WASHINGTON — Republicans pushed President Donald Trump’s signature tax and spending cut legislation through the House of Representatives after making several last-minute changes to the bill.

The legislation, known as the One Big Beautiful Bill Act, combines $1 trillion in cuts to federal health and food programs with nearly $4 trillion in tax cuts mostly benefiting higher earners.

The House’s passage of the legislation is a major win for Trump and House Speaker Mike Johnson (R-La.), who had to placate conservatives wanting steeper spending cuts as well as moderates seeking a bigger tax deduction for wealthy homeowners.

But the bill’s prospects remain uncertain, since a number of Senate Republicans have signaled they will not accept the House approach to either the tax cuts or the spending cuts, which would result in an estimated 8 million fewer Americans having health insurance, mostly because of cuts to Medicaid.

“I’m not for taking away health insurance from working folks who cannot afford private insurance otherwise,” Sen. Josh Hawley (R-Mo.) told reporters earlier Wednesday.