The bill, ushered through Congress by Republican leadership and signed by Trump Friday, includes $4.5 trillion in tax cuts, slashes spending on Medicaid, and creates temporary tax deductions for overtime and tipped income. It includes $170 billion for immigrant detention and for new personnel for Immigration and Customs Enforcement.

President Trump's signature tax and spending legislation, the "big beautiful bill," is now law, and that means cuts to Medicaid spending. The big picture: The law sets in motion almost $1 trillion in slashes to Medicaid and other health policy changes,