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Rural hospitals, SNAP cuts, Medicaid: Democrats force tough votes on GOP mega-bill

Senate Minority Leader Chuck Schumer, D-N.Y., walks back onto the Senate floor after speaking to reporters at the U.S. Capitol Building on June 30, 2025 in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

Senate Minority Leader Chuck Schumer, D-N.Y., walks back onto the Senate floor after speaking to reporters at the U.S. Capitol Building on June 30, 2025 in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — Senate Republicans were closing in Monday on passing their version of the “big beautiful” tax break and spending cut bill that President Donald Trump wants to make law by a self-imposed July Fourth deadline.

But the chamber’s Democrats first kicked off a marathon of amendment votes, forcing their GOP colleagues to go on the record on tough issues, including cuts to health and food safety net programs. As of early evening, Democrats had not prevailed on any votes.

The tactic is used by the opposition party during massive budget reconciliation fights to draw attention to specific issues even as their amendments are likely to fail.

Democrats decried numerous measures in the mega-bill, including new work reporting requirements for Medicaid, the federal-state health insurance program for low-income people and people with disabilities.

Loud opposition has also swelled as legislative proposals shift significant costs of the federal Supplemental Nutrition Assistance Program, or SNAP, to states for the first time.

“I say to our colleagues, ‘Vote for families over billionaires,’” Sen. Amy Klobuchar of Minnesota said on the Senate floor.

The heart of the nearly 1,000-page legislation extends and expands the 2017 tax law to keep individual income tax rates at the same level and makes permanent some tax breaks on business investments and research and development costs.

The bill would also put in motion some of Trump’s campaign promises, including no tax on qualifying tips, overtime or car loan interest, but only for a few years.

The tax cuts are estimated to cost nearly $4.5 trillion over 10 years, and a provision in the bill raises the nation’s borrowing limit to $5 trillion as the United States faces record levels of debt.

Overall, the Senate bill is projected to add $3.25 trillion to deficits during the next decade, according to the latest calculation from the nonpartisan Congressional Budget Office.

Here are some key votes so far:

Planned Parenthood 

Washington Democratic Sen. Patty Murray tried to remove language from the bill that would block Medicaid payments from going to Planned Parenthood for one year unless the organization stops performing abortions.

Federal law already bars funding from going toward abortions, with limited exceptions, but GOP lawmakers have proposed blocking any other funding from going to the organization, effectively blocking Medicaid patients from going to Planned Parenthood for other types of health care.

Murray said the proposal would have a detrimental impact on health care for lower-income women and called it a “long-sought goal of anti-choice extremists.”

“Republicans’ bill will cut millions of women off from birth control, cancer screenings, essential preventive health care — care that they will not be able to afford anywhere else,” Murray said. “And it will shutter some 200 health care clinics in our country.”

Mississippi Republican Sen. Cindy Hyde-Smith opposed efforts to remove the policy change and raised a budget point of order, which was not waived following a 49-51 vote. Maine Republican Sen. Susan Collins and Alaska’s Lisa Murkowski voted with Democrats.

“There was a time when protecting American tax dollars from supporting the abortion industry was an uncontroversial, nonpartisan effort that we could all get behind,” Hyde-Smith said.

Medicaid for undocumented immigrants

Senators from both political parties crossed the aisle over whether the federal government should reduce how much a state is given for its Medicaid program if that state uses its own taxpayer dollars to enroll immigrants living in the country without proper documentation.

The provision was included in an earlier version of the bill, but the Senate parliamentarian ruled it didn’t comply with the complex rules for moving a budget reconciliation bill.

The vote was 56-44, but since it was on waiving a budget point of order, at least 60 senators had to agree to set aside the rules and move forward with the amendment, so the vote failed.

Democratic Sens. Catherine Cortez Masto of Nevada, Maggie Hassan of New Hampshire, and Jon Ossoff and Raphael Warnock of Georgia voted with GOP senators. Maine’s Collins voted with most of the chamber’s Democrats against moving forward.

Texas Republican Sen. John Cornyn asked for the vote, saying he believes the policy change would reduce undocumented immigration.

“Border patrol talks about push and pull factors,” Cornyn said. “One of the pull factors for illegal immigration is the knowledge that people will be able to receive various benefits once they make it into the country.”

Senate Budget Committee ranking member Jeff Merkley, D-Ore., opposed Cornyn’s attempt to get the language back in the bill, saying the policy change would financially harm states that expanded Medicaid under the 2010 health care law for simple mistakes.

