The Republicans who control the U.S. House handed President Donald Trump a political victory -- and U.S. House Speaker Mike Johnson, a lifeline -- as they approved the White House's massive tax cuts and immigration agenda early Thursday morning.
Closer to home in Massachusetts, however, Trump's "One Big Beautiful Bill" could have sweeping impacts as it slashes $1 trillion over 10 years to such key social safety net programs as Medicaid, Medicare and the Supplemental Nutrition Assistance Program (SNAP), more widely known as "Food Stamps."
"The legislation passed [Thursday] morning by the Republican majority in the House of Representatives will make Americans sicker, billionaires richer and our children poorer. I voted against it," U.S. Rep. Seth Moulton, D-6th District, said in a statement reflecting the sentiment of the state's all-Democrat delegation on Capitol Hill.
U.S. Rep. Ayanna Pressley, D-7th District, offered a similar sentiment, saying in a scathing statement that the bill "would rip food out of the mouths of families already struggling to put meals on the table."
"It would decimate health care in America and worsen our maternal health crisis. It would gut mental health funding ... and cut cancer research, putting lives at risk and turning its back on people struggling with addiction, mental health crises, cancer diagnoses and much, much more," the Boston lawmaker said.
But before we go on, one big caveat:
The bill, which passed by a one-vote margin, still has a long way to go before it gets over the finish line. It still has to be approved by the U.S. Senate, where it will be amended, and then return to the U.S. House, before it finally lands on Trump's desk.
Still, the bill further complicates an already complicated budget picture for Massachusetts lawmakers and Democratic Gov. Maura Healey.
The state's annual fiscal document is premised on $16 billion in federal funding. In all, the state gets nearly $23 billion from Washington annually.
Policymakers across Beacon Hill have warned for weeks that the state doesn't have the cash reserves to make up for the lost federal funding. And the state Senate's top budget-writer has ruled out dipping into the state's Rainy Day Fund to make up for any reduction in support from Washington.
As it's currently written, the bill will cut federal funding for SNAP -- which helps low-income people purchase groceries -- by about $267 million over 10 years, according to The Hill.
States would shoulder 5% of benefit costs, beginning in fiscal 2028, and 75% of the administrative costs. Currently, states pay for none of the benefits and half of the administration costs.
Republicans are expanding the work requirements to receive food aid.
Under current law, able-bodied adults without dependents must fulfill work requirements until they are 54, and that would change under the bill to age 64.
Also, some parents are currently exempt from work requirements until their children are 18; that would change, so only those caring for a dependent child under the age of 7 are exempt.
The Healey administration sounded the alarm on the cuts last week, warning they could cost the state up to $710 million a year and affect 1 million residents from Boston to the Berkshires.
"The federal government and states have spent decades building and running the SNAP program in partnership at the current cost structure," Healey wrote to the top Republicans and Democrats on the U.S. House and Senate Agriculture committees.
"To shift it at this scale will decimate trust in a longstanding program that supports vulnerable families and strengthens local economies," the Democratic governor wrote.
Statewide, 236,000 people stand to lose benefits under the bill, according to an analysis by the left-leaning Center for American Progress. Massachusetts had a population of 7.1 million people as of 2024, according to the U.S. Census.
There are also new rules for Medicaid, which serves low-income people, children and people living with disabilities. The joint state/federal program is known as MassHealth in the Bay State.
The House-passed bill reduces Medicaid spending by $700 million, according to an analysis by the Congressional Budget Office.
People looking to qualify for benefits would face "new "community engagement requirements" of at least 80 hours per month of work, education or service for able-bodied adults without dependents.
The new requirement would not kick in until Jan. 1, 2029, after Trump leaves office. People would also have to verify their eligibility for the program twice a year, rather than just once.
MassHealth accounts for 37% of total general fund spending in the $61.3 billion budget blueprint that Massachusetts Senate Democrats rolled out earlier this month. More than 2 million people were enrolled in the sprawling health insurance program as of May 2024, state data show.
State Senate budget-writers have insisted that they'll move ahead with their spending plan with the money they have, not the money they wish they had. But "all bets are off" if Medicaid funding is reduced in the final version of the federal legislation.
