House Republicans on Thursday morning passed their sprawling budget reconciliation package after making last-minute changes to the legislation to mollify far-right hardliners.
The final count was 215-214, with every Democrat voting no and Rep. Andy Harris (R-Md.)—chairman of the House Freedom Caucus—voting present. The bill runs over 1,100 pages.
Earlier Thursday, the House voted to begin floor debate on the legislation after the GOP-controlled rules panel approved a slew of amendments to the bill, including a change that would move up the start date of draconian Medicaid work requirements to December 31, 2026—resulting in even bigger cuts to the program and more people losing coverage. Under an earlier version of the legislation, the work requirements would have taken effect at the start of 2029.
The updated bill would also "give states a financial incentive not to expand" Medicaid coverage under the Affordable Care Act "to people with higher incomes than traditional enrollees, though still near the poverty line," Politicoreported.
If enacted, the House GOP's legislation would slash roughly $1 trillion combined from Medicaid and the Supplemental Nutrition Assistance Program (SNAP), potentially stripping health coverage and food aid from tens of millions of low-income Americans to help fund trillions of dollars in tax cuts that would disproportionately benefit the wealthiest.
The bill would also trigger cuts to Medicare.
A Congressional Budget Office analysis released earlier this week showed that U.S. households in the bottom 10% of the income distribution would be worse off if the House Republican bill became law, while the top 10% would end up wealthier.
"Let's call this what it is—theft," said Rep. Jim McGovern (D-Mass.), the ranking member of the House Rules Committee. "Stealing from those with the least to give to those with the most. It's not just bad policy, it's a betrayal of the American people."
Rep. Maxwell Frost (D-Fla.) said in floor remarks just after midnight Thursday that "at least here tonight, the people stealing from Americans are not folks with tattoos and hoodies—it's people wearing suits and ties and congressional pins, sitting in this Capitol right now."
"Not in some random alley wrapped in darkness," Frost added as Republican lawmakers booed, "but in the United States Congress wrapped in the flag. It is disgusting, and we will never forget this."
One GOP lawmaker, Rep. Thomas Massie of Kentucky, blasted his party for advancing the legislation while most Americans were asleep.
"If something is beautiful, you don't do it after midnight," said Massie, alluding to the official title of the legislation—the One Big Beautiful Bill Act.
Republican lawmakers teed up the final House vote after days of marathon hearings, jockeying behind closed doors, and private meetings with President Donald Trump, who pressured far-right Republicans to drop their objections and fall in line.
The legislation still must clear the Republican-controlled Senate, which is expected to make significant changes.