“What this amendment says is that if one person, despite state law, through a bureaucratic mistake, is receiving funds, then the whole state pays the price and has their rate on expanded Medicaid changed from 90% to 80%,” Merkley said, referring to the percentage paid by the federal government.

Reduction in funding for Consumer Financial Protection Bureau

An amendment to stop a nearly 50% reduction in funding for the Consumer Financial Protection Bureau was blocked by Republican Sen. Tim Scott of South Carolina, who chairs the Senate Committee on Banking, Housing and Urban Affairs.

Sen. Elizabeth Warren, a Democrat who championed the CFPB after the 2008 financial collapse, attempted to bring the amendment to the floor saying the agency “is the financial watchdog to keep people from getting cheated on credit cards and mortgages and Venmo and payday loans and a zillion other transactions.”

“When this financial cop can’t do its job there is no one else in the federal government to pick up the slack,” Warren said.

Scott blocked her using a budget point of order, saying the reduction still provides “ample funding” for the agency. Democrats tried to waive that procedural tactic, but failed following a 47-53 vote.

An original provision to completely zero out the budget for the CFPB was not included because it did not meet the reconciliation process’ parameters.

Medicaid hospitals and maternal mortality

Senators voted 48-52 to reject Delaware Democratic Sen. Lisa Blunt Rochester’s proposals to send the legislation back to committee to remove language cutting certain funding for Medicaid, which she said would negatively impact “vital hospital services, especially labor and delivery rooms.”

“Today, Medicaid is the single largest payer of maternity care in the United States, covering 40% of births nationwide and nearly half of the births in our rural communities,” Blunt Rochester said. “Obstetric units, particularly in rural hospitals, are closing at alarming rates, actually creating maternity deserts.”

No Republicans spoke in opposition to the proposal, though Maine’s Collins voted in support. 

Supplemental Nutrition Assistance Program

New Mexico Democratic Sen. Ben Ray Luján offered a motion to commit the bill back to committee in order to remove all changes related to the Supplemental Nutrition Assistance Program, or SNAP. It was rejected following a 49-51 vote, though Alaska Republican Sens. Dan Sullivan and Murkowski voted in favor.

“I’m offering my colleagues the opportunity to step away from these devastating cuts, to show our fellow Americans that in this country we care for our friends, family and neighbors who need support,” Luján said.

Senate Agriculture Chairman John Boozman, R-Ark., opposed the proposals, saying that SNAP is “on an unsustainable path wrought with mismanagement and waste.”

“This program has devolved into viewing success as enrolling more individuals to be dependent on government assistance,” Boozman said. “SNAP is long overdue for change.”

Medicaid work requirements

Senators voted 48-52 to reject a proposal from Delaware Democratic Sen. Chris Coons that would have sent the bill back to committee to remove language requiring Medicaid enrollees to work, participate in community service, or attend an educational program at least 80 hours a month. Alaska’s Murkowski was the only member of her party to vote in favor of the effort.

Democrats have expressed concern for weeks that some people would lose access to Medicaid if they forgot to complete paperwork proving that time commitment or didn’t understand how to show the government they met the new requirement.

“It is cruel and dishonest to bury patients, kids and seniors in paperwork and then blame them when they lose their health care, all to further rig our tax code for the very wealthiest,” Coons said.

Kansas Republican Sen. Roger Marshall urged opposition to the proposal, saying that working helps people.

“My question is, don’t you think a job brings value, that it brings dignity?” Marshall said. “Do you not think it brings purpose and meaning to life?”

Rural hospitals and Medicaid

Maine’s Collins and Alaska’s Murkowski both voted for a proposal from Massachusetts Democratic Sen. Ed Markey that would have removed parts of the bill changing Medicaid.

But even with some bipartisan support, the changes were rejected on a 49-51 vote that would have technically sent the bill back to committee for three days to implement the changes.

“My Republican colleagues’ so-called Medicaid cuts replacement fund is like giving aspirin to a cancer patient,” Markey said. “It is not enough. It is pathetically inadequate to deal with the health care crisis Republicans are creating here today on the Senate floor. No billionaire tax break or Donald Trump pat-on-the-back is worth the risk of people’s lives.”

Senate Finance Committee Chairman Mike Crapo, R-Idaho, spoke out against the proposal, saying that rural hospitals have long had financial challenges and that it was clearly “intended to derail this very bill.”

“Unfortunately for far too long some rural hospitals have struggled to achieve financial stability, even with a wide-range of targeted payment enhances,” Crapo said. “These issues pre-date the consideration of the reforms that we are including in the legislation today.” 

