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the U.S. Senate approved Trump’s sweeping and ambitious bill on July 1, by a tense 51-to-50 vote.

Lawmakers approved a new $50 billion Medicaid fund to improve access to health care in rural areas.

The Congressional Budget Office estimates the bill will add about $3.3 trillion to the national debt over the next 10 years.

On Tuesday, the Republican-led Senate passed President Donald Trump’s sweeping, beautiful bill, approving his tax and spending priorities. The bill passed 51-50, with Vice President J.D. Vance casting the deciding vote.

The legislation, known in the GOP as the big beautiful bill, passed 51 to 50 after a multi-day process that began Saturday night and culminated in a 24-hour vote. The big, beautiful bill will now return to the House of Representatives, which passed its version of the bill last month.

Three Republicans voted against it, including Rand Paul of Kentucky, Susan Collins of Maine and Thom Tillis of North Carolina. The legislation would extend tax breaks passed by Republicans in 2017, preventing a possible rate hike at the end of the year when current provisions expire.

Senate Republicans doubled the size of the new fund to improve access to rural health care to $50 billion at the last minute, a move to win Collins’ support. Collins had previously offered an amendment to increase the funding to $50 billion, but it was defeated by a 78 to 22 vote, with most Democrats voting against it.

Lawmakers argued that the Medicaid initiative risked collapsing many rural hospitals, so they agreed to a new $50 billion fund to support rural hospitals. According to the Senate, the program would begin in 2026 and the funds would be spread out over five years.

Legislation would make changes to the Medicaid program by imposing work requirements and reducing the provider tax from 6 percent to 3.5 percent. The Congressional Budget Office estimates the changes to Medicaid will reduce the number of people with health insurance by nearly 12 million over the next decade.

the Senate also passed an amendment to lift the 10-year moratorium on government regulation of AI 99-1, with only Tillis voting against it. Most amendments offered by Democrats on everything from supporting Medicaid to tax cuts for the wealthy failed on the floor. Speaker Mike Johnson is also urging Republicans to return from recess, intending to hold a vote Wednesday to meet Trump’s July 4 deadline. Johnson said the House will work quickly to pass the bill, adding that Republicans are ready to finish the job and put the bill on President Trump’s desk by Independence Day.

With this legislation, we fulfill the mandate given to us last November and create an environment of security, strength and prosperity for our country and the American people.

John Thune, Majority Leader of the United States Senate.

The Congressional Budget Office estimates that the law will increase the national debt by about $3.3 trillion over the next 10 years. The White House disapproves of that projection, saying it would reduce the deficit by more than $5 trillion when combined with other deficit-increasing measures.