Santa Clara County officials fear that Republicans’ “big, beautiful bill” will rip a “seismic tear” in the country’s social safety net as they brace for more than $1 billion in lost federal revenues locally over the next few years.

Medicaid is the state's largest health insurer, covering a quarter of Michigan residents. Reform supporters say the changes will eliminate loopholes.

Florida did not expand Medicaid as most states did, so the impact may be lesser than other places, but reductions loom.

The recent approval of a sweeping tax and spending cut package by Republicans, led by President Trump, has sparked widespread concern. The legislation's $1.2 trillion Medicaid cuts threaten rural healthcare,