U.S. Senate Majority Leader John Thune, R-S.D., speaks to reporters at the Capitol as lawmakers work on the "One Big Beautiful Bill Act" on June 25, 2025 in Washington, D.C.  (Photo by Joe Raedle/Getty Images)

WASHINGTON — U.S. Senate Republicans appeared deeply divided Wednesday over how to establish a fund for rural hospitals to offset the budget impacts of Medicaid cuts in the “big, beautiful bill.”

The hospitals, which are generally already hurting financially, rely heavily on Medicaid, a state-federal partnership that provides health insurance for low-income households and for some people with disabilities.

GOP senators haven’t yet reached agreement on how to structure the fund, or on dozens of other unresolved provisions in the sweeping package, even though leaders hope to begin voting as soon as Friday. Still up in the air were agreements on major provisions of the measure involving the U.S. Department of Agriculture’s food aid program for low-income people and a proposed selloff of certain public lands.

Republican leaders continued to project optimism. “We’re well on our way to getting this bill passed this week,” Senate Majority Leader John Thune, R-S.D., said during a floor speech, continuing to press ahead toward a self-imposed Fourth of July deadline. 

Others saw it differently. Wisconsin Republican Sen. Ron Johnson cast doubt on the short timeframe leaders have set to reach final agreement and move the bill through both chambers.

“We’re still discussing some pretty fundamental issues,” Johnson said. “I’m just laying out the reality of the situation. We’ve got a lot of work to do.”

‘The only person up here that’s ever ran a rural hospital’

Dueling plans to establish the rural hospital fund to ease the threat of Medicaid cuts circulated among senators working to finalize the massive tax and spending cut measure, but an agreement had not surfaced by late afternoon.

Unofficial details showed Senate Republicans eyeing the inclusion of a $15 billion fund — $3 billion a year between fiscal 2027 and fiscal 2031 — to help rural hospitals, according to multiple reports.

But Sen. Roger Marshall, who sits on the Senate Committee on Finance, said he wants to increase that fund to $5 billion annually, with “half of that going to rural hospitals, and half of it going to primary care and prescription drugs and throw in physical therapy and occupational therapy, all the others as well.”

The Kansas Republican and physician said “we should probably only do it for four or five years and then regroup and see where we are.”

“I’m the only person up here that’s ever ran a rural hospital — I actually know something about them,” he added.

While Marshall said he loves “90%” of the broader bill, he said not nearly enough is being cut.

“But I can’t get the votes to do that, so it’d still be the largest cut in spending in my lifetime anyway,” he said, noting that “it’s going to be hard for the House to vote against it.”

Fund size criticized

On a midday call with reporters, Traci Gleason with the Missouri Budget Project said the stabilization fund being batted around by lawmakers “would fall well short of addressing these problems.”

“Forty-three percent of Missouri’s rural hospitals are at risk of closing, and 17% are considered to be at immediate risk,” said Gleason, who spoke during a virtual press briefing organized by the left-leaning Center for Budget and Policy Priorities.

“Those figures don’t account for all of the other health care providers in rural communities, like federally qualified health centers and others that operate on these incredibly thin margins. So the massive cuts to Medicaid are what is creating the problem and the only real way to address it is for Congress to not make these massive cuts,” she said.

‘Problematic’ Medicaid cuts

Sen. Susan Collins was advocating for a much bigger rural hospital stabilization fund, at $100 billion.

“I don’t think that solves the entire problem,” the Maine Republican and chair of the Senate Appropriations Committee said.

“The Senate cuts in Medicaid are far deeper than the House cuts, and I think that’s problematic as well.”

Sen. Jim Justice of West Virginia said that the $15 billion “is better than zero.”

“You know, naturally, I’d want it to be as high as it possibly can,” he said, adding that rural hospitals are the “lifeblood” of his state.

Sen. Josh Hawley of Missouri, a loud voice against Medicaid benefit cuts, said a stabilization fund is a “good idea but we’re still going to have to address the longer term effects of this.”

When asked for a dollar figure, Hawley said “it depends on the structure of it.”

Texas Republican Sen. John Cornyn said he keeps hearing the Senate will take a procedural vote on Friday, though that isn’t set in stone. 

“Should be a fun weekend for all of us,” Cornyn said. “Can’t wait.”

