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Republican megalaw helps earners with high and middle incomes, hurts poorest, CBO says

A sign in an Indianapolis store shown on Aug. 1, 2023, says SNAP benefits are accepted. A new analysis by the Congressional Budget Office projects 2.4 million fewer people per month will participate in the program under Republicans’ tax cut and spending law. (Photo by Getty Images)

A sign in an Indianapolis store shown on Aug. 1, 2023, says SNAP benefits are accepted. A new analysis by the Congressional Budget Office projects 2.4 million fewer people per month will participate in the program under Republicans’ tax cut and spending law. (Photo by Getty Images)

About 10 million people, mostly Medicaid recipients, will lose access to health insurance and 2.4 million fewer people per month will participate in a federal food aid program under Republicans’ massive tax cut and spending law, the nonpartisan Congressional Budget Office said Monday.

Median-income U.S. households will see a small overall gain in resources from President Donald Trump and the GOP’s “big, beautiful” law, CBO said.

But major changes to Medicaid and the Supplemental Nutrition Assistance Program, or SNAP, mean Americans at the bottom of the income distribution will see a net loss of benefits, CBO said.

The law, which both chambers of Congress passed without any Democratic votes and Trump signed July 4, significantly narrows eligibility for Medicaid and SNAP.

Those changes, even combined with federal tax cuts, will lead to a roughly 3% drop in resources over the next nine years for households in the bottom tenth of earners, the CBO analysis said.

“The changes in resources will not be evenly distributed among households,” the congressional scorekeeper said. “The agency estimates that, in general, resources will decrease for households toward the bottom of the income distribution, whereas resources will increase for households in the middle and toward the top of the income distribution.”

The projection shows households in the bottom two-tenths of the income distribution would see a net loss of resources.

Households in the middle 20% of the income distribution would receive, on average, between $800 and $1,200 more per year, which would account for 0.8% to 1% of their income.

At the top of the income distribution, households in the top tenth would see, on average, $13,600 more annually, about 2.7% of their projected income, from 2026 to 2034, the CBO said.

But the lowest tenth of households by income would see a drop of about $1,200 per year, which accounts for 3% of that group’s projected income, the CBO said.

Millions to lose benefits

Roughly 10 million people will lose access to health insurance by 2034, the CBO projected. Most of that group, 7.5 million, would lose Medicaid benefits.

A single section of the law creating new work requirements for Medicaid recipients would result in 5.6 million people losing access to care, the CBO said.

The law also creates new work requirements for SNAP participants and mandates that at least some states pay for a portion of the benefits. States had never been required to cover any share of the cost of SNAP benefits.

The changes to work requirements will result in reduced participation in the program by about 2.4 million people, the CBO said in another analysis published Monday.

The changes to state cost-share in SNAP will save the federal government about $41 billion from 2026 to 2034, CBO said. The agency expects states to pick up most, $35 billion, of that spending.

But the new requirements for states would still likely lead to 300,000 people fewer accessing benefits monthly. The report considered state officials would choose from policy responses including cutting benefits, reducing eligibility or leaving the program altogether in response to the new cost-share.

‘Stealing from working families’

In a press release, a quartet of Democratic leaders in Congress highlighted the regressive impact the CBO projected.

“Prices keep rising and American families are struggling,” House Budget Committee ranking Democrat Brendan Boyle of Pennsylvania said. “So what are President Trump’s Republicans doing to help? They passed a law that will make things worse by stealing from working families to give billionaires a tax break.”

“It is truly unfathomable that Trump and Republicans in Congress are championing a bill that gives the top 10 percent $13,600 more per year – while the least affluent 10 percent will lose $1,200 per year,” Senate Budget ranking Democrat Jeff Merkley of Oregon said. “This is families lose, and billionaires win.”

Senate Minority Leader Chuck Schumer and House Minority Leader Hakeem Jeffries, both of New York, made similar statements in the release.

‘Big, beautiful’ law draws mostly skeptical reaction in new nonpartisan poll

The U.S. Capitol building in Washington, D.C., is pictured on Sunday, June 29, 2025, as the reconciliation package was under debate. (Photo by Jennifer Shutt/States Newsroom)

The U.S. Capitol building in Washington, D.C., is pictured on Sunday, June 29, 2025, as the reconciliation package was under debate. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — A majority of Americans believe Republicans’ “big, beautiful” law will either hurt them or not make much of a difference, according to a poll released Thursday by the nonpartisan health research organization KFF.

