Congress passes “One Big Beautiful Bill,” extending tax cuts and cutting social safety net
On July 4, Congress passed a major legislative package known as the "One Big Beautiful Bill," extending Trump-era tax cuts, tightening Medicaid work requirements, and increasing spending on defense and border enforcement. The Congressional Budget Office projects it will add approximately $3.3 to $3.4 trillion to the national debt over the next decade. Former Treasury Secretary Larry Summers criticized the legislation as a "shameful act" that could substantially weaken the safety net. Analysts warn that up to twelve million Americans could lose Medicaid access, and some estimate up to 100,000 preventable deaths may occur over ten years due to reduced healthcare coverage.
On July 4, Congress passed a sweeping legislative package officially titled the "One Big Beautiful Bill," a name promoted by supporters of former President Donald Trump. The legislation is one of the most consequential fiscal policy packages in recent years, combining tax relief, increased security funding, and major reforms to federal assistance programs. At its core, the bill extends Trump-era tax cuts for individuals and corporations, which were originally set to expire in 2025. Supporters argue this will boost business investment and consumer spending, but critics note that the benefits are heavily skewed toward higher-income earners and large companies.
The bill also imposes stricter work requirements for Medicaid eligibility, particularly affecting low-income adults without dependents. Under the new rules, recipients in many states must prove consistent employment or job-seeking activities to maintain coverage. Health policy experts and public health advocates have expressed deep concern about this provision, warning that millions of vulnerable Americans could lose access to healthcare. The Congressional Budget Office estimates that as many as twelve million people may be removed from Medicaid rolls as a result of the changes.
In addition to domestic economic policy, the bill significantly boosts federal spending in areas such as defense, border security, and immigration enforcement. It authorizes increased funding for military modernization, border wall infrastructure, and the hiring of additional Customs and Border Protection agents. These provisions align with long-standing priorities of Trump-aligned lawmakers, many of whom view national security as a key campaign issue heading into the 2026 midterm elections.
The total projected cost of the bill is staggering. According to the nonpartisan Congressional Budget Office, the package will add between $3.3 and $3.4 trillion to the national debt over the next ten years. This estimate has sparked concern across the political spectrum, particularly among fiscal conservatives and economists. Former Treasury Secretary Larry Summers publicly criticized the legislation, calling it a “shameful act” that sacrifices long-term stability for short-term political gain. He and others have warned that such a large deficit increase could weaken the U.S. economy, drive up interest rates, and reduce the government’s ability to respond to future crises.
Healthcare analysts are especially alarmed. In public statements and policy briefs, several experts predict that the Medicaid restrictions, if not reversed, could contribute to tens of thousands of preventable deaths over the next decade. One estimate suggests that as many as 100,000 people could die from treatable or manageable conditions due to a loss of consistent healthcare access. Critics argue that the bill effectively trades healthcare for tax breaks, a move they view as fundamentally unjust and out of step with the needs of working-class Americans.
Despite these criticisms, the bill passed largely along party lines, with most Republican lawmakers supporting it and most Democrats voting against. It now heads to President Trump’s desk for signing, where it is expected to become law within days. The bill’s passage marks a major legislative victory for the former president and his allies—but one that is sure to be debated fiercely in the months and years ahead.
