Senate Republicans narrowly voted 51–49 to advance debate on a sweeping domestic policy bill championed by President Trump, even as a new Congressional Budget Office (CBO) estimate revealed the legislation would add at least $3.3 trillion to the national debt over a decade — and result in 11.8 million Americans losing health coverage by 2034.

The bill extends and expands 2017 tax cuts, slashes federal spending on Medicaid and food assistance, and imposes new work requirements for safety-net programs. It also includes new tax benefits for businesses and targeted provisions to win over key Senate holdouts.

Key facts:

• Debt impact: The Senate bill would increase the federal debt by $3.3 trillion, or closer to $4 trillion when interest is included — $900 billion more than the House version.
• Health care: Cuts would reduce federal spending by $1.1 trillion, stripping coverage from nearly 12 million Americans over 10 years.
• Tax changes: Adds $4.5 trillion in cuts, including permanent corporate breaks and temporary increases to the state/local tax deduction.
• Policy trade-offs: $25 billion for rural hospitals and carve-outs for Alaska helped secure Republican support.
• Major differences from House bill: Larger tax cuts, sharper clean energy rollbacks, and weaker offsets violate a cost cap set by House fiscal hawks.

Republican leaders aim to finalize Senate passage before July 4, but Democrats have forced procedural delays. House Republicans may resist the bill’s ballooning cost, placing final passage in doubt.