Once the Senate votes on what is called a motion to proceed, there’s a maximum of 20 hours of floor debate before the chamber must begin its marathon amendment voting session and eventually a passage vote.

SNAP provisions

Senate Agriculture Chairman John Boozman, an Arkansas Republican, said a revised version of his committee’s bill had not yet been reviewed by the parliamentarian.

The updated text alters a section restructuring the cost-share of the Supplemental Nutrition Assistance Program, or SNAP, a key food assistance program for low-income people.

The provision would require states for the first time to shoulder some of the cost of the program’s benefits. The amount a state owes would be determined by its error payment rate, with greater error rates requiring a higher state share.

Complex rules govern what can and can’t be included in the measure. The Senate parliamentarian ruled the language in the initial proposal did not comply with the chamber’s reconciliation rules.

The updated proposal would allow states more flexibility during the policy’s phase-in in fiscal 2028, allowing them to choose either the error rate in fiscal 2025 or fiscal 2026.

Boozman told reporters that change sought to respond to the parliamentarian’s ruling.

The parliamentarian “asked us to allow them (states) to use a different time frame — essentially gave them more time to understand what their error rate would be and to plan for it,” Boozman said. “And so we adjusted for that and I think we satisfied it.”

Lee and public lands

Senate Energy and Natural Resources Chairman Mike Lee of Utah reportedly narrowed a provision that would mandate the sale of Bureau of Land Management lands. He has not publicly said where it stands with the parliamentarian.

A committee spokesman did not return messages seeking clarification Tuesday and Wednesday, but a version of the changes obtained by news media shows changes consistent with what Lee proposed Monday.

Those changes include limiting the mandated sales to only the BLM — and not U.S. Forest Service lands, as Lee had initially proposed — and lowering the percentage of the agency’s lands that must be sold to between .25% and .5%. The initial proposal required between .5% and .75%.

The updated provision would also only require lands located within 5 miles of a population center to be sold and exempts lands that are currently used for grazing or another “valid existing right that is incompatible with the development of housing,” according to a copy of the changes obtained by hunting and angling publication Outdoor Life.

The provision has sparked opposition from Western lawmakers, including a handful of conservatives.

But it also has its share of supporters. Alaska Republican Dan Sullivan told reporters he had not seen the updated text but remained supportive of the idea.

“I’ve been supportive of what Sen. Lee is trying to do,” he said. “We have a lot of public lands in Alaska that the federal government abuses. But we’re in a good discussion on that, so I need to see the update.”

 

U.S. Education Secretary Linda McMahon testifies at a hearing of the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies on June 3, 2025. (Screenshot from committee livestream)

WASHINGTON — U.S. senators from both parties pressed Education Secretary Linda McMahon on Tuesday over the Trump administration’s proposal to eliminate funding for key programs administered by the Education Department for disadvantaged and low-income students.

McMahon defended those and other sweeping changes outlined in President Donald Trump’s fiscal year 2026 budget request — which calls for $12 billion in spending cuts at the department — while testifying before the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies to outline the president’s proposal.

Tuesday’s hearing followed the Education secretary’s testimony in front of the corresponding House panel in May. The House and Senate appropriations committees share jurisdiction over the bill to fund the department for the coming fiscal year.

McMahon said the budget request takes a “significant step” toward her and Trump’s goal “to responsibly eliminate the federal bureaucracy, cut waste and give education back to states, parents and educators.”

Senators blast move to eliminate programs

But the budget’s proposal to do away with the Federal TRIO Programs, which were funded at nearly $1.2 billion in fiscal year 2024, as well as the Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, which were funded at $388 million, garnered criticism from both Republicans and Democrats on the panel.

While the Federal TRIO Programs include federal outreach and student services programs to help support students who come from disadvantaged backgrounds, GEAR UP aims to prepare low-income students for college.

Neither TRIO nor GEAR UP has “met most of its performance measures for a number of years” and states and localities are “best suited” to determine how to support the activities in the programs rather than the federal government, according to the summary of the department’s more detailed budget request.

Sen. Susan Collins, chair of the broader Senate Appropriations Committee, said she “strongly” disagrees with the budget’s proposal to cut the TRIO programs.

The Maine Republican, who co-chairs the Congressional TRIO Caucus, said she’s “seen the lives of countless first-generation and low-income students, not only in Maine, but across the country, who often face barriers to accessing a college education changed by the TRIO program.”

