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.

It also takes aim at Medicaid, the federal and state health program that covered 78.6 million low-income children and adults as of March 2025, according to the Centers for Medicare & Medicaid Services.

Supporters of the sweeping tax and spending legislation that Congress has sent to President Donald Trump say the changes to Medicaid, food aid and other programs will encourage personal responsibility and halt those scamming the system.