The changes made to President Donald Trump’s big tax bill in the Senate would pile trillions onto the nation’s debt load while resulting in even steeper losses in health care coverage, the nonpartisan Congressional Budget Office said in a new analysis,

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 bill, containing tax breaks and spending cuts, would be a signature achievement for President Trump. But some Republican senators have concerns that have not been resolved.