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Republicans in the House, many of whom looked to the Senate to craft a bill that was less damaging than the House bill, must stand up for their communities and reject it. Now is their chance.
Following a series of middle-of-the-night backroom deals, and less than an hour after the final language was unveiled, Senate Republicans voted to pass a bill that would raise food and health care costs on families, increase poverty and hunger, and take health coverage away from millions of people while doubling down on costly tax cuts for the wealthy and corporations.
The Senate Republican bill’s federal Medicaid cuts are even deeper than the massive House cuts, making it more likely that states would cut their programs and putting rural hospitals and other community health providers at even greater long-term risk of closure.
House Republicans, many of whom looked to the Senate to craft a bill that was less damaging than the House bill, must stand up for their communities and reject it.
The more people have learned about the bill, the more opposition has grown. Now we will learn whether House Republicans, with time to reflect on the damage this agenda would cause and the ways the Senate made the bill worse, are as thoughtful as the people they serve.
Just days ago, some House Republicans expressed opposition to the additional Medicaid cuts the Senate was considering. Those additional cuts are in the Senate Republican bill that the House is expected to vote on as soon as tomorrow.
The Senate Republican bill would cut Medicaid by nearly $1 trillion, compared to $800 billion in the House Republican bill. The deeper cuts translate into larger harmful impacts.
The bill also would expand the House Republican bill’s provision that takes Medicaid coverage away from people who don’t meet a red-tape-laden work requirement by applying it to parents enrolled through the Medicaid expansion who have children older than 13.
Working parents who get tripped up by red tape, parents who get laid off and are looking for work, parents who lose their jobs when they get sick or need to care for a sick child — as well as adults without children who have disabilities, are between jobs, or are working — would lose access to the health care they need to work, to care for their children, and to beat treatable illnesses.
Relative to the House Republican bill, the Senate version would make it even harder for some states to finance their Medicaid programs. Senate Republicans know the bill would hurt rural hospitals — that’s why they added a face-saving temporary fund, but it won’t rescue rural providers when the funding runs dry and the permanent cuts to Medicaid and Affordable Care Act (ACA) marketplace coverage remain. This is particularly true because the revised Senate fund gives the Health and Human Services secretary significant discretion in how the funds would be allocated. Rural providers need people in their communities to have health coverage they can count on. Without that, more rural hospitals will close and more people with and without coverage will be cut off from care they need.
The Senate Republican bill also would take health coverage away from even more immigrants living and working in the U.S. lawfully than the House bill would. The Senate bill would take away federal funding of Medicaid and Children’s Health Insurance Program coverage for refugees, people granted asylum, certain victims of sex or labor trafficking, and certain victims of domestic violence, among others. This ban includes children, and as in the House bill, it also would take away Medicare, ACA premium tax credits, and food assistance through SNAP from these groups. Despite countless misleading statements, immigrants in the country without a documented status are already ineligible for all of these programs; everyone who would lose health coverage and food assistance because of this bill is living lawfully in the U.S. (One anti-immigrant health provision in the House bill was not included due to a parliamentarian ruling.)
The Senate Republican bill would also raise families’ grocery costs, taking food assistance away from millions of people, including children and veterans, and forcing unaffordable costs on states. When states can’t pay those costs, they would be left with two choices — take SNAP benefits away from large numbers of people or end their SNAP programs entirely.
Again, it is clear that at least some Senate Republicans understand how damaging the provision is — they created a preposterous carve out to delay implementation of the cost-shift for states with the highest error rates in the country as a way to secure the votes they needed. But delaying for a handful of states a harmful provision that could unravel our most important anti-hunger program as a national program would not undo its damage.
Even as the Senate Republican bill would make deeper health care cuts, it continues the House’s approach of large tax cuts for the wealthy, including raising the amount heirs can inherit tax free from the largest estates to $30 million per couple and extending a deduction for business owners that would deliver more than half its benefits to millionaires.
The Senate bill would cost about $3.3 trillion when you remove the gimmick of assuming it is free to extend tax cuts. That is basically the same cost as extending all of the 2017 tax law’s expiring tax cuts for families — including millionaires — without any cuts to Medicaid and SNAP.
House Republicans should step back and find the courage to say no to any bill that would raise costs and take health coverage and food assistance away from people struggling to afford the basics — all while making deficits and debt soar and exposing our economy to more long-term risk.