Sen. Shelley Moore Capito, chair of the subcommittee, echoed Collins’ concerns about cutting TRIO and GEAR UP, and encouraged her panel to reevaluate those parts of the budget request.

The West Virginia Republican said “my state, and many of our states, but mine in particular, I think, has a lot of first-time collegegoers, a lot of students that don’t have the aspirational goals either within their family, they’re not looking at how they can achieve education or a certificate or whatever, and that’s where I think these programs have been particularly useful.” 

McMahon said that while she “absolutely” agrees that there is some effectiveness in the TRIO programs, “these programs were negotiated at very tough terms in that the Department of Education has no ability to go in and look at the accountability of TRIO programs.”

“It specifically eliminates our ability to do that, and I just think that we aren’t able to see the effectiveness across the board that we would normally look to see with our federal spending,” she said.

Sen. Jeff Merkley fired back at McMahon’s claim, noting that there are benchmarks set and annual performance reports required for grantees.

“Let me just say, your argument that there’s no studies, no accountability, is just actually wrong, and the fact that you’re coming here not even having looked at your own department’s studies of these programs in order to be informed about them is profoundly troubling,” the Oregon Democrat said.

Education Department ‘responsibly winding down’

The White House released new details on the proposed budget last week, and according to a summary, the $12 billion spending cut “reflects an agency that is responsibly winding down.”

The more detailed request includes lowering nearly $1,700 from the maximum amount a student can receive annually through the Pell Grant — a government subsidy that helps low-income students pay for college.

The budget proposal also calls for consolidating 18 grant programs for K-12 education and replacing them with a $2 billion formula grant that would give states spending flexibility. The document asks for a $60 million increase to expand the number of charter schools in the country.

The proposal came as Trump has sought to dramatically redefine the federal role in education.

The administration was hit with a major setback to its education agenda in May after a federal judge in Massachusetts ordered the Education Department to reinstate the more than 1,300 employees who were gutted through a reduction in force effort.

The judge also blocked the agency from carrying out Trump’s executive order calling on McMahon to facilitate the closure of her own department and barred the department from carrying out the president’s directive to transfer the student loan portfolio and special education services out of the agency.

Secretary of Health and Human Services Robert F. Kennedy Jr. testifies before a Senate Appropriations subcommittee on Tuesday, May 20, 2025. (Screenshot from committee webcast)

WASHINGTON — U.S. Health and Human Services Secretary Robert F. Kennedy Jr. testified before Congress on Tuesday that a major report due out later this week from his agency will not disparage farmers or a commonly used pesticide.

Kennedy, who has long been critical of certain aspects of modern agriculture and processed food, at a U.S. Senate hearing urged lawmakers to read the widely anticipated “Make America Healthy Again” report once it’s published Thursday, but didn’t go into details about any possible recommendations.

“Everybody will see the report,” Kennedy said. “And there’s nobody that has a greater commitment to the American farmer than we do. The MAHA movement collapses if we can’t partner with the American farmer in producing a safe, robust and abundant food supply.”

His comments followed stern questioning from Mississippi Republican Sen. Cindy Hyde-Smith, who said she had read news reports from “reliable sources” that the MAHA Commission’s initial assessment “may unfairly target American agriculture, modern farming practices and the crop protection tools that roughly 2% of our population relies on to help feed the remaining 98%.”

“If Americans lose confidence in the safety and integrity of our food supply due to the unfounded claims that mislead consumers, public health will be at risk,” Hyde-Smith said. “I’ve said this before, and it’s worth saying again, countries have gone to war over many things — politics, religion, race, trade, natural resources, oil, pride, you name it — but threaten a nation’s food supply and allow people to go hungry. Let’s see what happens then.”

Hyde-Smith, who was her home state’s commissioner of agriculture and commerce from 2012 to 2018, probed Kennedy about his past work in environmental law and whether he might be inserting “confirmation bias” into the forthcoming report.

She asked Kennedy if he would try to change the current approval for glyphosate, a commonly used herbicide, that she referred to as “one of the most thoroughly studied products of its kind.”

“We’re talking about more than 1,500 studies and 50-plus years of review by the EPA and other leading global health authorities that have affirmed its safety when used as directed,” Hyde-Smith said. “Have you been able to review thousands of studies and decades of scientific review in a matter of months?”

Kennedy responded that her “information about the report is just simply wrong.”