The survey shows 46% of people expect the new tax and spending cuts law will generally hurt them or their family, while 28% said it likely won’t make much difference and 26% said it will help them.

Those beliefs were skewed by political parties, with 54% of Republicans saying the law will help them or their family, compared to 19% of independents and 7% of Democrats.

People enrolled in Medicaid, the state-federal health program for lower income individuals and people with disabilities, have significant concerns about how changes to the program will impact them.

Sixty-five percent of Medicaid patients under the age of 65 said they expect the law to hurt them or their family. Another 17% said it won’t make much of a difference for them and 18% expect the policy changes to help.

The law makes more than a dozen changes to how Medicaid is run, resulting in a $1.058 trillion spending cut to the program during the next decade, according to an analysis released earlier this week by the nonpartisan Congressional Budget Office.

The report projects that 10 million people will lose access to health insurance before 2034.

The law made permanent the 2017 tax cuts from President Donald Trump’s first term and provided billions to carry out his plans of mass deportations, an immigration crackdown and increased defense spending.

Some know little about new law

KFF’s survey shows most Americans know at least something about the new law, though 9% of those polled said they know nothing at all and 23% said they know just a little.

Democrats had the highest percent of respondents who said they knew either a lot, 35%, or some, 45%, about the law. Twenty-two percent of Republicans said they knew a lot about their party’s top legislative achievement this year, with 44% saying they knew something, 27% saying they knew a little and 7% saying they knew nothing.

Social media

The vast majority of those polled, 78%, said they saw information about Republicans’ new law on social media during the last month.

Facebook and YouTube were the more popular social media platforms for people to see information about the tax and spending cuts law, followed by Instagram, TikTok, X and Reddit.

Forty-seven percent of those surveyed said the content they saw on social media opposed the policy changes included in the law, while 41% said it was mixed and 11% said it supported the GOP’s work.

Republicans said 26% of what they viewed on social media was in support of the law, with 53% mixed and 21% opposed. Democrats polled said 76% of what they saw was opposed, 21% mixed and 3% was supportive.

Most of those surveyed said the social media content helped them understand what the new law actually does. Sixteen percent said it was very helpful, 46% said it was somewhat helpful, 27% said it was not too helpful and 11% said it wasn’t helpful at all. 

Trump tax law runs up deficit by $3.4T, throws 10 million off health insurance, CBO says

President Donald Trump holds up the "One Big Beautiful Bill Act" that was signed into law during an Independence Day military family picnic on the South Lawn of the White House on July 4, 2025 in Washington, D.C.  (Photo by Alex Brandon - Pool/Getty Images)

President Donald Trump holds up the "One Big Beautiful Bill Act" that was signed into law during an Independence Day military family picnic on the South Lawn of the White House on July 4, 2025 in Washington, D.C.  (Photo by Alex Brandon - Pool/Getty Images)

WASHINGTON — Republicans’ “big, beautiful” law will add $3.394 trillion to deficits during the next decade and lead 10 million people to lose access to health insurance, according to an analysis released Monday by the nonpartisan Congressional Budget Office.

The updated assessment of the sweeping tax and spending cuts law came weeks after nearly every GOP lawmaker voted to approve the legislation ahead of a self-imposed Fourth of July deadline. The law made permanent the 2017 tax cuts from President Donald Trump’s first term and provided billions to carry out his plans of mass deportations, an immigration crackdown and increased defense spending.

Maya MacGuineas, president of the Committee for a Responsible Federal Budget, wrote in a statement that it is “still hard to believe that policymakers just added $4 trillion to” deficits after Republican lawmakers “have spent months or years appropriately fuming about our unsustainable fiscal situation.”

“This is a dangerous game we are playing,” MacGuineas wrote. “It has been going on for years, and it was brought to new levels with this bill. And it is time to stop.” 

CBO released numerous reports throughout the months-long process showing how various parts of the bill would affect federal spending and health care access, but the scorekeeper needed additional time to evaluate changes Republicans made during the last few days of debate.

The latest figures are similar to a preliminary report CBO released earlier this month projecting the final version of the package, which underwent considerable changes in the Senate, would likely lead to a $3.4 trillion increase in deficits between 2025 and 2034.

That total was significantly higher than the $2.4 trillion increase in deficits CBO expected the original House version of the bill would have had during the next decade.