But at the very least, as House Republican leaders seek to jam the Senate bill through the House, concerned House Republicans should follow through on their promise not to support a final bill that threatens access to Medicaid coverage and reject it.
If they don’t, they, along with their Senate counterparts, will own its impacts. Unfortunately, it is their constituents who will pay the price for their poor leadership.
Sen. Lisa Murkowski was the deciding vote to pass Republicans' massive social safety net cuts through the Senate. She said she didn't like the bill, but voted for it anyway after getting Alaska exempted from some of its worst harms.
By the thinnest possible margin, the U.S. Senate voted Tuesday to pass a budget that includes the largest cuts to Medicaid and nutrition assistance in U.S. history while giving trillions of dollars of tax cuts to the wealthiest Americans.
The deciding vote was Sen. Lisa Murkowski (R-Alaska), who admitted she didn't like the bill. However, she voted for it regardless after securing relief for her home state from some of its most draconian cuts.
But in an interview immediately afterward, she acknowledged that the rest of the country, where millions are on track to lose their healthcare coverage and food assistance, would not be so lucky.
"Do I like this bill? No," Murkowski told a reporter for MSNBC. "I try to take care of Alaska's interests. I know that in many parts of the country there are Americans that are not going to be advantaged by this bill. I don't like that."
The 887-page bill includes more than $1 trillion in cuts to Medicaid and the Children's Health Insurance Program over the next decade—cuts the Congressional Budget Office (CBO) projects will result in nearly 12 million people losing health coverage. The measure also takes an ax to the Supplemental Nutrition Assistance Program (SNAP)—imperiling food aid for millions.
In recent days, Murkowski—a self-described "Medicaid moderate"—expressed hesitation about signing onto a list of such devastating cuts, calling the vote "agonizing". To get her on board, her Republican colleagues were willing to give her state some shelter from the coming storm.
As David Dayen explained in The American Prospect, Murkowski was able to secure a waiver that exempts Alaska from the newly implemented cost-sharing requirement that will force states to spend more of their budgets on SNAP.
In The New Republic, Robert McCoy described it as a "bribe."
Initially, Republicans attempted to simply write in a carve-out for Alaska and Hawaii. But after this was shot down by the Senate parliamentarian, they tried again with a measure that exempted the 10 states with the highest error rates.
Sen. Amy Klobuchar (D-Minn.) called it "the most absurd example of the hypocrisy of the Republican bill."
"They have now proposed delaying SNAP cuts FOR TWO YEARS ONLY FOR STATES with the highest error rates just to bury their help for Alaska," she said.
Murkowski also got a tax break for Alaskan fishing villages inserted into the bill. She attempted to have Alaska exempted from some Medicaid cuts as well, but the parliamentarian killed the measure.
"Did I get everything that I wanted? Absolutely not," she told reporters outside the Senate chamber.
However, as Dayen wrote, "Murkowski decided that she could live with a bill that takes food and medicine from vulnerable people to fund tax cuts tilted toward the wealthy, as long as it didn't take quite as much food away from Alaskans."
Murkowski showed herself to be well aware of the harms the bill will cause. After voting to pass the bill, she said, "My hope is that the House is gonna look at this and recognize that we're not there yet."
Rep. Pramila Jayapal (D-Wash.) called Murkowski's bargain "selfish," "cruel," and "expensive."
"Voting for the bill because [of] a carve-out for your state is open acknowledgement that people will get kicked off healthcare and will have to go to much more expensive emergency rooms," Jayapal wrote. "Clear you know it's a terrible bill for everyone."
"Historians—and voters—will look back at this as a dark day in U.S. history."
With a tie-breaking vote from Vice President JD Vance, Senate Republicans on Tuesday narrowly passed budget legislation that includes the largest cuts to Medicaid and nutrition assistance in U.S. history and trillions of dollars in tax breaks that would disproportionately benefit the wealthiest Americans.
The Senate tally was 50-50 prior to Vance's intervention, with Democrats unanimously opposed and Sens. Rand Paul (R-Ky.), Thom Tillis (R-N.C.), and Susan Collins (R-Maine) crossing the aisle to vote against the bill, which now heads back to the Republican-controlled House of Representatives.
"JD Vance was the deciding vote to cut Medicaid across the country," Rep. Alexandria Ocasio-Cortez (D-N.Y.) wrote in response to the Senate vote. "An absolute and utter betrayal of working families."
