Senate Republicans have revealed new proposals to modify President Donald Trump’s “Big, Beautiful Bill,” which would result in further changes being made to Medicaid, and a lower deduction of state and local taxes (SALT).
On Monday, the GOP unveiled its recommended adjustments to Trump’s bill, which included having work requirements for Medicaid enrollees who are parents of teens, and changing a previously updated $40,000 cap for SALT back to its current $10,000 deduction.
The proposed changes have reportedly angered a number of House Representatives, according to Reuters, and lawmakers’ opposing views on the legislation could make passing Trump’s bill more complicated as the self-set deadline in July draws closer.
Jose Luis Magana/AP
Why It Matters
Potential changes to the Medicaid system under Trump’s bill have been sparking significant concern in recent months, such as the rolling back of Affordable Care Act (ACA) expansions and implementing work requirements.
The Congressional Budget Office (CBO) estimated that as many as 13.7 million Americans would be left without health coverage by 2034 because of various new policies being brought in to transform the federal program.
Meanwhile, the SALT cap deduction allows taxpayers who itemize when filing federal taxes to deduct certain taxes paid to state and local governments, which the 2018 Tax Cuts and Jobs Act (TCJA) capped at $10,000 per year for those filing jointly and $5,000 for single filers. This includes property taxes plus state income or sales taxes, but not both, according to the Tax Foundation.
What the Proposals Mean for Medicaid
The proposals enhance the changes being made to Medicaid eligibility, which are being implemented as a major part of the legislation’s cost-saving strategy.
Previously, the House had exempted parents of dependents from Medicaid work requirements, but Senate Republicans are pushing for parents of children older than 14 to still fulfill the new expectations, of working a minimum of 80 hours a month.
Work requirements have been divisive in both the House and Senate. Critics warn they will substantially weaken the Medicaid system, the largest public health insurance program in the country, by forcing millions off the service, while supporters of the plan argue that work requirements foster employment, reduce fraudulent claims, and improve personal responsibility.
What the Proposals Mean for SALT
Senate Republicans are also proposing to maintain the $10,000 deduction cap, but that the amount is subject to continuing negotiations.
This suggestion has allegedly drawn significant hit-back from House Republicans whose constituents would have benefited from the higher deduction, Reuters reported.
“We have been crystal clear that the SALT deal we negotiated in good faith with the Speaker and the White House must remain in the final bill,” the co-chairs of the House SALT caucus, Republican Representatives Young Kim and Andrew Garbarino said in a joint statement Monday.
Republican Representative Nicole Malliotakis of New York posted on X, formerly Twitter, that the $10,000 cap in the Senate bill was not only insulting, but a “slap in the face to the Republican districts that delivered our majority and trifecta” with the White House.
What People Are Saying
Joan Alker, executive director of the Center for Children and Families at the Georgetown McCourt School of Public Policy, told Newsweek: “The [One Big Beautiful Bill] will impose the largest cuts to Medicaid in its 60 year history and result in millions of people losing their Medicaid coverage. Coverage losses will start shortly after the midterm elections but states will have to start making cuts in their budget sessions next year. The impact of the cuts will grow over time. Medicaid plays a critical role for children, pregnant women, low wage workers, people with disabilities and chronic conditions like cancer, and people in nursing homes.”
Jamila Michener, a professor of Government and Public Policy at Cornell University, told Newsweek: “At the core of the Senate proposal is a desperate need on the part of Republicans to cut spending on Medicaid so that they can fund massive, upwardly redistributive tax cuts. This is a reverse Robin Hood scheme that will ultimately result in taking health insurance coverage from low-income families to give resources to people who are much more wealthy and better off.”
She added: “Republicans are using a range of administrative and policy levers to take Medicaid away from people who need it. These levers include stricter work reporting requirements, that would now apply to even more families, more frequent eligibility redeterminations, that will lead to eligible people being dropped from the program due to administrative hurdles, requiring co-pays for health services, and punishing states for providing immigrants with health insurance. If enacted, this legislation may do more to undermine the health of low-income Americans than we’ve seen in a very long time.”
U.S. Senator for Maryland Chris Van Hollen wrote in a post on X: “The House version of Trump’s so-called “Big, Beautiful Bill” cut $800B from Medicaid—and the Senate version is even worse. There’s nothing “beautiful” about kicking millions off their health care. And to pay for billionaire tax cuts? We must fight this with everything we’ve got.”
U.S. Senator for Massachusetts Elizabeth Warren, wrote in a post on X: “House Republicans voted to kick 16 MILLION people off their healthcare. Today, Senate Republicans proposed BIGGER CUTS to Medicaid, just to fund bigger tax cuts for giant corporations. Call your senator.”
What Happens Next
Republicans plan to bring the bill to a committee vote in the coming weeks, with a current scheduled deadline of July 4.
This article contains reporting from The Associated Press.
Update 06/17/25, 10:04 a.m. and 10:53 a.m. ET: This article has been updated with comment from Joan Alker and Jamila Michener.