“The drafts that I’ve seen, there is not a single word in them that should worry the American farmer,” Kennedy said.

Hyde-Smith continued her questioning and told Kennedy that it would be “a shame if the MAHA commission issues reports suggesting, without substantial facts and evidence, that our government got things terribly wrong when it reviewed a number of crop protection tools and deemed them to be safe.”

Home energy program in Maine

Several other Republicans on the Senate Appropriations Labor-HHS-Education Subcommittee raised concerns during the two-hour hearing about how Kennedy has run HHS since they confirmed him in February.

Maine Sen. Susan Collins, chairwoman of the full Appropriations Committee, brought up the Low Income Home Energy Assistance Program, or LIHEAP, which the Trump administration has called on Congress to eliminate.

“The LIHEAP program, which we’ve talked about, is absolutely vital for thousands of older Mainers and low-income families,” Collins said. “It helps them avoid the constant worry of having to choose between keeping warm, buying essential foods and medications and other basic necessities.”

Kennedy sought to distance himself from the president’s budget request, saying that he understands “the critical, historical importance of this program.”

“President (Donald) Trump’s rationale and (the Office of Management and Budget’s) rationale is that President Trump’s energy policies are going to lower the cost of energy … so that everybody will get lower cost heating oil,” Kennedy said.

NIH indirect costs

Subcommittee Chairwoman Shelley Moore Capito, R-W.Va., brought up several issues with Kennedy, including efforts to change how much the National Institutes of Health provides to medical schools and research universities for Facilities and Administrative fees, often called indirect costs.

NIH sought to set that amount at 15% across the board for any institution that receives a research grant from the agency, a significantly lower amount than many of the organizations had negotiated over the years, bringing about strong objections from institutions of higher education.

That NIH policy has not taken effect as several lawsuits work their way through the federal court system.

Kennedy indicated NIH has figured out a way to help medical schools and research universities pay for items like gloves, test tubes and mass spectrometers, particularly at state schools.

“In the public universities, we are very much aware that those universities are using the money well, that it is absolutely necessary for them. And we’re looking at a series of different ways that we can fund those costs through them,” Kennedy said. “But not through the independent, indirect cost structure, which loses all control, which deprives us of all control of how that money is spent.”

Kansas Sen. Jerry Moran, a Republican, brought up the measles outbreak and pressed Kennedy on whether HHS needed additional resources to help his home state and others get the virus under control.

Kennedy testified the “best way to prevent the spread of measles is through vaccination” and that HHS has been urging “people to get their MMR vaccines.”

South Dakota grant on mine safety

South Dakota Sen. Mike Rounds called on Kennedy to continue fixing issues created earlier this year when HHS fired people working on mine safety issues at the National Institute for Occupational Safety and Health.

“My office has learned that staff at NIOSH’s Spokane mining research division have been laid off. This office focuses on the unique challenges of Western mining operations that are often more geologically complex and exposed to harsher conditions,” Rounds said. “This division provides critical technical support for institutions like the South Dakota School of Mines and Technology, which recently received a $1.25 million grant to improve underground mining safety. However, the grant has now been canceled due to loss of oversight from the Spokane office.

“This is not just a missed opportunity, it undermines our ability to meet national security goals tied to mineral independence and supply chain resilience.”

Kennedy testified that he’s been able to bring back 238 workers at the agency and said he would work with Rounds to address ongoing issues.

Pledge to fund Head Start, but no dollar amount

Alabama Sen. Katie Britt, a Republican, asked Kennedy about news reports earlier this year that HHS would ask Congress to zero out funding for Head Start, one of numerous programs left out of the administration’s skinny budget request. Head Start provides early learning, health, family and development programs for free for children from low-income families.

Kennedy testified that eliminating Head Start would likely not be in the full budget request, which is set to be released later this year, though the White House budget office has not said when. He said it would ask Congress to fully fund the program, but didn’t share a dollar amount.

“There’s 800,000 of the poorest kids in this country who are served by this program. It not only teaches the kids preschool skills — reading, writing and arithmetic — before they get to prepare them for school. But it also teaches the parents and teaches them how to be good parents.”

Kennedy said there are challenges faced by the Head Start program that he hopes to change during the next four years, including the quality of the food.

“The food they’re serving at Head Start is terrible. You need to change that,” Kennedy said. “We’re poisoning the poorest kids from their youngest years, and we’re going to change that.”