The plan would add $3.8 trillion to the federal deficit while shifting resources away from everyday Americans to the country’s wealthiest.

US House Republicans worked through the night to pass President Donald Trump’s “One Big Beautiful Bill Act.” This measure would tighten eligibility for health and food programs for the poor and could increase the US debt by $3.8 trillion, according to the Congressional Budget Office. Despite strong opposition from Democrats, Republicans found a hairline majority at 215-214 votes.

The bill could significantly impact Nevadans with wide-ranging consequences, from reduced access to health care for immigrant families to nonprofits and public institutions grappling with tax hikes. With Nevada’s more than 320,000 mixed-status households, nearly 200,000 public sector workers, and 738,000 children and adults on Medicaid, critics warn the bill could deepen inequality and destabilize vital support systems, hurting the most vulnerable across the state.

The proposal is headed to the Republican-controlled Senate, where it is expected to face amendments. However, GOP members remain divided, with some viewing cuts as going too far and others not steep enough.

As it stands, the legislation delivers on key Trump campaign promises by extending tax cuts for the wealthy, ending Biden-era clean energy incentives, and offering tax breaks on tips, overtime, and car loan interest. It would reportedly bankroll Trump’s aggressive immigration crackdown, adding tens of thousands of border agents and expanding deportation capacity to up to 1 million people annually.

“This is arguably the most significant piece of Legislation that will ever be signed in the History of our Country!” Trump wrote on X.

To pay for it, Republicans proposed deep cuts to Medicaid and food assistance, with new work requirements that analysts warn could strip millions of benefits. To pass the bill, Republicans introduced changes that shortened the timeline for when work requirements would start for non-disabled adults aged 18 to 65 to receive Medicaid benefits.

As for recipients who fall outside of those bounds, in order to receive Medicaid, they must work 80 hours a month or go to school, do community service, or job training to keep their coverage, according to CNN. The unprecedented change would kick in at the end of 2026 instead of the anticipated 2029, as originally proposed. However, it wouldn’t apply to parents with children younger than age 7, those who are pregnant or with debilitating health conditions. 

During the overnight session, Republicans also made cuts to the Affordable Care Act and cut $500 billion from Medicare, according to the Congressional Budget Office, which experts describe as the greatest wealth transfer in American history. This occurs as average people grapple with inflation, significant price fluctuations due to an unstable economy, and a nationwide housing crisis following the economic downturn from the global COVID-19 pandemic.

As part of Trump’s so-called “anti-woke” agenda, the bill also targets elite universities and large nonprofits, raising taxes on endowments and high-salaried organizations. It also rolls back $500 billion in Biden-era tax breaks, eliminates perks for billionaire sports owners, and blocks undocumented immigrants from receiving tax credits or federal health benefits by tightening ID requirements.