Today's News: Senate Republicans Advance Their Version of the “Big Beautiful Bill”

The nonpartisan Congressional Budget Office (CBO) estimates the legislation would lead to 11.8 to 12 million Americans losing health insurance by 2034.

Terrence Dorsey

Jun 29, 2025

Photo: Tom Williams/CQ-Roll Call

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Date: June 29, 2025
Topic: Senate Republicans Advance Their Version of the “Big Beautiful Bill”
Summary: The Republican-led Senate bill, dubbed “Trump’s agenda bill” or “tax megabill,” passed a key procedural vote despite internal GOP divisions. The nonpartisan Congressional Budget Office (CBO) estimates the legislation would lead to 11.8 to 12 million Americans losing health insurance by 2034, primarily due to over $1 trillion in cuts to Medicaid, and significant reductions to the Supplemental Nutrition Assistance Program (SNAP). The bill also includes tax cuts and increased funding for defense and border enforcement.

Sources

Key Points

A sweeping Republican-led domestic policy bill, often referred to as “Trump’s agenda bill” or “tax megabill,” is advancing through the Senate after a key procedural vote.
The legislation includes significant tax cuts, increased funding for defense and border enforcement, and substantial reductions to federal safety net programs, particularly Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
The nonpartisan Congressional Budget Office (CBO) estimates that the bill would lead to 11.8 to 12 million more Americans becoming uninsured by 2034 and over $1 trillion in cuts to Medicaid alone, while also increasing the national debt by approximately $3.3 trillion.
The proposed Medicaid cuts are substantial, achieved through provisions such as new national work requirements for recipients and restrictions on state mechanisms for financing the program.
The bill faces significant internal opposition within the Republican party, with moderates and centrists expressing concerns about the impact on their constituents and state budgets, while fiscal conservatives push for even deeper cuts.
President Trump is actively engaged in the whip effort, pressuring GOP senators to support the bill, including publicly criticizing holdouts.
Senator Thom Tillis of North Carolina is a prominent Republican who voted against advancing the bill due to concerns about Medicaid cuts in his state; he subsequently announced he would not seek re-election.
Democrats are unified in their opposition, criticizing the bill as a tax cut for the wealthy at the expense of working-class people, and employed a delay tactic by forcing the reading of the entire 940-page bill aloud on the Senate floor.

Unique Highlights

Specific Medicaid Cut Mechanisms (The New York Times): The New York Times details that the bulk of Medicaid savings come from a new strict national work requirement (80 hours/month, applied to parents of children older than 14) and new restrictions on state provider taxes and state directed payments, estimating these provisions would reduce federal spending by over $325 billion and $375 billion respectively.
Parliamentarian Rulings (The New York Times, The Wall Street Journal): The New York Times reports that the Senate parliamentarian ruled several health care provisions violated rules, including those increasing Medicare/Medicaid spending in Alaska and Hawaii, increasing paperwork requirements for Medicaid enrollment, and repealing a nursing home minimum staffing ratio. The Wall Street Journal also notes the parliamentarian advised stripping two provisions enhancing Alaska and Hawaii’s Medicaid budgets.
Historical Context of Safety Net Cuts (The Washington Post): The Washington Post provides historical context, stating that the bill’s cuts to Medicaid (approx. 18%) and SNAP (approx. 20%) are the largest reductions to federal safety net funding since at least the 1990s (for food stamps) and 1980s (for Medicaid), quoting an expert calling them “by a mile the biggest ever.”
Specific SNAP Program Changes (The Washington Post): The Washington Post details the bill’s changes to SNAP, including tightening work requirements for single mothers of teenagers as young as 14, raising the upper age for able-bodied adults without dependents from 49 to 64, and reversing the inclusion of internet access in cost-of-living calculations for eligibility.
SALT Deduction Provision (NBC News): NBC News highlights the bill’s proposal to lift the state and local tax (SALT) deduction cap from $10,000 to $40,000 for five years, a significant concession for blue-state House Republicans.
Trump’s Golf Outing (NBC News): NBC News mentions President Trump’s golf outing with Senators Rand Paul, Lindsey Graham, and Eric Schmitt on Saturday morning as part of his engagement on the bill.
Trump’s Deadline Flexibility (The Wall Street Journal): The Wall Street Journal notes that President Trump appeared to offer more flexibility on the self-imposed July 4 deadline, stating, “if we go two days late or five days late, everybody says, ‘Oh, you had a tremendous failure,’” implying the focus is on passage, not strict adherence to the date.
CBO Scoring Maneuver (The Wall Street Journal): The Wall Street Journal explains that senators are assuming all expiring tax cuts are extended at no cost, allowing them to claim the bill doesn’t increase deficits beyond 2034, which is essential for making tax cuts permanent under Senate rules, and notes Republicans refused a bipartisan meeting with the parliamentarian on this.

Contrasting Details

Effectiveness of Rural Health Fund: While The New York Times and NBC News mention a $25 billion fund to support rural health care providers was added to alleviate concerns, Senator Thom Tillis (The New York Times) still opposed the bill, finding the Medicaid effects “too extreme.” The Washington Post goes further, stating that the overall Medicaid changes “could also force already struggling rural hospitals to close or significantly pare back their services,” and quotes Senator Jim Justice (R-West Virginia) expressing concern about “cut[ting] into bone” and hurting rural hospitals, suggesting the fund may not be seen as sufficient or effective.
Alignment with Trump’s Past Medicaid Promises: The New York Times states that the bill’s cuts are “at odds with President Trump’s vow not to touch Medicaid except to do away with waste and fraud.” Similarly, The Washington Post notes that the cuts “fly in the face of prior promises made by party leaders: … Trump has repeatedly promised not to reduce benefits in the program.” This contrasts with the pervasive reporting across all articles that Trump is actively pushing for the bill’s passage and criticizing those who oppose it, indicating a discrepancy between his previous stated position and his current actions in support of a bill with significant Medicaid cuts.
Debt Impact and Fiscal Responsibility: NBC News and The Wall Street Journal explicitly state that the CBO projects the bill would increase the national debt by approximately $3.3 trillion over 10 years. Senator Rand Paul (NBC News) criticized the bill for adding to the debt, calling it “much more of a spending bill than a bill that rectifies the debt problem.” However, The Washington Post highlights that the spending cuts in the bill only “partially pays for its large price tag,” quoting Marc Goldwein of the Committee for a Responsible Federal Budget who laments that the “hard savings” from cuts are being used “not for deficit reduction… but to reduce the amount of money we’re borrowing,” suggesting a differing interpretation of the bill’s overall fiscal responsibility.

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