After months-long negotiations that culminated in lawmakers pulling an all-nighter, Republicans passed President Trump’s One Big, Beautiful Bill Act in the Senate 51-50, thanks to Vice President JD Vance’s tie-breaking vote. Three senators – Rand Paul of Kentucky, Susan Collins of Maine, and Lisa Murkowski of Alaska – had been vocally withholding their support for the bill, which was ultimately guaranteed after the latter changed her position just before the vote.
CNN reports that Republicans doubled the size of a rural hospital fund included in the bill to win Murkowski over, although the added funding remains well short of what’s needed to prevent the all-but-guaranteed closure of hundreds of facilities across the country. The proposed funding amounts to $25 billion distributed over five years, even as Medicaid, whose payments are a lifeline for hospitals in poor and rural areas, would be cut by around $1 trillion over the next decade.
Murkowski appeared ambivalent as she spoke to reporters after the bill’s passage, defending her vote while still criticizing the legislation. After she said that the bill was not perfect “by any stretch of the imagination,” reporters asked why it still got her vote, to which she replied: “because we have two options here, right? Kill it and it’s gone.” She then added: “I think I held my head up and made sure that the people of Alaska are not forgotten in this.” One of the Murkowski-focused changes added by Republican Senate leaders is tax break for whaling captains, a measure which exclusively affects her home state.
The Congressional Budget Office estimates that some 12 million lower-income Americans will lose their health insurance by 2034. If passed, the bill would also make Trump’s 2017 tax cuts permanent, which Pen Wharton estimates will continue to boost the income of top earners, while costing those in the bottom fifth nearly 11% of their after-tax income.
Other major programs that are cut in the One Big, Beautiful Bill Act include clean energy tax subsidies passed under the Biden administration in 2022. Despite decades of Republicans decrying growing budget deficits, the bill overall is expected to increase the it by $3 trillion over the next ten years.
The bill is now going back to the House, which is expected to begin the voting process on Wednesday. President Trump and Republicans have self-imposed a July 4th deadline to pass the One Big, Beautiful Bill Act.
