After months of GOP negotiations and a chaotic week where the bill’s future repeatedly appeared in doubt up until the last minute, the Senate passed its version of the massive reconciliation package Tuesday, finally bringing Republicans one step closer to enacting President Donald Trump’s legislative agenda.
In a 50-50 vote that Vice President JD Vance voted in favor of to break the tie, Republicans squeezed the reconciliation bill through the Senate with just three GOP dissenters: Sens. Susan Collins, Rand Paul and Thom Tillis. All 47 Senate Democrats voted against the legislation.
The win for Senate Republicans comes after days of intense negotiations, the latest of which revolved around Alaska Sen. Lisa Murkowski, a critical swing vote who’d been seeking carve-outs for her state.
In the final hours of the Senate’s vote-a-rama, around 11 a.m., Murkowski appeared to reach a deal with Senate GOP leaders, brokered on the floor near the end of amendment debate. She ultimately voted “yes.”
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She called the process “agonizing” due in part to the rushed timeline of the bill.
“We do not have a perfect bill by any stretch of the imagination,” she told reporters after the vote. “My hope is the House is going to look at this and recognize that we’re not there yet. And I would hope that we would be able to actually do what we used to do around here which is work back and forth, between the two bodies that’s going to be better for the people in this country and more particularly for the people of Alaska.”
The bill finally passed about a minute after noon on Tuesday. In the final negotiations, leaders hammered out a deal to soften the Medicaid and food assistance language, specifically throwing a bone to Alaska and Hawaii, and dropping some provisions that would have affected Medicaid coverage for immigrants and gender-affirming care.
Those changes may help with more moderate members in the House, but they’re sure to make it more difficult for conservatives. (One change Trump won’t love, made through a point of order in the final hour, was to strike the name of the bill: “The One Big, Beautiful Bill.” Because it’s a reconciliation measure, that provision needed to have a significant budgetary impact, and it didn’t.)
But the more substantive legislative changes will present a bigger challenge.
As Sen. Markwayne Mullin predicted, having largely acted as a liaison between the House and Senate, his old House colleagues are “not going to love it.”
“We don’t want to give an inch, and they don’t want to give an inch either, but somebody’s got to give,” Mullin said.
Some more moderate House Republicans, who voted for roughly $700 billion in Medicaid cuts when the House held a first vote on its reconciliation package, are already saying the Senate bill goes too far in reducing Medicaid. The Senate’s Medicaid cuts approach $1 trillion, though it will take days until there’s an official estimate from the Congressional Budget Office.
Rep. David Valadao said he supports the “reasonable provisions” in the House’s reconciliation bill, H.R. 1, “that protect Medicaid’s long-term viability and ensure the program continues to serve our most vulnerable.”
“But I will not support a final bill that eliminates vital funding streams our hospitals rely on, including provider taxes and state directed payments, or any provisions that punish expansion states,” Valadao said in a statement Saturday.
“I urge my Senate colleagues to stick to the Medicaid provisions in H.R. 1 — otherwise, I will vote no,” he added.
Some of the more conservative House Republicans, like Rep. Keith Self, are also already signaling that the Senate version is insufficient for them, albeit for opposite reasons.
“I think the commitment is to get back to the House framework,” Self told reporters Monday. “That’s what everybody’s committed to. I know that’s what the speaker has been talking to the Senate majority leader about. So we’ll see what happens.”
And Republican House leaders may also have some defections from Republicans who feel that the Senate’s compromise on the state and local tax deduction is insufficient.
While New York Rep. Mike Lawler supports the Senate’s SALT deal, his fellow New York Republican, Rep. Nick LaLota, told reporters over the weekend that it would be “hypocritical” of him to support an eventual SALT cap that he’s spent years criticizing.
House Republicans can only afford to lose a few votes before the bill goes down, and passing the Senate’s bill could be a slog.
With some House Republicans looking totally ungettable — like Rep. Thomas Massie — every GOP lawmaker who comes out against the Senate legislation makes passage more difficult. And the House simply amending the bill until it comports with the demands of a Republican majority would be time-consuming and require another Senate vote.
That’s something GOP leaders in both chambers seem to want to avoid.
Getting the bill this far has been no small feat for Republicans. Senate Majority Leader John Thune spent weeks corralling members of his conference around the legislation, which was only written in full as of Friday night and was still being amended, on and off the floor, until the final minutes.
Throughout this reconciliation process, Republicans have been rushing their bill in just about every way possible. In the House, the phrase “in the dead of night” became a catchphrase for how Republicans passed the legislation. In the Senate, GOP leaders were scheduling a motion to proceed vote even before they had their bill fully written. And it will take days to figure out how the last-minute manager’s amendment, which included a $50 billion rural hospital fund, and a delay in SNAP work requirements for states with high payment error rates — like Alaska — has further changed the bill.
Still, this Senate-passed legislation may not be the final language. Republicans remain deeply divided over the bill’s Medicaid cuts, the state and local tax deduction provisions, and a crackdown on clean energy credits.
And even though the legislation passed the Senate, leaving House Speaker Mike Johnson to get the bill out of the House this week and to the president’s desk by July 4, that deadline won’t be easy.
Johnson has been adamant that if the Senate changed the reconciliation bill too much from the House-passed version, it would be difficult to rally House Republicans behind the legislation. But those warnings didn’t deter the Senate from altering the measure.
Rather than tempering the Medicaid cuts in the House bill, senators deepened them. Most notably, senators added a decrease of the Medicaid provider tax, a key source of Medicaid funding for states. Moderates in both chambers had hoped to freeze the tax at its current rate, but the compromise was a delay of the cut, as well as a new rural hospital fund to offset the effects of the Medicaid cuts on some of the hospitals most reliant on the program.
While House Republicans from blue states warned that they wouldn’t accept a dollar less for the state and local tax deduction, the Senate bill found a way to bring down the price tag of the deduction while not lowering the new $40,000 cap — up from the current $10,000 cap — or the $500,000 income threshold that starts a phasing out of the deduction. The trick? Only offering the new $40,000 deduction, which allows people to write off their state and local taxes, for five years.
Meanwhile, even before the latest changes, the overall cost of the bill was previously projected to add more than $3.9 trillion to the national debt over the next decade, an eye-popping number for budget and deficit hawks. The House version would have added $2.4 trillion.
Whether the House can pass the bill without changes remains to be seen. If the House makes any additional changes, it will have to go back to the Senate for another round of passage.
Republicans in the upper chamber are warning their House counterparts to avoid that. Senators are already rushing to leave town, meaning any changes would require bringing senators back to D.C.
Trump is eager to get the bill done as soon as possible. While the president has enacted a number of his priorities through executive order, he’s had few legislative wins out of Congress. And while the bill’s provisions could prove to be unpopular, Republicans are betting that an extension of the 2017 individual tax rates will prove to be popular.
At the moment, however, the legislation lacks much support. A recent Fox News poll showed that 38% of registered voters supported the bill while 59% opposed it.
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Ursula Perano is a reporter at NOTUS. Helen Huiskes is a NOTUS reporter and an Allbritton Journalism Institute fellow.
Oriana González, a reporter at NOTUS, contributed to this report.
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