Health spending to fall by more than $1 trillion

Republicans’ numerous changes to health programs, predominantly Medicaid, will reduce federal spending during the next decade by $1.058 trillion.

The law made more than a dozen changes to the state-federal health program for lower income individuals and certain people with disabilities, though some of those have larger budget impacts than others.

Language barring Medicaid spending from going to Planned Parenthood for one year would actually increase federal deficits during the 10-year window by $53 million.

The CBO score shows that policy change would decrease federal spending by $44 million this fiscal year and another $31 million during the next fiscal year, before increasing deficits by $91 million during fiscal year 2027 and continuing.

That section of the law is on hold for the moment after a federal judge issued a temporary restraining order earlier this month that required the Trump administration to continue paying Planned Parenthood for routine health care coverage for Medicaid enrollees.

Federal law for decades has barred the federal government from spending taxpayer dollars for abortion services with limited exceptions, so the one-year prohibition on Medicaid funding to Planned Parenthood would have blocked patients enrolled in the program from going to their clinics for routine health appointments, like annual physicals and cancer screenings.

The CBO report didn’t include a state-by-state breakdown of the effects of the health care changes in the law, but the agency is expected to release more detailed analysis of the health impacts in the coming weeks.

Nutrition assistance cuts

Apart from Medicaid, two large projected deficit reductions in the law come in the agriculture title’s sections on the Supplemental Nutrition Assistance Program, or SNAP.

A provision requiring states to pay for some portion of SNAP benefits starting in fiscal 2028 would save the federal government between $5.7 billion and $6 billion per year, totalling just less than $41 billion for the first seven years it will be in effect.

And new work requirements for SNAP would result in $68.6 billion less in federal spending over the 10 years starting in fiscal 2026, the CBO projected.

Federal student loan program

Republicans’ streamlining of the federal student loan program is projected to reduce federal spending in the next decade by $270.5 billion.

As part of a sweeping overhaul of higher education, the law limits repayment options for borrowers with any loans made on or after July 1, 2026, to either a standard repayment plan or an income-based repayment plan.

Extension and expansion of tax cuts

The extension of Trump’s 2017 tax law, plus new tax breaks, will cost $4.472 trillion over the next decade, according to the latest CBO score.

The United States collects the majority of its revenue from individual taxpayers, and the continuation of lowered income tax brackets, plus an increased standard deduction, will comprise the bulk of lost revenue over 10 years, adding up to $3.497 trillion.

Trump also campaigned on several other tax cut promises, including no tax on tips and overtime, as well as no tax on car loan interest. The temporary provisions come with stipulations and will end in 2029. Together they will cost $151.868 billion.

The child tax credit increases under the new law to $2,200, up from $2,000, though lawmakers did not increase the amount lower income families can receive as a tax refund. The CBO estimates the bumped-up tax credit will cost $626.345 billion over the next decade.

Lawmakers offset some costs of the bill by repealing clean energy tax credits, including ending tax credits for personal and commercial electric vehicles, nixing energy efficiency improvement credits for homeowners, and terminating clean electricity production credits. In all, Republicans saved $487.909 billion from axing the measures meant to address the effects of climate change.

Jacob Fischler, Shauneen Miranda and Ashley Murray contributed to this report.

US Senate launches debate on GOP mega-bill, but passage still not assured

The U.S. Capitol on Sunday, June 29, 2025. (Photo by Jennifer Shutt/States Newsroom)

The U.S. Capitol on Sunday, June 29, 2025. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — The U.S. Senate began floor debate on Republicans’ “big, beautiful bill” Sunday afternoon, though there are several steps to go before the legislation can become law, and any one of those could lead to additional GOP opposition — potentially dooming the measure. 

Senators must wrap up an ongoing review of the bill with the parliamentarian to ensure it meets the strict rules for using the reconciliation process and then run the gauntlet during a marathon amendment voting session.

Additional changes to the sweeping tax and spending cuts package, some of which were being worked on as debate took place, need to garner the support of nearly every Republican in Congress. Otherwise, it will never become law.

Senate Majority Leader John Thune signaled during a brief hallway interview there may be enough votes for a new twist in the Medicaid changes in the bill — an amendment reducing in some way how much the federal government spends on Medicaid in states that expanded the program as a result of Democrats’ 2010 health care law. The federal government currently pays 90% of the costs for enrollees in the expansion.