The 887-page legislation includes more than $1 trillion in cuts to Medicaid and the Children's Health Insurance Program over the next decade—cuts that would result in nearly 12 million people losing health coverage. Analysts and advocates warn the proposed cuts would have cascading effects across the country, shuttering rural hospitals and devastating state budgets.
"Senate Republicans just voted to close nursing homes and hospitals around the country. These cuts will hit rural areas hardest, but nowhere is safe," said Alex Lawson, executive director of the progressive advocacy group Social Security Works. "Even if your local hospital doesn't close, it will have more patients and fewer staff due to the loss of Medicaid funding. Half of nursing homes will lose staff, and a quarter will close. All to give trillions in tax handouts to billionaires like Elon Musk and Jeff Bezos."
"In the end, billionaire political donors want a return on their investment, and Trump and Republicans are determined to give it to them with trillions in new handouts. The rest of us will suffer for it."
The measure also takes an ax to the Supplemental Nutrition Assistance Program (SNAP)—imperiling food aid for millions and potentially inflicting major damage to local economies across the U.S.—as well as clean energy programs, Planned Parenthood funding, and more.
Even with such seismic cuts, the Senate bill would still add more than $3 trillion to the deficit over the next 10 years due to the size of the measure's tax breaks, which would flow primarily to the rich and large corporations. Experts have said that, if enacted, the Republican legislation would spur the largest transfer of wealth from the poor to the rich in a single law in U.S. history.
"This abominable bill will make history—in appalling ways," said Amy Hanauer, executive director of the Institute on Taxation and Economic Policy. "Never before has legislation taken so much from struggling families to give so much to the richest. It makes the biggest cuts to food aid for hungry families, executes the largest cuts to healthcare ever, adds trillions to the national debt—all to give $114 billion to the richest 1% in a single year. It's no wonder that this bill is also extremely unpopular. Historians—and voters—will look back at this as a dark day in U.S. history."
The bill also contains a $150 billion boost for the Pentagon and tens of billions for Immigration and Customs Enforcement.
"This Republican bill is about caviar over kids, hedge funds over healthcare, and Mar-a-Lago over the middle class," said Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee. "If this becomes law, only the ultrawealthy will make it through unscathed. Every other American will be hurt in one way or another, whether it's cancer patients losing their health coverage, kids going hungry, or families being forced to pay higher utility bills and insurance premiums."
"In the end, billionaire political donors want a return on their investment, and [President Donald] Trump and Republicans are determined to give it to them with trillions in new handouts," Wyden added. "The rest of us will suffer for it. The United States will be a weaker, sicker, and poorer country as a direct result of what the Republicans are doing."
The Senate just passed the largest cut to low-income programs in a single law in US history. It would rip health insurance from more than 10 million people and take food assistance away from millions of households, including families with children and veterans.
— Bobby Kogan (@BBKogan) July 1, 2025
House Republicans are expected to move quickly to pass the Senate-approved legislation before Trump's July 4 deadline, but the bill appears likely to face significant pushback—particularly from far-right members who believe the measure's spending cuts aren't sufficiently aggressive.
Punchbowl reported that the House Rules Committee is expected to meet Tuesday "to begin to prepare the bill for floor consideration."
"The full House is expected back in Washington Wednesday morning, giving the chamber two days to pass the package before" July 4, the outlet noted.
Senate Republican leaders locked in the bill's passage after winning the support of Sen. Lisa Murkowski (R-Alaska). The American Prospect's David Dayen reported that Murkowski "was able to secure a waiver from cost-sharing provisions that would for the first time force states to pay for part of" SNAP.
"In order to get that past the Senate parliamentarian, 10 states with the highest payment error rates had to be eligible for the five-year waiver, including big states like New York and Florida, and several blue states as well," Dayen explained. "The expanded SNAP waivers mean that in the short term, only certain states with average or even below-average payment error rates will have to pay into their SNAP program; already, the language provided that states with the lowest error rates wouldn't have to pay."
After voting for the bill, Murkowski suggested that Republicans in the House should change it—meaning it would have to pass the Senate again before reaching Trump's desk.
David Kass, executive director of Americans for Tax Fairness, said in a statement that "this fight is not over," pointing to the House Republicans who have "voiced concern about the massive cuts to Medicaid and SNAP, in addition to the trillions this bill adds to the national debt."
"Since the House last voted for the bill, the Senate has only made the bill more expensive and enacted more cuts to critical programs that their constituents rely on," said Kass. "The question is: Will House members stand up for their constituents, or blindly follow Trump and his elite backers?"