From centrists worried about Medicaid cuts to conservative hard-liners demanding steeper spending reductions, Senate GOP leaders face a tricky balancing act.

The nonpartisan Congressional Budget Office said Wednesday that the “One Big Beautiful Bill Act” – in its current, House-passed form – would add $2.4 trillion to the national debt over the next decade, while also resulting in 16 million more Americans without health insurance by 2034.

Disputes among Republicans about parts of Trump's major tax bill threaten approval in the Senate and past compromises reached by the GOP-led House.