MassHealth would be "unsustainable without the federal partnership, the federal funds," Michael Curry, the president and CEO of the Massachusetts League of Community Health Centers, told Commonwealth Beacon ahead of the vote.
"So, you cut programs, right? You might cut benefits, right? Oral health under Medicaid is an optional program, optional coverage. And states like Massachusetts could choose to not cover oral health, which means that that's an implication for health centers [which also provide dental care], because now our patients couldn't go and get coverage or care, then have their insurance provide the health center with reimbursement for their oral health" Curry told the online news org.
The bill would add so much to the national debt that it also could force nearly $500 billion in cuts to Medicare, which serves older Americans, beginning in 2026, The Washington Post reported, citing a report by the nonpartisan Congressional Budget Office.
Democrats on Capitol Hill and their allies warned that such a reduction would strip coverage for older adults and people living with disabilities.
"This Republican budget bill is one of the most expensive -- and dangerous -- bills Congress has seen in decades. The nonpartisan CBO makes it clear: The deficit will explode so badly it will trigger automatic cuts, including over half a trillion dollars from Medicare," U.S. Rep. Brendan Boyle, D-Pa., the top Democrat on the House Budget Committee, said.
U.S. Rep. Katherine Clark, D-5th District, ripped into Trump in a post to X, asserting that the Republican president "promised not to touch Medicare. 24 hours and a half a trillion dollars later, Republicans passed a bill that will slash Medicare."
"There's no line they won't cross," Clark, the No. 2 Democrat in the House, wrote.
More than 1.4 million of the state's 7.1 million residents were Medicare beneficiaries in 2024, according to KFF, a health news website.
In all, 200,000 people statewide could lose health coverage by 2034 because of the Republican cuts, that same Center for American Progress analysis concluded.
This one's a big one for Massachusetts, a state whose economy is fired, in large part, by its wealth of private colleges and universities, and its public higher education institutions.
The bill calls for a wholesale revamping of the student loan program, resulting in $330 billion in budget cuts and savings.
The proposal would replace all existing student loan repayment plans with just two: a standard option with monthly payments spread out over 10 to 25 years and a "repayment assistance" plan that is generally less generous than those it would replace.
Among other changes, the bill would repeal Biden-era regulations that made it easier for borrowers to get loans canceled if their colleges defrauded them or closed suddenly.
Republicans are looking to make permanent the individual income and estate tax cuts passed in Trump's first term, in 2017, plus enact promises he made on the 2024 campaign trail to not tax tips, overtime and interest on some auto loans.
To partially offset the lost revenue, Republicans propose repealing or phasing out more quickly the clean energy tax credits passed during Joe Biden's presidency, helping to bring down the overall cost of the tax portion to about $3.8 trillion.
Repealing those clean energy credits could affect 1,171 jobs statewide, according to the Center for American Progress analysis.
The bill includes a temporary boost in the standard deduction -- a $1,000 increase for individuals, bringing it to $16,000 for individual filers, and a $2,000 boost for joint filers, bringing it to $32,000.
The deduction reduces the amount of income that is actually subject to income tax.
There is also a temporary $500 increase in the child tax credit, bringing it to $2,500 for 2025 through 2028. It then returns to $2,000 and will increase to account for inflation.
The estate tax exemption rises to $15 million and is adjusted for inflation going forward.
Because the bill piles up so much debt, it could drive up the cost of living for ordinary Americans.
The bill would add another $3.8 trillion to a national debt that's already an eye-watering $36 trillion, CNN reported, citing Congressional Budget Office estimates.
And the "more leveraged that investors believe the federal government to be, the more they will likely demand in compensation in the form of higher interest rates. And that has significant consequences," CNN reported.
And that could trickle down to higher borrowing costs for ordinary Americans for homes, cars and higher education, according to CNN. It would also make it harder for businesses to expand and to hire more workers.
"This bill is a disgrace, and the American people will not forget who is responsible for driving up costs and making their lives more difficult," U.S. Rep. Stephen Lynch, D-8th District, said in a statement.