The House approved legislation Thursday that would cut Medicaid spending by nearly $800 billion over the next 10 years, revising President Donald Trump’s so-called “big, beautiful bill” in the final hour to move up the start date for Medicaid work requirements and prohibit Medicaid for gender-affirming care.

A House-passed reconciliation bill would reduce federal funding to states that provide state-funded health insurance to people in the U.S. illegally, resulting in 1.4 million people losing coverage, according to a preliminary Congressional Budget Office analysis.

The speaker spent months keeping flare-ups from growing into a conflagration even Donald Trump couldn’t extinguish.

After a meeting with former President Donald Trump on Tuesday, House Speaker Mike Johnson praised the “Big Beautiful Bill” — officially titled the One Big Beautiful Bill Act — which proposes sweeping federal spending cuts and permanent tax reductions.

The House of Representatives passed Trump's "One Big Beautiful" reconciliation budget that will likely kick millions off programs like Medicaid.

An appearance by House Speaker Mike Johnson (R-LA) at a meeting with Republican senators reportedly did little to sway some naysayers who have no interest in passing the latest budget bill once in makes its way to the Senate floor.

House Speaker Mike Johnson teased plans to bump up the timeline for implementing work requirements on Medicaid to help win over support from fiscal hawks on the “One Big Beautiful Bill” that got shot down in committee on Friday.

Speaker Mike Johnson delivered a major win for President Donald Trump early Thursday morning, quashing a conservative rebellion and driving a deeply divided House GOP to pass a bill that many of them were still pushing fiercely to change.

The legislation could have significant implications for Medicaid coverage in Ohio, a state that expanded Medicaid to include low-income residents. Approximately 750,000 Ohioans may be at risk if the bill becomes law.