As Senate Republicans rushed to pass a massive budget package known as the “big, beautiful bill,” the political consequences of pushing for the deepest cuts in decades to Medicaid and other safety net programs serving millions of people were already becoming clear. After working overnight to vote on a number of amendments and pass the package ahead of an entirely symbolic July 4 deadline imposed by President Donald Trump, Senate Majority Leader John Thune was still struggling to find enough votes by the morning of July 1.
Vice President J.D. Vance arrived at the Capitol Tuesday morning to cast the tie-breaking vote, allowing the GOP majority to pass the package by a slim 51-50 margin that largely fell along party lines, with Republican Senators Thom Tillis (North Carolina), Rand Paul (Kentucky), and Susan Collins (Maine) joining Democrats to vote against the bill. The final version now goes back to the House for approval, where Speaker Mike Johnson must bridge divisions between far-right fiscal hawks and moderates wary of defunding rural hospitals in their districts before sending the bill to Trump’s desk.
