As Senate Majority Leader John Thune (R‑S.D.) grapples with the need to secure votes from two undecided moderates and three conservatives to pass President Donald Trump's "Big, Beautiful Bill," this week's marathon amendment session has pushed the Republican Party into a moment of introspection.
Despite broad confidence in the key GOP legislation, significant roadblocks remain — especially on Medicaid funding, The Hill reported Monday.
Sens. Ron Johnson (R‑Wis.), Rick Scott (R‑Fla.) and Mike Lee (R‑Utah) are insisting on a new amendment to slash an additional $313 billion from Medicaid, per the report.
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Johnson and Scott have suggested they may withhold their votes unless it passes. The amendment aims to roll back the 9‑to‑1 federal match for able‑bodied Medicaid recipients (those without dependent children), but its passage seems unlikely given the bill’s current makeup.
Sen. Josh Hawley (R‑Mo.) has emerged as a leading voice against Medicaid cuts, saying, “Frankly, my party needs to do some soul‑searching.” In his comments to The Hill, he warned, “If you want to be a working‑class party, you’ve got to deliver to working‑class people. You cannot take away health care from working people.”
He argues that scaling back Medicaid not only undermines moral obligations but also risks alienating the very voters Republicans are courting.
Sens. Susan Collins (R‑Maine) and Lisa Murkowski (R‑Alaska) remain undecided, according to the report.
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Collins has proposed a 39.6 percent tax on ultra‑high earners, directing the revenue toward doubling a rural hospital relief fund —from $25 billion to $50 billion.
Both senators are signaling they need major policy adjustments before committing their votes.The bill pits fiscal conservatives (looking for deeper Medicaid cuts) against more populist or moderate Republicans, fueling debate over which faction truly represents the GOP’s future.
To pass the bill by the July 4 deadline, Thune must bridge divides — satisfying conservative demands and addressing moderate concerns about healthcare access and rural hospital viability. Sen. Shelley Moore Capito (R-W.Va) has publicly expressed her uneasiness with how the bill's Medicaid cuts could impact rural hospitals in her state.
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