 

US Senate mega-bill drops requirement states help pay for SNAP program

At a farm market in St. Petersburg, Florida, on April 14, 2012, SNAP recipients were able to use their Electronic Benefits Transfer cards for food. (Photo by Lance Cheung/USDA).

At a farm market in St. Petersburg, Florida, on April 14, 2012, SNAP recipients were able to use their Electronic Benefits Transfer cards for food. (Photo by Lance Cheung/USDA).

WASHINGTON — U.S. Senate Democrats have succeeded in eliminating more than a dozen policy changes from Republicans’ “big, beautiful bill” after successfully arguing before the chamber’s parliamentarian that the elements didn’t comply with the strict rules that go along with writing a budget reconciliation bill.

Removed is language that would have transferred some of the cost of running the Supplemental Nutrition Assistance Program to state governments, potentially leaving states on the hook for billions in added spending on the food aid program for lower-income people.

Democrats also fended off a proposal to eliminate funding for the Consumer Financial Protection Bureau, which fields complaints on banking and other financial institutions, and another that sought to bar federal district court judges from issuing nationwide injunctions. 

Among the contested items that remained, Missouri Republican Sen. Josh Hawley announced in a social media post that his years-long effort to reauthorize the Radiation Exposure Compensation Fund, or RECA, passed what’s known on Capitol Hill as the “Byrd bath” test.

“Terrific news for Missouri, radiation survivors, and MAHA: RECA has passed the ‘Byrd bath’ – Democrats did not strip it – and will be in the final bill,” Hawley wrote, referring to the Trump administration’s Make America Healthy Again slogan. “Huge step forward #MAHA.”

Democrats to continue challenges

Budget Committee ranking member Jeff Merkley, D-Ore., has cheered many of the parliamentarian’s rulings, though Republican committee chairs say they’ll look for ways to rewrite the various proposals.

“Today, we were advised by the Senate Parliamentarian that several more provisions in this Big Beautiful Betrayal of a bill will be subject to the Byrd Rule — and Democrats plan to challenge every part of this bill that hurts working families and violates this process,” Merkley wrote in a statement released Saturday night. “Republicans’ relentless attack on middle class families in order to fund tax breaks for billionaires is a slap in the face to working families everywhere, and Democrats are fighting back.”  

The changes could create several issues for Senate Majority Leader John Thune, R-S.D., and eventually for Speaker Mike Johnson, R-La., who need nearly every GOP lawmaker in Congress to vote for the sweeping tax and spending cuts package in order for it to become law.

The House voted 215-214 to approve its version of the bill in May, but since the Senate is making substantial changes, the House will have to vote on the measure again before it can go to President Donald Trump for his signature. GOP leaders hope to complete all that before the Fourth of July.

Republicans are using reconciliation, instead of moving the bill through the regular legislative process, to avoid needing Democratic votes to get past the Senate’s 60-vote legislative filibuster.

But the lower threshold for passing a reconciliation bill comes with several requirements, including that all of the proposals in the package have an impact on spending or revenues that’s not “merely incidental.”

The Senate parliamentarian, the chamber’s official scorekeeper who holds a detailed understanding of the rules and procedures, examines each of those policies and hears from both Republicans and Democrats before issuing the rulings.

The Byrd bath began last week behind closed doors and will continue for at least several more days. Once it concludes, Senate GOP leaders can move the bill to the floor, where members of both parties can call for votes on as many amendments as they want.

SNAP program

Agriculture, Nutrition and Forestry Committee Chairman John Boozman, R-Ark., released a written statement defending his committee’s bill after the parliamentarian ruled several provisions must go to comply with the rules.

“To rein in federal spending and protect taxpayer dollars the committee is pursuing meaningful reforms to the Supplemental Nutrition Assistance Program (SNAP) to improve efficiency, accountability and integrity,” Boozman wrote. “We are continuing to examine options that comply with Senate rules to achieve savings through budget reconciliation to ensure SNAP serves those who truly need it while being responsible stewards of taxpayer dollars.”

The parliamentarian ruled the committee erred in including language that would have shifted some of the cost of the SNAP program to state governments if they didn’t meet an efficiency benchmark before 2028.

A proposal to eliminate SNAP eligibility for “immigrants who are not citizens or lawful permanent residents, with certain exceptions,” was also determined not to comply with the rules, according to a press release from Merkley.

