'Big Beautiful Bill' Passed By House: What It Means For MA

MASSACHUSETTS — President Trump's "big beautiful bill" was passed by the U.S. House of Representatives Thursday, a major victory for MAGA's landmark legislation that could eliminate health insurance for millions while providing huge tax breaks for the wealthy and increasing inequality.

The latest vote tally is 218-214, with one person left to cast their vote. One of the final Republican dissenters was from Pennsylvania, Bucks County's Rep. Brian Fitzpatrick. The other was Kentucky Rep. Thomas Massie.

The One Big Beautiful Bill Act has been uniformly vilified by Democrats and faced significant pushbacks from segments of the Republican Party, whom Trump threatened with the removal of his support in their primary races if they did not "fall in line." The fraught passage represents a major, if deeply divisive, victory for the Trump administration in advancing their vision for the nation, and is the first big legislative win of Trump's second term.

The bill, which provides huge tax relief to the wealthiest Americans while cutting services for the poorest, was championed by several major corporations, including Delta, Uber, Comcast, Verizon, Dell, and 3M.

Fitzpatrick said he supported middle class tax cuts, but that damaging Medicaid amendments swayed his decision.

"It was the Senate’s amendments to Medicaid, in addition to several other Senate provisions, that altered the analysis for our PA-1 community," Fitzpatrick said. "The original House language was written in a way that protected our community; the Senate amendments fell short of our standard. I believe in, and will always fight for, policies that are thoughtful, compassionate, and good for our community. It is this standard that will always guide my legislative decisions."

In Massachusetts, the biggest impact for residents could be the proposed cuts to Medicaid, which would leave some 10 million nationwide without health insurance. Massachusetts is home to 2.1 million Medicaid enrollees.

“No one voted to kick 17 MILLION people off their health care. No one voted to RAISE the cost of groceries. No one voted to give handouts to BILLIONAIRES. Donald Trump and Republicans just sold out working people. This is a gut punch — but we will NOT stop fighting back,” Senator Elizabeth Warren said in a statement on X.

At least 3 percent of those enrollees would fully lose health coverage with the passage of the bill, according to KFF, an independent source for health policy research. Somewhere between 260,000 and 430,000 residents would be negatively impacted, KFF says.

Gov. Shapiro said his office calculated that exact number of residents who would lose Medicaid access to about 310,000, while around 200,000 would lose access to state's health care marketplace, and 140,000 would lose access to SNAP.

The White House argues that the tax cuts would return money to the pockets of Massachusetts families. Homes that fall within the median-income bracket would get back somewhere between $9,400 and $16,400 in take-home pay annually, according to the Trump administration.

Tax breaks, however, disproportionately benefit the wealthiest and significantly increase existing inequalities, providing massive savings for the top income tiers while returning comparatively small amounts to lower income homes. Middle and lower income residents also make up nearly all of the individuals impacted by the cuts of key services, like Medicaid.

U.S. Sen. John Fetterman, who has waffled on a wide variety of issues he once championed in a former life as a progressive stalwart, also condemned it.

"Not one single Democrat will vote for the 'big beautiful bill,'" he said. "I’m here to vote on these amendments and keep the ball rolling. I’m a HARD NO on the final bill and won’t support cutting Medicaid, SNAP or adding up to $5T to our national debt."

While it's a foregone conclusion that Fetterman is right about Democratic support for the bill, the more compelling storyline is the support of middle of the ground Republicans whose identity goes beyond MAGA.

Drama in the House

House Democratic leader, Hakeem Jeffries, used his "magic minute" on the House floor to speak out against Trump's bill, calling it an "all-out assault" on ordinary Americans.

"I feel the obligation, Mr. Speaker, to stand on this House floor and take my sweet time to tell the stories of the American people and that's exactly what I intend to do," Jeffries added. "Take my sweet time on behalf of the American people."

