House Republicans, led by Speaker Mike Johnson, on Thursday muscled through President Donald Trumps signature domestic policy bill, voting to slash health and nutrition programs that millions of Americans, including large numbers of LGBTQ+ people, rely on, to extend tax cuts for the wealthy. The bill passed on a party-line vote of 218 to 214, with Reps. Brian Fitzpatrick of Pennsylvania and Thomas Massie of Kentucky joining all Democrats in oppositionThe measure, which Trump demanded be named the One Big Beautiful Bill before Democratic New York Sen. Chuck Schumer, the minority leader, had the name stripped, cleared the House of Representatives after more than eight hours of delaying tactics by Democratic Leader Hakeem Jeffries. The bill cut funding for Medicaid, SNAP (the food stamp program), and other social safety net programs, and bars federal funds for Planned Parenthood. The vote capped weeks of bitter partisan fighting and set the stage for a political reckoning in the 2026 midterms.Related: How Trumps one big beautiful tax bill could impact women, children and LGBTQ+ AmericansThis disaster of a bill has always been about one thing: funneling more wealth to the ultra rich while hardworking Americans including LGBTQ+ people suffer, Kelley Robinson, president of the Human Rights Campaign, said in a statement after the vote. MAGA members of Congress voted to kick millions of people off their health care, jeopardize access to essential HIV prevention and treatments, and erode the ability of Planned Parenthood to continue to serve all who rely on it.The final bill dropped one of its most controversial provisions: a nationwide ban on federal funding for gender-affirming care under Medicaid and CHIP. That language was cut after Senate Parliamentarian Elizabeth MacDonough ruled that it violated the Byrd Rule, which bars unrelated policy changes in budget bills. Behind-the-scenes lobbying from lesbian U.S. Sen. Tammy Baldwin of Wisconsin and U.S. Rep. Sarah McBride of Delaware, the first out transgender member of Congress, helped ensure its removal.LGBTQ+ advocates caution that the bill still threatens queer communities. The nonpartisan Congressional Budget Office projects nearly 14 million people will lose Medicaid coverage under the measure, a program that disproportionately serves LGBTQ+ Americans. According to the HRC, Medicaid covers 21 percent of transgender people and 40 percent of individuals living with HIV. It is also the largest single funder of HIV care in the nation.Jeffries, who spoke for eight hours and 45 minutes in an impassioned speech that broke the record for the longest continuous House floor address, condemned the legislation as an extraordinary assault on the health care of the American people. His remarks, delivered in the cadences of a Sunday sermon, framed the bill as both a moral and political crisis, warning that leadership requires courage, conviction, compassion and yet what we have seen from this administration and co-conspirators on the Republican side of the aisle is cruelty, chaos and corruption.The reductions extend to community health centers that serve LGBTQ+ communities, threatening services ranging from mental health care to STI testing and gender-affirming treatment. The legislations tightened rules around SNAP eligibility and benefits, advocates say, will also hit LGBTQ+ people particularly hard, given persistent disparities in poverty and food insecurity. Research cited by the HRC shows that over 27 percent of LGBTQ+ adults have struggled to afford food in the past year, with LGBTQ+ people of color and transgender people especially vulnerable.The bill also funnels $150 billion toward immigration enforcement, and adds $100 asylum fee for those seeking safety, a $550 fee for work permits, and expand ICE detention that would harm queer immigrants and those living with HIV, according to Immigration Equality.This bill is a roadmap to suffering. It turns asylum into a luxury, punishing LGBTQ and HIV-positive people fleeing persecution. LGBTQ people cannot wait out violence and discrimination in their home countriesand now they are being told safety in the U.S. comes with a price tag," said Immigration Equality's director of law and policy Bridget Crawford. "Asylum is a legal right, not a privilege. Rushing this bill through Congress today, before July 4, in the name of so-called patriotism, is a betrayal of this countrys core values. Instead of offering protection, America will be locking the door to asylum seekers behind a paywall.For Republicans, the legislation is a pillar of Trumps domestic agenda and a means to cement tax cuts enacted during his first term. The bill also funnels billions of dollars to fund immigration detention and deportation efforts. For Democrats, it is a potent symbol of what they describe as Republican extremism and a rallying point they hope to wield against vulnerable incumbents in the 2026 midterms.Related: Republicans pass Big Beautiful Bill banning federally funded gender-affirming care for trans peopleThe American people are not without power, Robinson said. In every district across the country, members of Congress need to hear from their constituents and be reminded that we will not forget this betrayal when it comes time to be heard at the ballot box.Trump is expected to sign the bill into law at a White House ceremony on Friday, the Fourth of July.