After weeks of back-and-forth over the details, President Trump’s “One Big, Beautiful Bill” is now poised to reach the Senate floor, following the passage of a key procedural vote over the weekend.
The vote passed 51-49 after a tense, hours-long standoff that included more than three hours of negotiations with key holdouts like Alaska Sen. Lisa Murkowski, who ultimately voted in favor of moving forward. In the end, only two Republicans broke ranks: Kentucky Sen. Rand Paul and North Carolina Sen. Thom Tillis, who recently announced he won’t seek a third term. In his announcement, Tillis likened himself to former Democratic Sens. Joe Manchin and Kyrsten Sinema — both of whom left the party and became independents by the end of their tenures.
The vote marked the start of a marathon effort to pass the bill through Congress and ultimately to Trump’s desk. But before the Senate debate could begin in earnest, Democrats slowed the process with a procedural move, demanding that all 940 pages of the bill be read aloud on the Senate floor. The reading stretched more than 15 hours and wrapped up Sunday afternoon.
The upper chamber has now entered up to 20 hours of debate, followed by a “vote-a-rama” — a rapid-fire series of unlimited amendment votes that could stretch well into the next day. Only after that can the chamber hold a final vote and send the bill back to the House, where significant differences between the two versions still need to be ironed out.
New cost estimates are already raising alarms. According to the Congressional Budget Office, the Senate’s version would result in deeper healthcare cuts — and more Americans losing coverage — than the House-passed bill.
So what’s actually in the legislation? Here’s a closer look at some of the key provisions.
Extending Trump-era tax cuts
A key focus of the bill is extending provisions from the 2017 Tax Cuts and Jobs Act. That law lowered tax rates for individuals across most income levels, though the largest benefits went to high earners and corporations.
Republicans argue the extension is essential to avoid a major tax hike for many households starting in January, when the individual tax cuts are set to expire. (The corporate tax cuts were made permanent in 2017.)
If the bill passes, those lower individual tax rates would be here to stay.
Medicaid cuts
To meet their budget goals, Republicans are proposing deep cuts and tighter eligibility rules for Medicaid, the federal health program that covers more than 70 million low-income and disabled Americans.
While Senate parliamentarian Elizabeth MacDonough struck several provisions from the bill late this week, not everything was scrapped. One measure that survived: a proposed 80-hour-per-month work requirement for Medicaid recipients, which the CBO estimates could put coverage at risk for millions.
Left on the cutting room floor were Medicaid funding boosts for Alaska and Hawaii — incentives aimed at winning over moderates like GOP Sen. Lisa Murkowski — as well as a Republican push to roll back Biden-era rules on Medicaid enrollment protections and nursing home staffing requirements, a move projected to save $23 billion. The parliamentarian also struck down a proposal to exempt additional orphan drugs — treatments for rare diseases that typically affect fewer than 200,000 people in the U.S. — from Medicare price negotiations.
Trump has since echoed calls to ignore the parliamentarian altogether, posting on Truth Social that “An unelected Senate Staffer (Parliamentarian) should not be allowed to hurt the Republicans’ Bill.”
Even so, some of the most heavily debated provisions stayed in. Measures restricting non-citizens from accessing Medicare and Affordable Care Act subsidies were allowed to stand. A separate proposal to block Medicaid funding for Planned Parenthood remains under review.
Taken together, the Senate’s version would result in sweeping changes to health coverage. A CBO report released late Saturday estimates that 11.8 million more people would become uninsured by 2034 — an even steeper loss in coverage than under the House bill. It also projects more than $1.1 trillion in cuts to Medicaid, Medicare, and the Affordable Care Act over the next decade, with over $1 trillion of those cuts hitting Medicaid alone.
Raise the debt ceiling
Think of the debt ceiling as the government’s credit limit — it’s the cap on how much the U.S. can borrow to cover bills it’s already racked up. The Senate’s bill would raise that limit by $5 trillion, even as the CBO estimates the package would add $3.3 trillion to the national debt over the next decade.
Technically, the government hit the cap at the end of 2024, but the Treasury Department has been using so-called “extraordinary measures” to keep things running without adding new debt. Those workarounds are expected to run out by August.
On Friday, Treasury Secretary Scott Bessent declined to provide a specific deadline, marking a noticeable shift from how past administrations have handled similar situations.
Rural hospital bailout fund
To offset the expected drop in Medicaid funding, the Senate bill includes a proposed $25 billion Rural Hospital Transformation Fund — a notable jump from the $15 billion previously offered by Senate GOP leadership to appease a group of Medicaid-focused moderates, including Maine Sen. Susan Collins and Missouri Sen. Josh Hawley.
The fund is designed to stabilize struggling rural hospitals and health clinics and would launch in 2028 — the same year new provider tax policies take effect. It’s set to expire in 2032.
Raising the SALT Deduction Cap
The package includes a temporary increase to the cap on the state and local tax deduction, which allows taxpayers to deduct what they pay in state and local taxes from their federal tax bill. The cap would rise from $10,000 to $40,000 for five years before reverting to $10,000. That’s a significant shift from current law, which capped the deduction at $10,000 under Trump’s 2017 tax law. The change is expected to reduce the approximately $350 billion price tag of the House plan by at least $100 billion.
The SALT deduction has long been a politically divisive issue. Critics argue that expanding it disproportionately benefits high-income earners in wealthier states, while supporters — including several blue-state Republicans — say it’s essential for protecting their constituents from double taxation. In fact, some GOP lawmakers in high-tax states, such as California and New York, have warned they won’t support the broader bill without the SALT expansion.
Restricting food stamps
The legislation would shift the full cost of the Supplemental Nutrition Assistance Program from the federal government to individual states — potentially forcing local officials to either cut benefits or dip into state and municipal budgets to make up the difference.
Some states, including Alaska and Hawaii, would receive temporary exemptions from this cost-sharing requirement. Both could qualify for a two-year reprieve if the Department of Agriculture determines they are “actively implementing a corrective action plan.”
Like the House version, the Senate’s proposal would also raise the age range for SNAP work requirements — expanding it from ages 18-54 to 18-64 — with some exemptions for parents. All told, the CBO estimates that under this version, 3 million people wouldn’t qualify for food stamps.
Savings accounts for newborns
Expecting a child? The Senate bill includes a proposal to establish a $1,000 savings account for every newborn, with the option for parents or beneficiaries to contribute up to $5,000 annually until the child turns 31.
The concept isn’t entirely new — it closely resembles a proposal from Democratic Sen. Cory Booker, known as “baby bonds,” which aims to build generational wealth.
Billions for the border wall and other barriers
Much like the House-passed version, the Senate bill would allocate $46.5 billion to complete Trump’s border wall. It also includes $5 billion for Customs and Border Protection facilities and another $10 billion for broader border security measures.
Compared to the House plan, the Senate version allocates less funding for hiring and retaining border agents and officers — $4.1 billion versus $6 billion. The bill also invests in upgraded technology to enhance screening and surveillance at U.S. borders.
New immigration fees
The Senate bill proposes a series of new or increased fees tied to immigration services. One provision would introduce a $550 fee for work authorization applications, with renewals required every six months.
Not everything made the cut. The Senate parliamentarian struck down a proposed $1,000 fee for asylum applications, saying it didn’t qualify under the rules of budget reconciliation — the process that lets certain legislation pass with just a simple majority, or 51 votes, instead of the usual 60 needed to break a filibuster.
