House GOP leadership has agreed to a series of last-minute changes to its sweeping tax and spending package designed to win over holdouts.

The manager’s amendment includes changes to the state and local tax (SALT) deduction cap and proposed Medicaid reforms, along with other proposals, as leadership works to satisfy various factions of the GOP conference to lock down sufficient support to secure its passage.

Here are some of the changes made to the bill before leadership brings it to the House floor. 

Medicaid work requirements

The updated bill outlines a more aggressive timeline for implementing new work requirements for Medicaid recipients.

In the original House version of Trump’s “big, beautiful bill,” Republicans called for the new requirements to take effect in early 2029. However, the changes call for the requirements to be implemented no later than the end of next year.

Conservatives pressed for the earlier date as part of their push to increase savings in the bill. Other changes are also aimed at disincentivizing Medicaid expansion.

SALT deduction cap

The bill initially called for state and local tax (SALT) deduction cap to be raised from $10,000 to $30,000 for those earning up to $400,000. The updated plan puts the cap at $40,000 for people making up to $500,000.

The SALT deduction allows taxpayers — especially those in higher-tax blue states — to deduct part of their regional taxes from their federal tax bill.

GOP moderates from high-tax blue states pressured leadership for more relief for their constituents — and had threatened to tank the bill if they didn’t get it.

Earlier end date for green tax credits

The new version speeds up the rollback of tax credits for climate-friendly energy sources — handing a win to hardliners who lamented that they were allowed to remain on the books for too long. The prior iteration phased out the credit for projects that began producing electricity after 2028, with partial credit available up until 2032. 

Under the new version, there is no partial credit, and any projects that begin producing electricity after 2028 will not be eligible at all. Projects also need to start construction within 60 days of the bill’s enactment.

However, a carveout is added for nuclear power which will only need to begin construction rather than begin producing electricity by the end of 2028 to receive the tax credit.

Gender-affirming care

While the original bill text calls for blocking Medicaid funding for gender transition procedures for minors, the changes unveiled Wednesday night would extend that prohibition to adults as well. 

‘Trump accounts’

The changes would also change the name of proposed “Money Accounts for Growth and Advancement,” or “MAGA accounts,” in the original text to “Trump accounts.”

Republicans have described the proposals as a type of savings account partly aimed at incentivizing education. The proposal also calls for the government to contribute $1,000 per child into eligible accounts for children born between January 1, 2024, and December 31, 2028.

Public lands sales and related provisions

Republicans have also stripped a controversial provision added during the amendment process that would have allowed the sale of certain public lands in Utah and Nevada.

The updated text also strips out provisions that would have required additional Arctic drilling opportunities in the National Petroleum Reserve-Alaska and the approval of an Alaska mining road. 

Retirement benefits for federal workers

The changes include the elimination of a proposal that members on both sides criticized as targeting federal employees’ earned benefits.

The bill had initially proposed calculating the federal workers pension formula based on employees’ five top years of earnings compared to the three years under current law.

Rep. Mike Turner (R-Ohio) had previously spoken out against the proposal.

“Making changes to pensions and retirement benefits in the middle of someone’s employment is wrong,” he said in a quote obtained by GovExec. “Changing the rules, especially when someone has already been vested in their benefits, is wrong. Employee benefits are not a gift, they’re earned.”

“I understand the need for reform, and we can certainly have changes occur for the benefits of new hires, but for current employees, to change the rules for people in the middle of the game is just wrong.”