House Republicans are on the verge of passing legislation that is projected to strip health coverage and food aid from millions of people across the United States, all to pay for tax breaks that will flow disproportionately to a small sliver of rich Americans.
The final vote on the sprawling budget reconciliation package, which narrowly passed the Senate on Tuesday, is expected Thursday after hours of jockeying among Republican leaders and holdovers in the GOP's ranks overnight. Republicans finally cleared a procedural hurdle to begin debate on the measure after 3 am ET on Thursday.
If Republicans are so proud of their Big Bad Betrayal Bill... why did they begin debate at 3:28 am?" asked Rep. Pramila Jayapal (D-Wash.). "Why are they hiding from the American people?"
House Minority Leader Hakeem Jeffries (D-N.Y.) delayed the final vote on the bill with an hours-long—and, as of this writing, still ongoing—speech that featured stories from constituents who are horrified that they will soon lose health coverage or food aid.
"This isn't abstract, taking away healthcare from the American people," said Jeffries. "It's concrete, it's real, it has devastating implications."
The unpopular legislation that set to clear the House Thursday is substantially more expensive than the version the chamber's Republicans approved in May, and it includes roughly $300 billion more in cuts to Medicaid. The bill now heads to the desk of U.S. President Donald Trump, who has repeatedly pledged not to cut Medicaid.
Analysts estimate that over the next 10 years, roughly 17 million Americans will lose health coverage under the GOP package, both due to the measure's Medicaid cuts and its failure to extend Affordable Care Act subsidies set to expire at the end of the year.
The bill's assault on Medicaid—including its restriction on states' use of provider taxes to fund their programs—is expected to ravage rural hospitals, notwithstanding Republicans' last-ditch attempt to put a Band-Aid on the massive wound they're set to create.
The legislation would also trigger more than $500 billion in automatic cuts to Medicare due to its multitrillion-dollar addition to the deficit.
One recent study estimated that the bill's healthcare cuts would result in more than 51,000 additional, preventable deaths across the U.S. each year.
"The decision we have been entrusted by the American people to make will have ramifications for millions of our fellow Americans, and indeed for our country, for decades to come," Rep. Brendan Boyle (D-Pa.), the top Democrat on the House Budget Committee, said in floor remarks early Thursday.
"In just a few short hours, some of them on Medicaid will be waking up and turning on the news to find out if what we did here tonight means they're about to lose it," said Boyle. "Some of the people who get their healthcare from the ACA exchanges will be turning on their TV to find out what we've done in these next few minutes, and if they will still be able to have healthcare... The kids who rely on SNAP, the nutrition assistance program, they may not quite understand it, but make no mistake about it—what we are about to do in the next few minutes here will have a profound effect on their lives."
The GOP bill proposes $186 billion in Supplemental Nutrition Assistance Program cuts over the next decade, which analysts say will imperil benefits for millions—including many children. The Center on Budget and Policy Priorities estimates that around 1 million children "would see food assistance to their families cut substantially or terminated" due to the legislation's SNAP cuts, including its expanded work requirements.
The measure's unprecedented cuts to the safety net, as well as clean energy programs, will only partially offset its trillions of dollars in tax cuts. According to the Institute on Taxation and Economic Policy (ITEP), more than 70% of the legislation's net tax breaks "would go to the richest fifth of Americans in 2026, only 10% would go to the middle fifth of Americans, and less than 1% would go to the poorest fifth."
"The effects of President Trump's tariff policies alone offset most of the tax cuts for the bottom 80% of Americans," ITEP found. "For the bottom 40% of Americans, the tariffs impose a cost that is greater than the tax cuts they would receive under this legislation."
Rep. Gabe Amo (D-R.I.) said in a floor speech early Thursday that "budgets are statements of values," and Republicans "are showing they have none."
"People will suffer, people will die, and it will be the hands of Republicans who vote yes," said Amo. "The top 1% are salivating over getting an extra $300,000 a year because of this dangerous bill. Billionaires win."
Ahead of the bill's final passage, state leaders warned that the cuts pushed by Republican lawmakers could be deeply destructive to their residents and economies.
"Voices across North Carolina are sounding the alarm—our hospitals, healthcare providers, county leaders, state leaders, business leaders, workers, nonprofits, and, most importantly, the people who rely on these essential services and industries every day," North Carolina Gov. Josh Stein wrote in a letter to his state's congressional delegation on Wednesday. "Many North Carolinians are worried about feeding their families, being able to continue seeing their doctor, or keeping their jobs. We are united in our concern that this reconciliation bill would undo decades of bipartisan progress and harm the health, well-being, and economic security of our individuals, families, and communities."