House Republicans unveiled the cost-saving centerpiece of President Donald Trump's " big, beautiful bill " late Sunday, at least $880 billion in cuts largely to Medicaid to help cover the cost of $4.5 trillion in tax breaks. Tallying hundreds of pages, the legislation is touching off the biggest political fight over health care since Republicans tried to repeal and replace the Affordable Care Act, or Obamacare, during Trump's first term in 2017 " which ended in failure. While Republicans insist they are simply rooting out "waste, fraud and abuse" to generate savings with new work and eligibility requirements, Democrats warn that millions of Americans will lose coverage.