The passage of President Donald Trump's massive budget legislation was only possible with the support of Sen. Josh Hawley (R-Mo.), who publicly railed against the bill's provisions gutting Medicaid funding before it became law last week.
Now, NBC News is reporting that Hawley is standing by his vote for the bill, while simultaneously maintaining that more needs to be done in order to protect his constituents who rely on Medicaid for their health insurance. He's insisting that healthcare provider tax changes (which limit the amount of money that states can reimburse for Medicaid) won't go into effect until 2030 – when he's up for reelection.
“I think that if Republicans don’t come out strong and say we’re going to protect rural hospitals, then, yeah, I think voters aren’t going to like that,” Hawley told NBC News on Wednesday. “The truth of the matter is, we shouldn’t be cutting rural hospitals. I’m completely opposed to cutting rural hospitals period. I haven’t changed my view on that one iota.”
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The Missouri Republican notably pivoted from the unpopular Medicaid cuts to his successful gambit to get funding for rural hospitals and for the Radiation Exposure Compensation Act (RECA) included in the megabill, which he argued would be a boon for Missouri residents who have health-related issues from prolonged exposure to radioactive waste. RECA expired in 2024, and Hawley acknowledged the work done by Democratic lawmakers from Missouri to get RECA re-authorized.
"Gotta take the wins that you can," Hawley said.
Hawley's vote in favor of the new budget law was somewhat surprising, given that he wrote a New York Times op-ed in May slamming its Medicaid cuts, calling them "morally wrong and politically suicidal." He accused the "Wall Street wing" of the GOP for sticking to its "old-time religion" of steep cuts to social welfare programs in exchange for more "corporate giveaways."
The sweeping tax, spending and immigration enforcement bill only passed the Senate with the help of a tie-breaking vote cast by Vice President JD Vance, and would have been defeated if Hawley voted no. Sens. Susan Collins (R-Maine), Rand Paul (R-Ky.) and Thom Tillis (R-N.C.) voted against the bill, along with all 47 Senate Democrats.
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Click here to read NBC's full report.