“We’re going to do what we can to support the effort,” Thune said, referring to an amendment offered by Florida Sen. Rick Scott that was not yet public. “It’s great policy and something that there’s a high level of interest in our conference in getting made part of the bill, and obviously scores a substantial savings.”

But Thune, R-S.D., sidestepped a question about whether making that change would create vote-count issues if Republicans in the House with affected districts object, potentially preventing the bill from reaching President Donald Trump’s desk.

“We have had some of these conversations with (Speaker Mike Johnson) and others over there, and then also with our colleagues for some time,” Thune said. “But I think the way this is designed, and the way that Sen. Scott has written it; it should be something that I don’t know how Republicans couldn’t be in favor of what he’s trying to get done here.

“So, you know, we’ll cross that bridge when we come to it. Obviously, we’ve still got to get into the debate over here and get through the amendment process and we’ll see what the fate of the amendment is on the floor.”

Currently 41 states, including the District of Columbia, have adopted the Medicaid expansion, according to the health care research organization KFF.

A Scott spokesperson told States Newsroom they would share his amendment once it was final.

Still fluid

Typically when a major piece of legislation comes to the Senate floor the text is set and amendment debate is closely controlled to ensure delicately negotiated deals don’t crumble in full public view.

That isn’t the case this time around and much could change before senators take a final passage vote later this week, potentially as soon as Tuesday.

GOP leaders using the complex reconciliation process to move their signature policy bill through Congress means every provision must have an impact on federal spending or revenue that is not “merely incidental.”

That involves Democrats and Republicans going before the Senate parliamentarian, the chamber’s official referee, to argue over dozens of provisions. She then decides if a given policy meets the strict and sometimes murky rules.

That process hadn’t yet wrapped up when debate on the megabill began and is expected to continue as the 20-hour clock ticks down toward a marathon amendment voting session.

Senate bill would add $3.2 trillion to deficits

There are also increasing concerns among Republicans, including those in the House Freedom Caucus, over how the bill will impact the federal government’s balance sheet during the next decade.

The nonpartisan Congressional Budget Office announced Sunday morning the Senate’s revised tax and spending cuts package will add $3.253 trillion to deficits during the next decade compared to current law.

Trump appeared to try to assuage concerns through a social media post.

“For all cost cutting Republicans, of which I am one, REMEMBER, you still have to get reelected,” Trump wrote. “Don’t go too crazy! We will make it all up, times 10, with GROWTH, more than ever before.”

The latest score came just hours before senators officially began floor debate on the sweeping package that will extend the 2017 GOP tax law, rework how much state governments have to contribute to the Supplemental Nutrition Assistance Program, overhaul several aspects of Medicaid and cut its spending, restructure higher education aid programs and much more.

Senators voted mostly along party lines late Saturday to proceed with the legislation, though leaders had to hold the vote open for more than three hours as they worked to get the votes needed.

Even after taking that crucial procedural step, the bill continued to evolve.

The parliamentarian ruled Sunday morning that another six provisions must be revised to comply with the rules or be removed from the 940-page package

One Alaska sweetener knocked out

GOP senators cannot include, or might need to restructure, language meant to bring Alaska Republican Sen. Lisa Murkowski on board by enhancing the federal matching rate for Medicaid in two states with high poverty guideline levels: Alaska and Hawaii. The program for low-income people and some people with disabilities is run as a state-federal partnership.

Since Hawaii is represented in Congress by a Democratic delegation, the Republican benefit would largely have applied to Alaska’s two GOP senators.

Senate Republicans did receive some good news from the parliamentarian in her latest ruling, which cleared language that will steadily lower the maximum percent states can set for Medicaid provider tax rates from the current 6% to 3.5% in 2032.

The in-the-weeds policy has caused considerable frustration among GOP senators across the political spectrum, who argued a prior version would likely cause financial strain for rural hospitals by beginning the process one year sooner.

Planned Parenthood

The parliamentarian is still reviewing several other policy changes in the bill, including whether Republicans can prevent Medicaid funding from going to Planned Parenthood for one year, effectively blocking beneficiaries from receiving care there at all.

Federal law already bars federal taxpayer dollars from going toward abortions with limited exceptions for rape, incest, or the life of the pregnant patient. So this change would prevent Medicaid patients, who may have few other options, from using Planned Parenthood for other types of health care, like annual physicals, contraception and cancer screenings.

