The GOP-controlled House of Representatives on Thursday narrowly passed a Senate-approved budget resolution that moves Republicans one step closer to their ultimate goal of delivering massive tax breaks to the wealthiest Americans and imposing “grotesque” and “heartless” cuts to Medicare, Medicaid, and other life-saving safety net programs.

“The representatives who just chose the bank accounts of their donors over the health and wellbeing of their constituents should be ashamed.”
—Morris Pearl, Patriotic Millionaires

The final vote tally was 216-212, with 20 Republicans defecting from their party. No Democrats backed the measure.

Frank Clemente, executive director of Americans for Tax Fairness, called the GOP budget an “immoral calamity” in a statement following Thursday’s vote.

“The Republicans in the House have just advanced an immoral tax plan that will have disastrous real-world consequences for many millions of Americans,” Clemente said. “It’s a calamity of their own making, and voters will remember it.”

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Despite insistence from President Donald Trump and the GOP that their budget is pro-working class, analysis after analysis has shown that their proposals would in fact raise taxes on many middle class families while sending an enormous windfall—$1.5 trillion over the next decade—to the top one percent.

Meanwhile, notes Vox‘s Dylan Matthews, “the federal welfare state would be rolled back in just about every dimension.”

“All non-Medicare health programs would see a cut of $1.3 trillion, or nearly 30 percent, by 2027,” Matthews adds. “Medicare would be cut too, to the tune of $473 billion. There is $1 trillion over 10 years in mystery cuts to mandatory programs, cuts that would in practice almost certainly hurt programs for the poor.”