A controversial budget bill championed by President Donald Trump is under intense scrutiny after a new Congressional Budget Office (CBO) analysis revealed it could strip health insurance from nearly 12 million Americans and add $3.3 trillion to the national debt.
Dubbed the “One Big Beautiful Bill Act,” the sweeping legislation narrowly passed a procedural vote in the Senate late Saturday, 51–49, with Republicans Thom Tillis (North Carolina) and Rand Paul (Kentucky) breaking ranks. Tillis later announced he would not seek reelection, citing concerns about healthcare funding impacts in his state.
The bill proposes $1 trillion in healthcare cuts, largely targeting Medicaid, a vital safety net for low-income, elderly, and disabled Americans. It introduces work requirements for recipients and reduces federal support for state-run programs, shifting some costs to states beginning in 2028.
Democrats have fiercely opposed the bill, calling it a giveaway to the wealthy at the expense of vulnerable populations. “This is tax cuts for the wealthiest to end up cutting healthcare, plain and simple,” said Democratic Senator Mark Warner.
Under the proposal, over 80% of Americans would receive tax cuts next year, but the wealthiest would benefit the most proportionally, according to the Tax Policy Center. Key provisions include deductions on Social Security benefits and eliminating taxes on overtime and tips, while extending 2017 tax breaks.
The bill also restricts food stamp eligibility by requiring most adults with children over 14 to show proof of work. Meanwhile, a rural hospital relief fund was expanded from $15 billion to $25 billion to address GOP concerns about access to healthcare in less urbanized regions.
Republicans hold 53 Senate seats and can afford no more than three defections. Vice President JD Vance stands ready to cast a tie-breaking vote if needed.
Democrats, leveraging Senate rules, forced a 16-hour reading of the nearly 1,000-page bill to delay progress. They are expected to use the full 20-hour debate allocation to stall a final vote, while Republicans push for swift passage ahead of Trump’s self-imposed July 4 deadline.
Despite the political tension, Trump hailed the Senate’s advancement of the bill as a “great victory.” The White House has warned that failure to pass the legislation would be “the ultimate betrayal.”
While some Republican lawmakers defend the bill as an effort to eliminate fraud and encourage work, its impact on healthcare and rising debt has sparked sharp national debate , with the final Senate vote hanging in the balance.