A prior version of the bill blocked federal funding from going to Planned Parenthood for the next decade.

Senate Finance Committee Chairman Mike Crapo, R-Idaho, did not immediately respond to a request from States Newsroom about how the rulings might impact the bill going forward.

Senate Finance Committee ranking member Ron Wyden, D-Ore., wrote in a statement the latest rulings show “that Republican attempts to give away goodies that benefit certain states will not pass muster under Senate rules.”

“Senate Democrats have also successfully challenged a giveaway to Big Pharma, as well as policies that make it harder for seniors and kids to get affordable health care through Medicaid,” Wyden wrote. “Republicans wanted to bring back the health care tactics of yesteryear, like waiting periods, lock-outs and annual limits on care, but Democrats have wrestled these out of the bill. I am disappointed that the Republican rewrite of the provider tax changes will remain in the bill: this policy will force states into devastating cuts to health care that seniors, kids and Americans with disabilities depend on. We will continue to fight any attempt to sneak through harmful health care policies in this morally bankrupt legislation.”

Amendment fights ahead

Republicans hope to pass the entire package before the Fourth of July, though they have several hurdles to jump over before they can meet that goal.

Senate floor debate can last up to 20 hours. After that, senators will begin a marathon amendment voting session where members of each political party can propose changing or removing certain pieces of the legislation.

GOP leaders generally like to avoid public disputes within the party but the rules of reconciliation don’t really allow that and several Republican senators are expected to offer amendments.

There is no time limit or cap on the number of amendments that can be offered during vote-a-rama, so that can last hours or even days in theory.

Whenever Democrats and Republicans decide they’ve debated their last amendment, they’ll move on to voting to approve the Senate’s version of the “big, beautiful bill.”

At least 50 Republicans need to vote to approve the measure, with Vice President JD Vance’s tie-breaking vote. More than four GOP senators objecting to the overall bill means it cannot pass as it’s written.

Thom Tillis, Rand Paul

Republican Sens. Thom Tillis of North Carolina and Rand Paul of Kentucky voted against moving forward with debate so it’s likely they will vote against final passage as well. Two more senators deciding not to back the bill would halt its momentum, at least until GOP leaders could make changes to get their votes.

Tillis on Sunday announced he would not run for reelection, after being attacked by Trump for voting against advancing the legislation.

Senate approval of the bill would send it back to the House for a final vote, though centrist and far-right members of the Republican Conference in that chamber have voiced concerns about changes made in the upper chamber.

Johnson, R-La., will need to keep nearly every one of the 220 House GOP lawmakers supportive if that chamber is to send the legislation to  Trump for his signature before Friday. 

U.S. Senate GOP will try to drag Trump’s mega-bill across the finish line

U.S. Senate Majority Leader Sen. John Thune, R-S.D., left, listens as Sen. Mike Crapo, R-Idaho, center, speaks to reporters outside of the West Wing of the White House on June4, 2025 in Washington, D.C.  (Photo by Anna Moneymaker/Getty Images)

U.S. Senate Majority Leader Sen. John Thune, R-S.D., left, listens as Sen. Mike Crapo, R-Idaho, center, speaks to reporters outside of the West Wing of the White House on June4, 2025 in Washington, D.C.  (Photo by Anna Moneymaker/Getty Images)

WASHINGTON — U.S. Senate Republican Leader John Thune will spend a crucial next few weeks working behind the scenes with other top GOP senators to reshape the party’s “big beautiful bill” — a balancing test accompanied in recent days by incendiary exchanges between President Donald Trump and billionaire Elon Musk over whether the current proposals are so bad that Congress should just go back to the drawing board.

South Dakota’s Thune will need to gain support from deficit hawks, who want to see the mega-bill cut at least $2 trillion in spending, and moderates, who are closely monitoring how less federal funding for safety net programs like Medicaid and food assistance could harm their constituents and home-state institutions like rural hospitals.

Interviews by States Newsroom with Republican senators in early June showed many major elements of the package could change, including provisions that would put states on the hook for unanticipated costs. Arkansas Sen. John Boozman, for example, indicated the Senate may rewrite a proposal in the House-passed bill that would shift some of the cost of the Supplemental Nutrition Assistance Program, which provides food aid to low-income people, to state governments.

“We can do whatever we want to do,” the Agriculture, Nutrition and Forestry Committee chairman said when asked by States Newsroom about amending that policy.

