Republicans tax bill will cut $1 trillion from Medicaid and Affordable Care Act insurance plans. Nearly 12 million people to lose health insurance.

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.

After weeks of deliberation, the Senate passed its version of the Trump tax bill on Tuesday. In the approved package, there are several major changes to Medicaid, which would lead to deeper spending cuts than the version passed by the House.