• The House approved Trump's "One Big, Beautiful Bill" along party lines, with a vote of 218-214.
• The legislation includes significant cuts to Medicaid, potentially affecting 12 million Americans.
• Tax reforms make 2017 tax cuts permanent and increase the SALT deduction limit.
• New measures proposed to enhance immigration enforcement and border security.
• The bill may lead to rising healthcare costs for many Americans, exacerbated by changes to the ACA Marketplace.

On Thursday, the U.S. House of Representatives passed President Trump’s "One Big, Beautiful Bill," with the legislation set to make extensive changes to the country's fiscal landscape, especially concerning taxes and Medicaid. The bill passed narrowly by a vote of 218 to 214, marking a crucial victory for Trump and Congressional Republicans who leveraged their majority to push through significant tax reforms and cuts to various welfare programs, such as Medicaid, which experts warn could exacerbate healthcare access issues for vulnerable populations, according to HuffPost and India Times.

The legislation proposes nearly $1 trillion in cuts to Medicaid over the next decade, potentially resulting in about 12 million Americans losing their health coverage. Changes include imposing stringent work requirements and eligibility checks that critics argue will disproportionately impact low-income individuals, particularly in rural areas where reliance on Medicaid is higher. Experts indicate that the bill's requirements are more about increasing bureaucratic hurdles rather than addressing employment issues among Medicaid users, as approximately 92 percent of beneficiaries are already working or qualify for exemptions, as noted by Al Jazeera and Newsweek.

Additionally, the tax provisions of the bill make Trump’s 2017 tax cuts permanent, lifting the cap on state and local tax deductions from $10,000 to $40,000 for five years. While this is intended to boost financial benefits for certain income groups, it is forecasted to further increase the federal deficit by $3.4 trillion over a decade, which raises concerns among fiscal analysts, according to India Times and HuffPost.

The bill also increases funding for immigration enforcement, providing $45 billion for immigration detention centers and other related expenses, which some critics describe as a substantial shift towards militarizing immigration policy. This funding boost removes focus from health care issues and reflects the ongoing prioritization of border security over social welfare programs, as observed by Al Jazeera and Newsweek.

Furthermore, the changes to the Affordable Care Act (ACA) resulting from this bill are expected to drive premium costs higher by an average of nearly $1,300 annually, raising further concerns about accessibility to necessary health services. Health care facilities, particularly in rural settings, may face dire financial challenges due to decreased funding from Medicaid, putting patients at risk of losing access to critical health care services, noted specialists in health policy, according to HuffPost and Newsweek.

As the bill heads to President Trump's desk for signing, it has faced unanimous opposition from Democrats who argue that it prioritizes tax benefits for wealthy households while significantly undermining essential services for the most vulnerable populations, generating heated debates among lawmakers. The ramifications of this legislation are likely to be felt widely across the health care system and beyond, as outlined by Al Jazeera and India Times.