Minnesota state officials warned the bill would cut $500 million a year in reimbursements for hospital and nursing home coverage.

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.

Millions will lose Medicaid coverage, hospitals’ uncompensated work will increase and insurers will lose big business.