points as bonds tank amid tax debate. Bitcoin hits fresh high. After several marathon days of negotiations, including a May 21 meeting at the Trump White House, Republican leadershipmade additional changesand enough lawmakers came on board to pass it. "What we're going to do here this morning is truly historic, and it will make all the difference in the daily lives of hard working Americans," Johnson said in a floor speech shortly before the bill passed. Democrats have slammed the bill as a giveaway to the wealthy at the expense of people who benefit from social safety net programs like Medicaid and SNAP. "This is one big, ugly bill that House Republicans are trying to jam down the throats of the American people under the cover of darkness," House Minority Leader Hakeem Jeffries, D-New York, said on the House floor. More:'Don't f--- around with Medicaid': Trump works to clear out GOP opposition to policy bill Still, it has a long way to go before it becomes law. The bill will next go to the Senate, which has already made clear that it plans to make changes. If that happens, the two chambers would still have to hash out the details capable of winning majority votes before they can send it to Trump's desk to be signed into law. The clock is ticking: Treasury Sec.Scott Bessent warnedthat the U.S. is likely to hit the debt ceiling in August, and urged lawmakers to finalize the package – which raises the debt ceiling by $4 trillion – before leaving for their summer recess at the end of July. The sweeping House billis expected to touch many corners of American life, from their wallets and healthcare to the southern border and the national debt. The 2017 Tax Cuts and Jobs Act, which lowered income tax rates for all income groups but disproportionatelybenefitted the highest earners, is set to expire at the end of 2025. The bill would make those tax rates permanent at an expected cost of more than $2 trillion over the next 10 years. The bill would also implement temporary tax breaks for tipped wages and overtime, create a new temporary deduction for the interest on loans for American-made cars, and create a new tax deduction for people over age 65. Children under 8 years old could also benefit from a new "Trump" savings account seeded with $1,000 from the federal government. Medicaid, the program that provides health insurance to more than 71 million low-income Americans, would undergobig changes. That includes new work requirements for adults enrolled in Medicaid expansion beginning in December of 2026, more frequent eligibility checks, and disincentives for states to cover unauthorized migrant children, among other provisions. Collectively, the Medicaid proposal would save at least $625 billion and cause 7.6 million Americans to lose their health insurance over the next 10 years, according to initial estimates by the nonpartisanCongressional Budget Office. More:How much do Americans rely on programs like Medicaid and Social Security? Trump warned Republicans who wanted to squeeze additional changes out of the health insurance program, telling them "Don't f‒‒‒ around with Medicaid," at a May 20 meeting. The proposal would also implementnew requirementsin the Supplemental Nutrition Assistance Program, known as SNAP or food stamps, which provides assistance to around 42 million Americans. That would save up to $300 billion over the next ten years and shift more of the cost of the program to states. The bill would put more than $140 billion toward Trump's plan to crack down on illegal immigration, including $50 billion for a border wall, $45 billion for detention centers, $8 billion for immigration officers and $14 billion for deportations. It would also put around $150 billion toward defense spending, including $20 billion that would go, in part, to creating a "Golden Dome" missile defense system that Trump has promoted. Residents of high-tax states like New York, California and New Jersey making under $500,000 will be able to claim a deduction of up to $40,000 on their federal returns for taxes paid to their state and local governments – which those holdout lawmakers pushed up from the initially-proposed $30,000. Right now, the cap on that deduction is $10,000. The bill would eliminate several green energy provisions passed under former PresidentJoe Biden, such as tax credits for electric vehicles and renewable energy, and would accelerate permitting for fossil fuel projects. Families could use new vouchers collectively worth billions dollars for education outside of public schools, such as for private schools, parochial schools or homeschooling. Meanwhile, private universities could face new taxes for large endowments. This article originally appeared on USA TODAY:Trump's deficit-swelling tax bill passes House
