In a near party-line vote, House Republicans approved a sweeping budget bill on Thursday after last-minute negotiations to appease the most conservative members of their caucus.

The final vote tally was 215-214. Every Democrat voted against the measure. Rep. Andy Harris (R-Md.), chair of the House Freedom Caucus, voted present. Representatives Thomas Massie (R-Ky.) and Warren Davidson (R-Ohio) voted no.

earlier in the day,the House agreed to open floor debate on the bill after the House Rules Committee approved several amendments. One amendment moved up the start date for Medicaid work requirements to December 31, 2026, which would result in deeper cuts and more people losing coverage. The original bill had the requirements going into effect in 2029.

According to Politico, the revised bill also aims to “give states a financial incentive not to expand” Medicaid coverage as outlined in the Affordable Care Act “to people with higher incomes than traditional enrollees, though still near the poverty line.”

If it becomes law, the House GOP’s bill would cut an estimated $1 trillion from Medicaid and the Supplemental Nutrition Assistance Programme (SNAP). this could lead to tens of millions of low-income individuals losing health coverage and food assistance. The savings would be used to fund trillions of dollars in tax cuts that would disproportionately benefit the wealthiest Americans.

The 1,100-page bill would also trigger cuts to Medicare, eliminate clean energy tax credits, and increase military spending by $150 billion.

Partisan Reactions to the Bill

Rep. Brendan Boyle (D-Pa.), the ranking Democrat on the House Budget Committee, stated, “Republicans just voted for