Minnesota Democratic Sen. Amy Klobuchar, ranking member on the committee, wrote the parliamentarian’s ruling “made clear that Senate Republicans cannot use their partisan budget to shift major nutrition assistance costs to the states that would have inevitably led to major cuts.

“While Republicans’ proposed cuts to SNAP will still be devastating to families, farmers, and independent grocers across the country, we will keep fighting to protect families in need. Instead of a rushed partisan process, Republicans should work with us to lower costs for Americans and pass a bipartisan Farm Bill that works for all farmers and rural America.”

Consumer financial agency victory for Dems

The Senate Banking, Housing and Urban Affairs Committee’s proposal to eliminate funding for the Consumer Financial Protection Bureau, which Congress established in the 2010 Dodd-Frank Wall Street Reform and Consumer Protection Act, also doesn’t comply with the rules, under the parliamentarian’s ruling.

Massachusetts Democratic Sen. Elizabeth Warren, ranking member on the panel, wrote in a statement that the GOP’s proposal for the CFPB represented “a reckless, dangerous attack on consumers and would lead to more Americans being tricked and trapped by giant financial institutions and put the stability of our entire financial system at risk–all to hand out tax breaks to billionaires.”

But committee Chairman Tim Scott, R-S.C., wrote in a separate statement that he remains “committed to advancing legislation that cuts waste and duplication in our federal government and saves taxpayer dollars.”

Scott listed provisions that he said will remain.

“As it stands now, the Banking Committee’s reconciliation provisions will delay the implementation of Section 1071 of Dodd-Frank, which reduces CFPB spending and protects the privacy and data of small business owners; rescind unused funds earmarked for green initiatives to give HUD discretion in funding critical housing programs; and save taxpayer dollars by eliminating an unnecessary reserve fund at the SEC,” Scott wrote. “My colleagues and I remain committed to cutting wasteful spending at the CFPB and will continue working with the Senate parliamentarian on the Committee’s provisions.”

Judges and injunctions

The parliamentarian told lawmakers that various elements of the Judiciary Committee’s bill don’t comply with the rules, including an attempt to block federal district court judges from issuing nationwide preliminary injunctions or temporary restraining orders.

The issue has become a thorn in Trump’s side during the past few months as he’s watched the courts block several of his executive orders and other unilateral administration actions.

The Judiciary Committee’s reconciliation bill cannot block the Department of Justice from awarding Byrne JAG and COPS grants to “sanctuary cities.” The bill also can’t send funding to local and state governments for the purpose of “apprehending aliens who are unlawfully present in the United States.”

Judiciary Committee Chairman Chuck Grassley, R-Iowa, did not respond to a request for comment, but a committee spokesperson wrote in an email to States Newsroom that “Democrats are clinging to their radical open borders legacy by fighting to keep criminal migrants in the United States.

“Republicans are committed to enforcing the rule of law, and will continue using all available avenues to secure our borders, clean up the mess left by the Biden-Harris administration’s disastrous policies and ensure courts operate according to lawful and constitutional standards.”

Illinois Democratic Sen. Dick Durbin, ranking member on the committee, issued a statement calling the bill’s policies “an attempted power grab by our Republican colleagues that we would not stand for.”

“Here’s what Senate Republicans attempted to sneak into their so-called Big, Beautiful Bill: a provision intended to limit the ability of individuals and organizations to challenge lawless Trump Administration executive actions by putting those potential plaintiffs on the hook for millions of dollars; and a provision conditioning grant eligibility on a state or locality’s compliance with federal immigration policies,” Durbin wrote.

Artificial intelligence and states

The parliamentarian didn’t, however, remove all of the proposals contested by Democrats.

Language that would prevent local and state governments from regulating artificial intelligence for the next decade if those jurisdictions want to receive money from a $500 million fund does meet the reconciliation requirements and can remain in the Committee on Commerce, Science and Transportation’s bill.

But that doesn’t mean the provision will stay in the bill moving forward, since several GOP lawmakers have expressed concern about potentially tying the hands of local and state governments when it comes to AI.

Georgia Rep. Marjorie Taylor Greene wrote in a social media post after she voted for the House’s bill that she had no idea about the AI provision. That chamber’s package barred state and local AI regulation for a decade without tying it to any funding stream.

“We have no idea what AI will be capable of in the next 10 years and giving it free rein and tying states hands is potentially dangerous,” Greene wrote. “This needs to be stripped out in the Senate.

“When the OBBB comes back to the House for approval after Senate changes, I will not vote for it with this in it.”

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