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Senate Nears Vote on Trump’s ‘One Big Beautiful Bill’ as GOP Splits Over Medicaid Cuts

Negotiations over deep Medicaid reductions are testing Republican unity ahead of a critical vote.

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Overview

  • Senate Majority Leader John Thune aims to begin floor votes by Friday to meet a self-imposed July 4 passage deadline.
  • The Congressional Budget Office warns nearly 11 million people could lose health coverage and 3 million could lose food aid under proposed Medicaid work requirements.
  • Senators including Susan Collins and Josh Hawley are pushing for a rural hospital relief fund, with estimates ranging from $15 billion to $100 billion.
  • A group of House Republicans from swing and high-tax districts has threatened to reject the Senate’s version over deeper Medicaid cuts and unchanged SALT caps.
  • The bill would make 2017 tax cuts permanent and boost immigration enforcement funding, but faces unified Democratic opposition and parliamentarian rulings that have trimmed some provisions.