The U.S. House of Representatives passed the "one big beautiful bill" touted by President Donald Trump in the early hours of Thursday morning, a sweeping tax and immigration package that includes significant reductions to Medicaid and Medicare funding.

Among the biggest impacts is a $700 billion cut to Medicaid over the next decade. Advocates say that could leave millions of Americans, especially low-income families in Missouri, without health coverage.

“Medicaid helps keep Missourians healthy so they can work, succeed in school and contribute to their communities, and about 9-in-10 Missourians with Medicaid health insurance are already working or qualify for an exemption because of a disability, caregiving, or school," said Amy Blouin, president and CEO of the Missouri Budget Project.

Medicare could also be cut by about $500 billion. These cuts could decrease access to care and increase out-of-pocket costs, especially for seniors.

In Missouri, rural hospitals would be directly impacted, as many are already on the brink of closure and rely on Medicaid to keep doors open.

“Medicaid helps rural health care providers stay afloat so they can serve everyone in their communities,” Blouin said. “Many rural hospitals are already on the brink of closing, and decreased Medicaid funding could push them over the edge."

The bill includes a $300 billion cut to the Supplemental Nutrition Assistance Program, or SNAP. The cuts would put the cost on states and families.

“SNAP benefits are spent directly in local stores,” she said. “Federal funds from both programs directly support critical jobs in our communities, which then fuels additional economic activity in Missouri."

The bill now heads to the Senate, where pushback and changes are possible.

The Kaiser Family Foundation reports that over 1 million children and adults in Missouri are enrolled in Medicaid.

Check back for updates as this is a developing story.