Senate Republicans release Trump agenda bill text on Medicaid, Medicare and SALT

The legislation keeps some House provisions, like new Medicaid rules, while making significant changes in other areas, including Medicare and the state and local tax deduction.

WASHINGTON — Republicans on the Senate Finance Committee released their portion of the massive bill for President Donald Trump’s domestic agenda on Monday, with some significant changes compared with the House-passed package.

The 549-page bill extends the expiring Trump tax cuts and includes provisions to slash taxes on tips and overtime pay.

It contains a slew of Medicaid spending cuts and new rules, including work requirements that would kick in at the end of 2026, like the House bill. It also contains policies to force more frequent checks on eligibility and tougher screenings to prove lawful immigration status, in order for people to keep their coverage.

Another Medicaid change is more aggressive than the House bill.

“The House bill placed a moratorium on taxes on providers that help states fund their Medicaid programs and increase payments to providers for services they provide. The Senate bill goes further, limiting the provider taxes that many states already have in place, but only in states that have expanded Medicaid under the ACA,” said Larry Levitt, executive vice president for health policy at KFF, a research group. “There were expectations that the Senate might moderate the Medicaid cuts passed by the House, but if anything they’re doubling down.”