House Passes Trump’s ‘Big Beautiful Bill’ 218–214 After Fierce Medicaid Clash

The U.S. House of Representatives narrowly approved President Donald Trump’s sweeping “Big Beautiful Bill” on 3 July, passing it 218–214 with all Democrats opposed and Republican Representatives Thomas Massie and Brian Fitzpatrick breaking ranks. The measure combines extensive tax reductions with major changes to federal social-welfare programs and border security funding.

According to details outlined during debate and after the vote, the legislation would end federal taxes on tips and deliver roughly $1 trillion in tax relief that Democrats say is tilted toward high-income households. It earmarks more than $45 billion for additional border-wall construction and expanded resources for Immigration and Customs Enforcement and the Border Patrol.

To offset those costs, the bill cuts Medicaid by about $1 trillion, adds work requirements and funding caps to the Supplemental Nutrition Assistance Program, and pares other safety-net programs. Opponents estimate up to 17 million people could lose health coverage if the plan becomes law.

Democrats condemned the package. Representative Alexandria Ocasio-Cortez called the vote “one of the saddest days in modern American history,” arguing that it “strips away healthcare and basic dignity” and will leave “people … hungry.” Senator Bernie Sanders said the bill represents the largest Medicaid cut in U.S. history and predicted 51,000 additional deaths annually because of lost coverage.

Republican leaders framed the legislation as a pro-growth overhaul and victory for middle-class taxpayers. The measure now moves to the Senate, where opposition from several moderates to the depth of the Medicaid reductions could complicate its prospects.