Senate Republicans are moving closer to a vote on a significant tax and spending bill that aligns with several of President Trump’s key campaign promises. This legislation aims to make the tax cuts from 2017 permanent and allocate more funds for border security and defense. However, a major sticking point remains: Medicaid.
Elena Moore, an NPR political reporter, is on Capitol Hill tracking the developments. She notes that lawmakers are still working through amendments, and voting is expected to continue into the evening. Democrats have proposed several changes, but those have mostly been rejected by Republicans. Some Republican amendments are also facing uncertainty, as Senate Majority Leader John Thune needs to maintain support for the bill.
The stakes are high for this legislation. Trump has been pressuring senators to finalize a deal by July 4. After Senator Thom Tillis of North Carolina voted against the bill due to concerns over Medicaid cuts, Trump indicated he would support a primary challenge against him next year. Following this, Tillis announced he would not seek re-election, highlighting the political risks associated with the bill.
Tillis expressed his concerns directly to Trump, stating that the president was misinformed about how supporting the Senate’s version of the bill would negatively impact those eligible for Medicaid. Medicaid is a joint federal and state program that provides health care for low-income, elderly, and disabled individuals. Some Republicans, especially those from rural areas, are wary of significant changes to Medicaid, fearing it could harm rural hospitals.
On the other hand, some hard-right conservatives are pushing for deeper cuts to Medicaid, arguing that it would help offset the costs of the overall bill. Senator Rick Scott from Florida is proposing an amendment that would reduce federal contributions for individuals on Medicaid expansion, potentially saving hundreds of millions.
However, these cuts come with serious consequences. Democrats on the Joint Economic Committee estimate that nearly 20 million people could lose their health insurance if Scott’s amendment passes. Even without it, the Congressional Budget Office warns that about 12 million individuals could lose coverage under the current bill. This situation poses a challenge for Senators Susan Collins of Maine and Lisa Murkowski of Alaska, who have expressed concerns about Medicaid changes. With Republicans able to lose only three votes, every senator’s decision is crucial.
As the vote approaches, the tension on Capitol Hill continues to build, with both political and personal stakes at play.