The final deal — intended to extend the 2017 tax cuts — cannot lose more than three GOP senators and still make it back across the Capitol to the House for final approval, since all Democrats are expected to oppose the bill. Thune only needs a majority vote in the Senate for the special process being used by Republicans.

Internal debates about just how to rework the Trump-backed tax and spending cuts measure began in the first week of June during meetings on Capitol Hill and at the White House, as GOP senators began critiquing the House-passed package line-by-line to ensure it complies with their strict rules for the complex reconciliation process and their policy goals.

Republicans said during interviews that several provisions in the House version likely won’t comply with the chamber’s Byrd rule, which could force lawmakers to toss out some provisions.

Complicating all of it was the very public back-and-forth between not just Trump but GOP leaders and former White House adviser Musk over the bill, which Musk on social media labeled “a disgusting abomination” and a “big, ugly spending bill” for its effect on the deficit and debt limit. “KILL the BILL,” Musk said on X, the platform he owns. Senate leaders so far have dismissed Musk’s criticisms.

Fragile House coalition

The talks, and whatever the legislation looks like after a marathon amendment voting session expected in late June, have already raised deep concerns among House GOP lawmakers, who will have to vote on the bill again in order to send it to Trump.

The extremely narrow majorities mean House Republican leaders cannot lose more than four of their own members if all the lawmakers in that chamber vote on the party-line bill.

Any changes the Senate makes could unbalance the fragile coalition of votes Speaker Mike Johnson, R-La., cobbled together last month for a 215-214 vote. But GOP senators are adamant they will amend the legislation.

Complicating matters is a new report from the nonpartisan Congressional Budget Office that shows the proposed changes to tax law, Medicaid, the Supplemental Nutrition Assistance Program and higher education aid wouldn’t actually help to reduce deficits during the next decade but raise them by more than $2.4 trillion.

The numbers are the exact opposite for what Republicans hoped their sweeping tax and spending cuts package would accomplish.

Scrutiny begins

The first stop for the House-passed reconciliation package in the Senate appears to be the parliamentarian’s office, where staff have begun evaluating whether each provision in the current version of the bill complies with the upper chamber’s strict rules.

Boozman said staff on his panel have already begun meeting with the parliamentarian to go over the House provisions within its jurisdiction.

He expects that section of the package will have to change to comply with the strict rules that govern the reconciliation process in the Senate and to better fit that chamber’s policy goals.

“We can’t really decide exactly what we want to use in the House version until we know what’s eligible,” Boozman said. “We’ve got some other ideas too that we asked them about. But we need to know, of the ideas that we have, what would be viable options as far as being Byrd eligible.”

The Byrd rule, which is actually a law, requires reconciliation bills to address federal revenue, spending, or the debt limit. This generally bars lawmakers from using the special budget process to change policies that don’t have a significant impact on those three areas.

Alabama Sen. Tommy Tuberville, who is campaigning to become his home state’s next governor, said pushing some of the cost of the nutrition program to states may be problematic.

“We’re trying to send more costs to the states. Most states can’t afford that, so we want to take care of people, but we need people to go back to work,” Tuberville said. “It’s not a forever entitlement. It’s for part-time, you know, take care of yourself until you get a job, go back to work and let people that need it really, really get it.”

Rural hospitals on edge

Senate GOP leaders will have to navigate how best to reduce federal spending on Medicaid, the state-federal health program for lower-income people and some with disabilities, that is relied on by tens of millions of Americans, many of whom are loyal Republican voters.

The nonpartisan Congressional Budget Office projects that 7.8 million people would lose access to Medicaid during the next decade if the House’s policy changes are implemented as written.

There are also concerns among GOP lawmakers about how losing the revenue that comes with treating Medicaid patients would impact rural health care access and hospitals.

Missouri Sen. Josh Hawley said under no circumstances would he vote for a bill that cuts benefits to Medicaid recipients and is worried about how provisions in the House package would affect rural hospitals.

“They’re very concerned about it, rightly so,” Hawley said, referring to conversations he’s had with health care systems in his home state.

“This is something that we need to work on. I don’t know why we would penalize rural hospitals,” he added. “If you want to reduce health care spending, then cap the price of prescription drugs. I mean, that’s the way to do it. If you want to get major savings in the health care sector, don’t close rural hospitals, don’t take away benefits from working people. Cap the costs, cap the price that (the Centers for Medicare & Medicaid Services) is going to pay for prescription drugs.”

