A cap on state and local tax deductions, slashes to Medicaid, increased immigration enforcement and more are included in the spending bill.

Republican infighting defined a caustic debate that saw significant opposition to Medicaid cuts, which could define the 2026 midterm elections

All told, the Senate bill includes $4.5 trillion in tax cuts, according to the latest CBO analysis, making permanent Trump’s 2017 rates, which would expire at the end of the year if Congress fails to act, while adding the new ones he campaigned on, including no taxes on tips.