Congress has signed off on a $3.4 trillion legislative package featuring new tax breaks, spending cuts, and more funding for defense and immigration enforcement, delivering President Donald Trump his “big, beautiful bill” despite rumblings from fiscal hawks about the projected $4 trillion it could add to the national debt over the next decade.

Sharp Medicaid cuts could result in vulnerable Americans no longer being able to receive care, either by losing coverage or by closing the centers that provide such care.