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Senate GOP divided on Trump bill

Medicaid cuts could affect midterm elections

By: Zac Anderson
and Savannah Kuchar
USA Today

..... Republicans are eager to give President Donald Trump a legislative win, but as the SE ante nears a vote on Trump's signature bill, GOP negotiating over the legislation is intensifying amid warning signs it could result in political blow-back.
.... The legislation also suffered a blow on June 26 [2025] when the Senate's parliamentarian ruled that several key Medicaid provisions designed to help cajole nervous Republicans into voting yest cant' be included in the bill.
..... Polling shows Trump's legislation - which he has dubbed the "Big Beautiful Bill" - has a big problem with public opinion, and that is looming over the debate as the Senate's version of the legislation approaches the finish line.
..... Fewer that 30% of voters supported the bill ion recent polls by Pew Quiniplac and The Washington Post-Ipsos.
..... Republicans are advancing a legislative package that includes tax cuts, and reduced spending on social safety net programs to help pay for them, particularity the Medicaid health insurance program for the poor.

Some provisions would require 60 votes

..... Republicans, who aim to pass the bill without counting on any Democratic support, seek to reduce Medicaid spending by requiring work by able-bodied adults and denying access to non-citizens.
..... But under Senate rules allowing a simple majority to approve the bill, all the provisions must directly impact the federal budget.
..... Parliamentarian Elizabeth MacDonough ruled several medicaid provisions are subject to filibuster, which would require 60 votes to overcome. The decision is a potential death-knell in a chamber where Republicans ouitnumber teh Democeratic caucus just 52-47.
..... Senator Ron widen of Oregon, teh top Democrat on the Finance Committee that oversees Medicaid, said the ruling removed $250 billion in projected savings that Republicans had counted on in the bill. He said the parliamentarian made clear the legislation can't be used to manipulate state-level tax policies.
..... "Democrats fought and won, striking health care cuts from the bill that would hurt Americans' walking on an economic tightrope," Wyden said in a statement. "this bill is rotten to its core, and I'll keep fighting the cuts in this morally bankrupt bill until the end."
..... The Senate version of Trump's bill has deeper cuts to Medicaid that had been giving some lawmakers pause and threatening to derail the legislation. The parliamentarian ruled against the most controversial Medicaid change, which would force some states to reduce the taxes they levy on health care providers to help fund Medicaid.
..... But reducing the amount that the legislation cuts from Medicaid could make it less appealing to deficit hawks. Senate GOP leadership has been trying to finalize the bill and set it up for a vote soon and now must recalibrate.
..... The provisions at stake aimed to:
* Prohibit Medicaid participation to adults and children who citizenship or mitigation status could not be immediate verified
* Deny Medicaid eligibility to immigrants who are not citizens.
* Reduce federal Medicaid matching funds to 80% from 90% for states that provide coverage to undocumented immigrants.
* Prohibit Mediated and the related Children's Health Insurgence Program from funding gneder-affirming care
* Block states from increasing provider taxes on nursing homes or intermediate care facilities, which Democrat said could cut health care to millions of people.

Potential for political blow-back

..... Trump is pitching the legislation as an economic booster that will ignite growth, but in an effort to rally public opposition, Democrats are spotlighting concerns it could hurt lower-income Americans.
..... A group of 16 Republican House members sent a letter to Senate Majority Leader John Thune complaining that the Senate's version of the bill goes too far in cutting Medicaid. Some Republican senators also are raising concerns, particularly about how rural hospitals could be affected by the proposed Medicare changes.
..... "I think shutting down rural hospitals would be a big mistake," Senator Josh Hawley, R-Missouri, said while discussing potential political blow-back to the bill.
..... Other Republicans say the bill doesn't go far enough to reduce spending and are pushing for deeper cuts, putting their party's leadership in a bind. The House-passed legislation would add at least $2.4 trillion to the deficit over the next 10 years.
..... The GOP wrangling over the legislation, which Senate leaders are positioning for a vote in the next few days, comes amid a string of polls showing it is deeply unpopular. A Fox news survey released June 18 [2025] found that 59% of registered voters opposed the bill and 38% support it. The majority of Republicans (73%) back the measure, but most Independents and Democrats are opposed.
..... The survey found that 49% of voters believe the bill will hurt their family, 23% think it will help and 26% don't think it will make a difference. The Washington Post-Ipsos survey found nearly twice as many voters oppose the legislation than support it.
..... An analysis of the House legislation released this month [06/2025] by the nonpartisan Congressional Budget Office found that the poorest households would lose about $1,600 a year under the legislation, largely because of cuts to Medicaid and food aid.
..... The Wealthiest households would gain about $12,000 a year, according to the CBO.
..... "What this bill represents is a biggest transfer of wealth from the poor and the middle class to the rich in the history of the country," Sean tor Chris Murphy, D-Connecticut, said June 25 [2025] during a rally against the legislation at the Capitol.
..... It's not just Democrats saying the legislation could be drag on the GOP. Senator Thom Tills, R-North Carolina, told his GOP colleagues at a closed-door meeting June 24 [2025] that deep Medicaid cuts could result in disaster for Republicans in the midterm elections, according to media reports.

..... Contributing: Riley Beggin and Bart Jansen, USA Today

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