West Virginia Sen. Shelley Moore Capito said she’s not yet come to a decision about whether to keep, amend, or completely scrap some of the House changes to Medicaid.

“I talked to a lot of our hospitals when I was home to see what the impacts would be, because we have a very high Medicaid population,” Capito said. “I want to see it work and be preserved, but I want it to be there for future generations. And it’s just getting way out of control on the spend side. So right now, we’re looking at everything.”

Louisiana Sen. Bill Cassidy — chairman of the Health, Education, Labor and Pensions Committee — said he doesn’t expect all of the health care provisions in the House bill make it through the “Byrd bath” with the parliamentarian. But he declined to go into detail.

“Some of it is more regulatory, that’s all I can say,” Cassidy said.

West Virginia’s Sen. Jim Justice said he is in favor of requiring some Medicaid enrollees to work, participate in community service, or attend an educational program at least 80 hours a month to stay on the program, a sentiment shared by many of his GOP colleagues.

“I’m good with every bit of that,” he said. 

But Justice expects the Senate will make its own changes to the package and that it will be “proud of their own pond.”

“Any frog that’s not proud of your own pond’s not much of a frog,” Justice said.

He did not go into detail on what those changes would entail.

SALT shakers

The state and local tax deduction, or SALT, represents another tightrope  for Thune, who is no fan of the changes made in the House. But he has said repeatedly this week he understands altering that language too much could mean a Senate-amended version of the bill never makes it back through the House to actually become law.

Thune said outside the White House following a June 4 meeting with Trump and others that there will very likely be changes to SALT.

“There isn’t a single Republican senator who cares much about the SALT issue,” Thune said. “It’s just not an issue that plays.” States that are most affected generally don’t elect Republicans to the Senate.

The House tax-writing panel originally proposed raising the SALT cap from $10,000 to $30,000, but Johnson had to raise that to $40,000 in order to secure votes from House Republicans who represent higher tax states like California, New Jersey and New York. The revised cap would benefit more high-income taxpayers in their states.

“In 2017, that was one of the best reforms we had in the bill,” Thune said. “But we understand it’s about 51 and 218. So we will work with our House counterparts and with the White House to try to get that issue in a place where we can deliver the votes and get the bill across the finish line.”

Republicans hold 53 seats in the Senate, but can rely on Vice President J.D. Vance to break a tied vote if necessary.

At least 218 House lawmakers must vote to pass bills when all 435 seats are filled. But with three vacancies at the moment, legislation can move through that chamber with 216 votes. The GOP has 220 seats at the moment, meaning Johnson can afford four defections on party-line bills.

North Dakota Sen. John Hoeven told reporters this week that he’d like to see GOP senators rework the SALT section of the bill, even if that causes challenges for Speaker Johnson’s ability to pass a final version.

“Let’s talk about SALT, for example. The House has a very large SALT number. The Senate is probably going to take a look at that,” Hoeven said. “There’ll be a lot of areas we can look at. There’ll be other things we’re going to look at. We’d like to get to $2 trillion in savings.”

Ohio Sen. Bernie Moreno joined in putting his House colleagues on notice that they likely won’t get the agreement they struck with the speaker in the final version of the bill.

“I think we’re going to make common-sense changes. For example, the SALT cap, by the way, something that definitely helps very wealthy people in blue states,” Moreno said. “I think that cap, the 400% increase, is too much, so we’re going to work on tweaking that.”

Hawley, of Missouri, speaking more generally about the tax provisions, said he would like the Senate to make sure middle-class Americans benefit from the tax changes, just as much as companies.

“I want to be clear, I’m in favor of additional tax relief for working people. So my view is this corporate tax rate, which they lowered in 2017, they made that permanent back then. I know some workers that would like permanent tax relief,” Hawley said. “So I think it’s imperative that we do some addition to tax relief for workers. So I think that’s important.”

A new $4 trillion debt limit

Deficit hawks in the Senate have also voiced objections to raising the nation’s debt limit by $4 trillion, arguing that GOP leaders haven’t done enough to assuage their concerns about the nation’s fiscal trajectory.

Kentucky Sen. Rand Paul argued that the debt limit increase is more about next year’s midterm elections than good governance.

