Senate Republicans restored major Medicaid cuts to Donald Trump’s signature economic legislation, re-fashioning a key provision to overcome a procedural obstacle.Spending cuts to the health insurance program for the poor and disabled partially offset revenue losses from tax cuts in the measure and are a crucial demand of GOP fiscal conservatives.

The GOP package includes tax reductions, Medicaid cuts and changes to student loans.

The Senate Republican tax bill includes the biggest reduction for the federal safety net since at least the 1990s, targeting more than $1 trillion in social spending.