With funding at risk, hospitals are warning they might have to close — and leave communities without badly needed access to care.

Officials are warning that millions of Americans could lose their insurance under changes in the law — including 330,000 people in Illinois who could be impacted by changes to Medicaid. However, Republican lawmakers say the changes are aimed at eliminating waste, fraud and abuse in the system.

“This is an abomination. This is sinful. It’s unholy,” Mayor Brandon Johnson said. “This bill is a fundamental attack on our democracy and our way of life.”

President Donald Trump’s sweeping tax and spending bill is now law, after days of heated debate and close votes in Congress. Democrats say the cuts will impact low-income Americans.

The bill, passed late last week and signed into law by President Donald Trump on July 4, will bar Medicaid users from coverage with a health care provider that also provides abortion services.

Congress on Thursday passed President Donald Trump’s so-called “Big, Beautiful Bill,” which the president is expected to sign into law. The tax and spending plan cuts federal funding for services such as food aid and Medicaid, as well as Planned Parenthood.

At nearly 900 pages, the legislation is a sprawling collection of tax breaks, spending cuts and other Republican priorities, including new money for national defense and deportations.

In Illinois, 1.9 million residents receive SNAP benefits, including more than 891,000 people in Cook County. Approximately 3.4 million Illinoisans are covered by Medicaid.

Health secretary Robert F. Kennedy Jr.’s advisers ordered the release of a dataset that includes the private health information of people living in California, Illinois, Washington state, and Washington, D.C., to the Department of Homeland Security, The Associated Press first reported last month.

Vice President JD Vance broke a 50-50 tie to push it over the top. The three Republicans opposing the bill were Sens. Thom Tillis of North Carolina, Susan Collins of Maine and Sen. Rand Paul of Kentucky.

The Senate parliamentarian has advised that a Medicaid provider tax overhaul central to President Donald Trump’s tax cut and spending bill does not adhere to the chamber’s procedural rules, delivering a crucial blow as Republicans rush to finish the package this week.

The dataset includes the information of people living in California, Illinois, Washington state and Washington, D.C., all of which allow non-U.S. citizens to enroll in Medicaid programs that pay for their expenses using only state taxpayer dollars.

Nursing home industry officials are urging Illinois lawmakers to increase the rates they receive from the state’s Medicaid system, arguing the current rates are outdated and are forcing many facilities around the state out of business.

Employees across the massive U.S. Health and Human Services Department began receiving notices of dismissal on Tuesday in an overhaul ultimately expected to lay off up to 10,000 people.

About 3.9 million Illinoisans are enrolled in Medicaid. Of that total, 44% of Medicaid recipients are children, 9% are seniors and 7% are adults with disabilities, according to the Illinois Department of Healthcare and Family Services.

Health Secretary Robert F. Kennedy Jr. criticized the department he oversees as an inefficient “sprawling bureaucracy” in a video announcing the restructuring Thursday. He faulted the department’s 82,000 workers for a decline in Americans’ health.