U.S. Senate passes Trump's 'big, beautiful' bill, what's next?

U.S. Senate Republicans passed President Donald Trump's massive tax-and-spending bill on Tuesday by the narrowest of margins, advancing a package that would slash taxes, reduce social safety net programs and boost military and immigration enforcement spending while adding $3.3 trillion to the national debt.

The bill passed narrowly by 51 to 50, with U.S. Vice President JD Vance casting the deciding ballot. Three Republicans were the only GOP lawmakers to vote no: Thom Tillis of North Carolina, Susan Collins of Maine and Rand Paul of Kentucky.

The vote followed an all-night debate in which Republicans grappled with the bill's price tag and its impact on the U.S. healthcare system.

The legislation now heads to the House of Representatives, where Republicans hold a 220-212 majority, for possible final approval, though a handful of Republicans there have already voiced opposition to some of the Senate provisions.

Trump wants to sign it into law by the July 4 Independence Day holiday, and House Speaker Mike Johnson said in a statement that he aimed to meet that deadline.

Who will benefit? Who will lose?

The Senate bill would deliver some of its biggest benefits to the top 1 percent of U.S. households, earning $663,000 or more in 2025, according to the Tax Foundation. These high earners would gain the most from the bill's tax cuts, the nonpartisan Congressional Budget Office (CBO) has said.

The measure would extend Trump's 2017 tax cuts, give new tax breaks for income from tips and overtime pay and increase spending on the military and immigration enforcement.

It also would cut about $930 billion of spending on the Medicaid health program and food aid for low-income Americans and repeal many of Democratic former President Joe Biden's green-energy incentives.

CBO forecast that nearly 12 million more people would become uninsured under the Senate plan.

The legislation, which has exposed Republican divides over the nation's fast-growing $36.2 trillion debt, would raise the federal government's self-imposed debt ceiling by $5 trillion. Congress must raise the cap in the coming months or risk a devastating default.

Besides, the bill's increase in the national debt effectively serves as a wealth transfer from younger to older Americans, nonpartisan analysts have said.

The final Senate bill included two provisions: one that sends more food-aid funding to Alaska and several other states, and another providing $50 billion to help rural hospitals cope with the sweeping cuts to Medicaid.

'Largest assault on American healthcare in history'

Republicans have struggled to balance conservatives' demands for deeper spending cuts to reduce the impact on the deficit with moderate lawmakers' concerns that the Medicaid cuts could hurt their constituents, including service cutbacks in rural areas.

"There's a significant number who are concerned," Republican Representative Chip Roy said of the Senate bill.

A group of more moderate House Republicans, especially those who represent lower-income areas, have objected to the steeper Medicaid cuts in the Senate's plan.

Senate Democratic Leader Chuck Schumer said the vote "covered this chamber in shame," adding that the bill would be "ripping health care away from millions of Americans, taking the food out of the mouths of hungry kids."

"This is the largest assault on American healthcare in history," House Democratic Leader Hakeem Jeffries told reporters. "It's the largest assault on nutrition in American history."

Republicans rejected the cost estimate generated by CBO and have argued the Medicaid cuts would only root out "waste, fraud and abuse" from the system.

Following the vote, Senate Majority Leader John Thune said the bill "will permanently extend tax relief for hard-working Americans...that will spur economic growth and more jobs and opportunities for American workers."

Meanwhile, Republicans have faced separate concerns from a handful of House Republicans from high-tax states, including New York, New Jersey and California, who have demanded a larger tax break for state and local tax payments.

The legislation has also drawn criticism from billionaire Elon Musk, the former Trump ally who has railed against the bill's enormous cost and vowed to back challengers to Republican lawmakers in next year's midterm elections.

(With input from agencies)