“​​This is really about avoiding having to talk about the debt during election times because people like to go home and talk to the Rotary or the Lions Club and tell them how they’re fiscally conservative and they’re against debt,” Paul said. “It’s embarrassing to them to have to vote to keep raising the debt. But they’re unwilling to have the courage to actually look at all spending.”

Paul suggested that House Republicans created problems by inflating some of the spending levels in their package, including to continue construction of a wall along the U.S.-Mexico border. Paul is chairman of the Homeland Security and Governmental Affairs Committee.

“The $46.5 billion for the wall is eight times higher than the current cost of the wall. If you’re going to do 1,000 miles, you can actually do it for $6.5 billion. They want $46.5 billion,” Paul said. “We can’t be fiscally conservative until it comes to the border, and then we’re no longer fiscally conservative.”

The border wall has been a constant focus for Trump, who made it a central part of his 2016 presidential campaign, when he said repeatedly that the United States would build it and Mexico would pay for it.

South Carolina’s Lindsey Graham, chairman of the Budget Committee, hinted during a brief interview that Congress can only cut so much spending without going near programs like Social Security, which accounted for $1.5 trillion in expenditures last year, or Medicare, which spent $865 billion. Both are normally considered untouchable.

“I think we’re going to make some changes to try to find more spending reductions. I think that’s a fair criticism of the bill, but you can’t do Social Security by law,” Graham said, referring to one of the many rules that govern the reconciliation process. “Nobody’s proposed anything in the Medicare area.”

Graham added that “trying to make the bill more fiscally responsible is a good thing, but we need to pass it.” 

Immigration surge cost state, local governments $9 billion in 2023, nonpartisan CBO says

Education was one of the primary areas of additional cost states and local governments that saw a surge in new immigration starting in 2021. (Photo by Phillippe Gerber/Getty Images)

Education was one of the primary areas of additional cost states and local governments that saw a surge in new immigration starting in 2021. (Photo by Phillippe Gerber/Getty Images)

WASHINGTON — The unprecedented increase in immigration starting in 2021 brought extra revenue to states and local governments, but the cost of services for those newly arrived migrants was greater, leading to a net cost of $9.2 billion in 2023, according to a report the nonpartisan Congressional Budget Office published Thursday.

The roughly 4.3 million immigrants who arrived from 2021 to 2023 paid about $10.1 billion in state and local taxes in 2023, according to the report. Accounting for births and deaths, the net population gain from immigration in those years was about 4.4 million, CBO said.

Across the country, state and local governments spent about $19.3 billion in goods and services for those immigrants, with costs concentrated on providing education and shelter, CBO estimated.

The $9.2 billion direct net cost amounts to 0.3% of state and local spending, CBO said.

“State and local governments saw both their tax revenues and their spending increase in 2023 as a result of the surge in immigration,” the CBO report said. “In CBO’s estimation, the increase in spending was greater than the increase in taxes.”

In an alternative calculation, CBO estimated that when accounting for indirect effects — for example, increases in property taxes and economic activity, greater demand for government services — the surge led to a spending increase of $28.6 billion and increased revenue of $18.8 billion for state and local governments, netting a loss of roughly $9.8 billion.

More than half of newly arrived immigrants resided in six states: California, Florida, Illinois, New Jersey, New York and Texas.

CBO estimated that in 2023, about 550,000 children in public schools, or 1.1% of students, were immigrants who’d arrived since 2021. 

“In CBO’s estimation, the surge in immigration directly increased spending for public primary and secondary education by $5.7 billion, or 0.7 percent, in 2023,” according to the report.

Those higher costs were “due to lower English proficiency among the surge population.”

“Because recent immigrants are often English-language learners, they tend to need additional instructional and support services,” according to the report. “CBO estimates that those services cost state and local governments $1.2 billion in 2023.”

Another high cost was shelter services, CBO found. Four states — New York, Massachusetts, Illinois, and Colorado — “spent a total of $3.3 billion to provide shelter and related services, including food and legal support, to the surge population in 2023,” according to the report.

In 2021, the Biden administration dealt with the highest levels of migration at the southern border in 20 years. In an effort to ease the increase at the U.S.-Mexico border, several programs were created to allow migrants to obtain work permits or enter the country while their asylum cases were pending before immigration court.

A nonpartisan New York think tank that studies domestic and international migration, the Center for Migration Studies, released a report that found the population of people in the United States without permanent legal status increased to by 2 million to 12.2 million by 2023, using the most recent Census Bureau American Community Survey data.

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