Millions of Americans who get health insurance through Medicaid will face new hurdles after the House passed President Donald Trump's massive tax cut and spending bill, which includes deep cuts to nation's safety-net health insurance program.

Congress has signed off on a $3.4 trillion legislative package featuring new tax breaks, spending cuts, and more funding for defense and immigration enforcement, delivering President Donald Trump his “big, beautiful bill” despite rumblings from fiscal hawks about the projected $4 trillion it could add to the national debt over the next decade.

Spanning nearly 900 pages, the legislation is a vast collection of tax breaks, welfare rollbacks, and GOP priorities — from border security to defence spending and new work mandates for safety net programmes.