The nonpartisan Congressional Budget Office estimates President Trump's "big, beautiful bill" will add $3 trillion to the deficit.

To pay for that, lawmakers made deep cuts to safety net programs, including Medicaid, which is concerning for some families in the Tri-State Area.

"What are we supposed to do?"

Theresa Luoni, of Basking Ridge, New Jersey, is a full-time caregiver for her autistic twin sons.

"They both get speech and occupational therapy through Medicaid, and they rely on these systems for not just their health care but their education," she said.

She now worries what will happen to her family as the federal tax and spending bill passed by Congress aims to cut nearly $1 trillion from Medicaid.

"So to think that there won't be a reduction in services is kind of silly when there's so much money being cut from the budget," Luoni said.

Luoni is waiting to see what, if any, of her sons' services that are funded by Medicaid will be impacted.

"I think all the parents of vulnerable children — whether you're living in poverty or have disabled children — are feeling the same way I am right now. Like, what are we supposed to do?" Luoni said.

"How do you trade somebody's life over overtime?"

The Congressional Budget Office estimates the Medicaid cuts could leave nearly 12 million Americans uninsured.

"It's going to kick over 1 million New Yorkers off their medical coverage," said Nancy Hagans, president of the New York State Nurses Association.  

The legislation will eliminate federal taxes on tips and overtime pay, including for nurses like Hagans.

"How do you trade somebody's life over overtime?" she said. "We are being asked as health care workers to say, I would rather receive an extra 50 cents over somebody else's life."

One of the biggest changes will be strict work requirements for some Medicaid recipients. There are exceptions for poor parents of children under 14 years old.

Rep. Mike Lawler praises increased cap on SALT deductions

The 900-page bill boosts security and United States Immigration and Customs Enforcement, increases defense spending and extends Trump's 2017 tax cuts, which includes an increase in the child tax credit and raises the cap on state and local tax deductions.

"This will cover, in my district, 90 percent of my constitutions will be able to fully deduct their state and local taxes, and I live in one of the highest taxed districts in the country," Rep. Mike Lawler said.

• Medicaid