President Trump's tax and spending bill sets in motion nearly $1 trillion in cuts to Medicaid and other health policy changes that could loom over the midterm elections. But the real effects likely won't be felt until well after the ballots are cast.

State officials warn 360,000 elderly, disabled and working poor residents will lose $3.6 billion in Medicaid coverage as cuts take effect.

The Senate passed President Trump's sweeping spending package, including work requirements for some Medicaid recipients.