Senate Republicans are in a race against time to pass a significant domestic agenda bill by July 4, as demanded by President Trump. The clock is ticking, and they face several hurdles that could delay their plans. One major issue is funding for rural hospitals, which has emerged as a key sticking point among GOP lawmakers.
In recent days, Senate committee leaders have made important changes to the bill. However, the debate continues over whether certain tax provisions comply with Senate rules. The Senate parliamentarian is currently reviewing these elements to ensure they directly impact the budget. Some provisions from the House version, including one that would restrict nationwide judicial injunctions, have already been removed.
Senate Majority Leader John Thune, who is leading the charge, spoke to reporters after a meeting with GOP lawmakers and Treasury Secretary Scott Bessent. He emphasized the urgency of getting the bill to President Trump by the holiday. Thune can afford to lose only three votes from his party to pass the legislation.
One of the most contentious issues is Medicaid funding. The bill proposes to reduce the tax on Medicaid providers from 6% to 3%. Critics argue that this tax is vital for many states and that cutting it could harm rural hospitals that rely on these funds. Mehmet Oz, who oversees the Medicaid program, defended the bill, calling it a necessary reform to ensure the program’s sustainability.
However, some senators, like Josh Hawley from Missouri, are worried that the changes could lead to prolonged negotiations with the House. Hawley highlighted the importance of maintaining access to hospitals for those affected by radiation exposure, noting, "But they have to have a hospital to go to."
In response to concerns about rural hospitals, the Senate Finance Committee proposed a compromise to allocate $15 billion over five years to support states in need. Still, some senators, like Susan Collins from Maine, argue that this amount should be closer to $100 billion. Collins expressed the need for careful consideration of the bill’s provisions rather than rushing to a vote.
Senator Thom Tillis from North Carolina echoed these sentiments, warning that the costs of addressing these issues might be much higher than anticipated. He highlighted the potential impact on states, particularly in light of significant cuts projected over the next decade.
Thune acknowledged the need to address these concerns, stating that discussions have been ongoing to mitigate the impact on rural hospitals. Other Republicans are also worried about the overall effects of Medicaid changes, fearing that they could shift costs to states and lead to increased financial burdens on low-income and elderly patients.
As the Senate grapples with these issues, some factions of House Republicans have already indicated they might oppose the Senate’s version of the bill. The negotiations also include a contentious debate over preserving a state and local tax break, known as SALT, which is particularly important for lawmakers from high-tax states like New York and California.
Senator Jon Hoeven from North Dakota commented on the situation, suggesting that the Senate will produce a bill they believe is best for the country, regardless of the House’s stance. Meanwhile, Senator Markwayne Mullin from Oklahoma noted that while there may not be a perfect solution that satisfies everyone, they are working towards a compromise.
Thune believes that by adhering to the timeline set by Trump, the pressure will ultimately encourage Republicans in both chambers to support the legislation. As the deadline approaches, it remains to be seen whether the Senate can resolve these issues and deliver a bill that meets the president’s expectations.