The bill would be an extension of the 2017 tax cuts from Trump's first term, which are set to expire after December.

The more than 1,000-page bill also includes many of Trump's 2024 campaign promises, including no tax on tips and overtime wages. At around 3:30 a.m. on Thursday, House Speaker Mike Johnson announced he had secured enough votes to move the bill along in a sign it should pass later in the day.

The Bill

The 1,200‑page package includes:

• A permanent extension to the 2017 Trump tax cuts, while exempting overtime pay, tips and some Social Security income from taxation.
• 80‑hour‑per‑month work requirements on many adults receiving Medicaid and enforce existing SNAP work rules to additional beneficiaries.Repealing most clean‑energy tax credits created under the previous administration.
• Approval for a $40 billion border security surge and funding for a nationwide deportation effort.
• Raising the federal debt ceiling by $5 trillion.

Tax Cuts

• An estimated $4.5 trillion in tax cuts
• The existing tax rates and brackets would become permanent. Temporary new tax breaks that Trump campaigned on: no taxes on tips, overtime pay, the ability to deduct interest payments for some automotive loans, along with a $6,000 deduction for older adults who earn no more than $75,000 a year.
• $2,000 child tax credit is raised to $2,200. Millions of families at lower income levels, however, would not get the full credit.
• State and local deductions caps, called SALT, would quadruple to $40,000 for five years.
• Certain businesses will be able to immediately write off 100% of the cost of equipment and research.
• Wealthy households would see a $12,000 increase from the legislation, also costing the poorest people $1,600 a year, according to the nonpartisan Congressional Budget Office analysis of the House’s version.
• Middle-income citizens would see a break of $500 to $1,500, the CBO said.

Border Security

More than $140 billion towards the efforts to crack down on illegal immigration:

• $50 billion for the border wall
• $45 billion for detention centers$8 billion towards compensating immigration officers
• $14 billion towards the costs of deportations

Medicaid

Budget that would cap how much states can collect in hospital assessment fees used to draw federal Medicaid matches, significantly reducing Medicaid spending to help pay for an extension of expiring tax cuts.

Medicaid is the primary program providing comprehensive health and long-term care to one in five people in the United States and accounts for nearly $1 out of every $5 spent on health care. It is administered by states within broad federal rules and jointly funded by states and the federal government. Restrictions in federal spending could leave states with tough choices about how to offset reductions

National Debt

According to the nonpartisan Congressional Budget Office, the bill would increase the U.S. deficit by $2.4 trillion through 2034 if passed. The Senate's version of the bill also raises the U.S. debt ceiling by $5 trillion, the largest increase in American history.

The Lead Up

On Tuesday, Vice President JD Vance broke a 50-50 tie in the Senate to pass the bill after three Republicans had defected. An original version passed in the House by a narrow margin in May, where it was now being reconciled for final approval.

A handful of Republicans have joined Democrats in being vocal about their opposition of some of the issues over the last few months. Marjorie Taylor Greene of Georgia has been critical of the bill because it includes a provision that would ban states from regulating artificial intelligence. On Steve Bannon's War Room podcast, she said that the fight to stop the bill's passage was "far from over" and said "there's no way" it would pass in the House.

She has since voted in favor of advancing the bill.

In the hours leading up to Thursday's House vote, President Trump relayed his thoughts on Truth Social, writing: "Largest Tax Cuts in History and a Booming Economy vs. Biggest Tax Increase in History, and a Failed Economy. What are the Republicans waiting for??? What are you trying to prove??? MAGA IS NOT HAPPY, AND IT'S COSTING YOU VOTES!!!"

The bill now awaits Donald Trump's signature.

See Also:

• Which Boston TV, Radio Stations Will Lose Funding Under New Trump Order?
• These MA Industries Hit Hardest In Tit-For-Tat U.S.-China Trade War
• New Trump Tariffs: What MA Residents Need To Know

With reporting from Patch correspondent Eddie Callahan