The bill includes over $5 trillion in tax breaks such as extending prior individual provisions, boosting the standard deduction and child tax credit, increasing the estate tax exemption to $15 million, expanding deductions for pass-through businesses, and adding new tax breaks on tipped wages, Social Security benefits, and auto loans. It also proposes cuts to Medicaid, food assistance programs, and green energy initiatives.

There is internal GOP opposition specifically related to imposing stricter Medicaid work requirements, cuts to food assistance, and the extent of state and local tax (SALT) deductions. Lawmakers from high-tax states, such as New York and California, are negotiating to increase SALT deductions beyond the proposed tripling to $30,000 for couples, which some consider insufficient.

Democrats have strongly opposed the bill, criticizing the cuts to Medicaid and food assistance as 'cruel' and harmful to vulnerable populations. They have also protested during hearings and continue to denounce the legislation for undermining health care and basic needs programs while favoring the wealthy.

Speaker Mike Johnson is actively negotiating changes to the bill to secure votes within the GOP, with particular focus on adjusting state and local tax deduction provisions to satisfy lawmakers from high-tax states who are concerned about the current limits.

While the bill proposes tax cuts for all income groups, analyses indicate that the highest-income households would benefit disproportionately more than low- and middle-income filers. The package also includes reductions in social programs affecting older Americans and lower-income populations, such as Medicaid and food assistance, potentially increasing economic disparities.