House Republicans have unveiled what they’re calling the cost-cutting centerpiece of Donald Trump’s proposed “big, beautiful bill”—but it comes with a price tag that millions of Americans may feel directly.
The legislation drops a staggering $880 billion in proposed cuts, largely targeting Medicaid, all to help foot the bill for $4.5 trillion in tax breaks, renewing Trump’s 2017 tax overhaul. The bill, revealed Sunday night, has already triggered the biggest health care fight since the GOP’s failed Obamacare repeal in 2017.
The bill proposes new work requirements, eligibility verifications, and out-of-pocket costs for Medicaid recipients. While Republicans argue these measures are necessary to reduce “waste, fraud, and abuse,” Democrats say the plan could strip health coverage from more than 8.6 million people—including families, seniors, and working-class Americans.
“This is shameful,” said Rep. Frank Pallone of New Jersey. “Millions will lose coverage. Hospitals will close. Seniors will suffer.”
The GOP plan would require able-bodied adults without dependents to work or participate in job training programs at least 80 hours a month to qualify for Medicaid. Verification would also jump from once to twice a year, and households with homes valued over $1 million would be barred from enrolling.
The bill even takes aim at states that provide Medicaid to undocumented immigrants, proposing a 10% cut in federal contributions to those programs and requiring proof of lawful presence for Affordable Care Act (ACA) eligibility.
Meanwhile, House Speaker Mike Johnson is racing toward a Memorial Day deadline to get Trump’s full bill passed—bundling tax breaks, health care cuts, and energy rollbacks into one sweeping package.
Trump himself has been quiet about the Medicaid cuts, vowing during his campaign that he wouldn’t touch the program. And some Republicans aren’t on board either. Senator Josh Hawley called the plan “morally wrong and politically suicidal.”
Still, House Republicans say this is about fiscal responsibility—and covering the cost of extending Trump’s tax breaks before they expire.
The final bill is expected to merge proposals from 11 House committees, including cuts to Biden-era green energy programs and new rules for oil and gas development.
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