WASHINGTON >> A divided Senate on Tuesday narrowly passed Republicans’ marquee bill to slash taxes and social safety net programs, sending it to an uncertain fate in the House amid deep GOP divisions that still threaten to derail President Donald Trump’s first-year domestic agenda.

The 51-50 vote reflected the considerable angst among majority Republicans over the legislation and underscored the rough road it still faced in the House, where several Republicans were vowing to block it in defiance of Trump’s demand that it be enacted by July 4.

In the Senate, all Democrats voted against the bill. Three Republicans — Sen. Susan Collins of Maine, Thom Tillis of North Carolina and Rand Paul of Kentucky — joined the Democrats, forcing Vice President JD Vance to cast the tiebreaking vote.

It came after a brutal slog of debating, voting and negotiating that lasted more than 24 hours, as party leaders worked through Monday and into Tuesday morning huddling with Republican holdouts — particularly Sen. Lisa Murkowski of Alaska.

In the end, she supported the legislation after GOP leaders packed it with sweeteners for her state, including a provision aimed at insulating Alaska from some of the bill’s harshest cuts to Medicaid and SNAP food assistance.Extending tax cuts

The bill would extend roughly $3.8 trillion in tax cuts enacted during Trump’s first term in 2017 and add new tax breaks on tips and overtime that he promised during the campaign, while providing hundreds of billions of dollars in new funding for border security and the military. Republicans hailed it as the legislative pinnacle of their governing trifecta.

“We’re here passing legislation that will permanently extend tax relief for hardworking Americans that will spur economic growth, and more jobs and opportunities for American workers; that will rebuild our military; secure our borders; unleash American energy; and cut waste, fraud and abuse in federal programs,” said Sen. John Thune, R-S.D., the majority leader.

A House vote was expected as soon as Wednesday. But the bill faced pushback from politically endangered Republicans who say the Medicaid cuts the Senate advanced, which are deeper than what the House initially approved, go too far. And fiscal conservatives are furious at some of the measures the Senate added that increased the cost of the legislation and its impact on the national debt.

Skepticism in the House

Shortly after the Senate passed the bill, Speaker Mike Johnson pledged that the House would quickly clear it for Trump. Yet it remained unclear whether Johnson would be able to muster the necessary support in the closely divided House, where he can afford to lose no more than three Republican votes.

Rep. Chip Roy of Texas said the Senate’s phaseout of clean energy tax credits was not aggressive enough and called it “a deal-killer of an already bad deal.”

And Rep. David Valadao of California, who represents a district in the Central Valley where 64% of residents are on Medicaid, has said for days that he would not support the bill.

“I’ve been clear from the start that I will not support a final reconciliation bill that makes harmful cuts to Medicaid, puts critical funding at risk or threatens the stability of health care providers across” the district, he said in a statement.

A White House official said Trump would be calling skeptical House Republicans to cajole them into voting for the bill, and did not want to see them propose new changes that would require new negotiations with the Senate. He took to social media to discourage his party’s “occasional ‘GRANDSTANDERS,’” writing: “UNITED, have fun, and Vote ‘YAY.’”

In the days leading up to the Senate vote, several Republicans publicly savaged the plan — before eventually voting to pass it. The process of squeaking it through the chamber was messy, with Republicans shattering long-standing budgeting rules, cutting side deals and haggling with skeptics until the very last moments.

The Senate vote amounted to a political and policy gamble for Republicans, who embraced the bill despite considerable reservations in their ranks about a measure that would swell the deficit and cut vital federal programs including Medicaid — and that polls show is deeply unpopular with voters. In the end, spurred by fear of crossing Trump and allowing a tax increase to take effect at the end of the year, they rallied around the measure.

Fiscal, political costs

The measure would add at least $3.3 trillion to the already bulging national debt over a decade, the nonpartisan Congressional Budget Office said Sunday — a cost that far exceeds the $2.4 trillion price of the version passed in the House. And it would result in $1.1 trillion in health care cuts, nearly $1 trillion of them to Medicaid, causing 11.8 million more Americans to become uninsured by 2034, the same office found.

But the legislation would slash taxes by a total of $4.5 trillion, including through an expanded child tax credit, a larger standard deduction for some older Americans and one for buyers of new cars made in the United States.

As if to underscore the political peril, Tillis abruptly announced during debate on the bill that he would not seek reelection next year, having drawn Trump’s ire for his vocal opposition to it.

“What do I tell 663,000 people in two years or three years, when President Trump breaks his promise by pushing them off of Medicaid because the funding is not there anymore?” Tillis asked on the Senate floor.

“It is inescapable that this bill in its current form will betray the very promise that Donald J. Trump made” to go after only waste, fraud and abuse in the program, he continued.

Collins, of Maine, said that while she backed the extension of the tax cuts, “my vote against this bill stems primarily from the harmful impact it will have on Medicaid, affecting low-income families and rural health care providers like our hospitals and nursing homes.”

That is the message Democrats plan to trumpet in the midterm elections.

“Today’s vote will haunt our Republican colleagues for years to come as the American people see the damage that is done as hospitals close, as people are laid off, as costs go up, as the debt increases,” said Sen. Chuck Schumer of New York, the Democratic leader. “They will see what our colleagues have done, and they will remember it. And we Democrats will make sure they remember it. The American people will not forget the betrayal that took place today.”

Some specifics

The bill includes a plan to lift the cap on the state and local tax deduction, currently set at $10,000, to $40,000.

It would steer about $175 billion toward immigration enforcement and border security, and add about $150 billion in new military spending.

In an effort to offset part of the costs, the legislation would make unprecedented cuts to Medicaid. It would establish a new, strict national work requirement for some people on the program and put in place new restrictions on a strategy many states use to finance Medicaid, by imposing taxes on medical providers to leverage a larger federal contribution.

The legislation would also impose new work requirements on recipients of the nutrition assistance program known as SNAP, or food stamps, and would require some states for the first time to shoulder some of the costs.

And it would make sharp cuts to clean energy tax credits established under President Joe Biden for renewable energy projects including wind and solar farms, as well as for makers of electric vehicles and hydrogen fuels.