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

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

WASHINGTON – Senate Republicans on Monday wrapped up passage of their version of the “Big Beautiful” tax relief and spending cuts bill that President Donald Trump wants to implement by his self-imposed July 4 deadline.

But first, Democrats in the chamber began a marathon of votes on amendmentsforcing his Republican colleagues not to disclose complex issues, including cuts to the health and food safety networks programs. As of early evening, Democrats had not won any votes.

This tactic is used by the opposition party during mass budget reconciliation fights to draw attention to specific issues, even if its amendments are unlikely to work.

Democrats condemned numerous provisions included in the mega bill, including fresh work reporting requirements under Medicaid, the federal health insurance program for low-income people and people with disabilities.

Vocal opposition has also grown as legislative proposals shift significant costs of the federal Supplemental Nutrition Assistance Program (SNAP) to states for the first time.

“I tell our colleagues, ‘Vote for families, not billionaires,’” Sen. Amy Klobuchar of Minnesota said on the Senate floor.

The gist of the nearly 1,000-page legislation extends and extends the 2017 tax law to keep personal income tax rates the same and make certain tax breaks on corporate investment and research and development costs indefinite.

The bill would also implement some of Trump’s campaign promises, including no tax on qualified tips, overtime and interest on car loans, 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 debt limit to $5 trillion amid record U.S. debt levels.

Overall, the Senate bill is projected to augment the deficit by $3.25 trillion over the next decade, according to fresh research. calculation from the nonpartisan Congressional Budget Office.

Here are some of the key voices so far:

Planned parenthood

Washington Democratic Sen. Patty Murray tried to remove language from the bill that would have blocked Medicaid funding for Planned Parenthood for a year unless the organization stopped providing abortions.

Federal law already prohibits giving funds for abortion, with narrow exceptions, but GOP lawmakers have proposed blocking any other funds from being given to the organization, effectively preventing 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-held target for anti-choice extremists.”

“The Republican bill will cut off millions of women from birth control, cancer screenings and basic preventive health care – care they cannot afford anywhere else,” Murray said. “And it will close about 200 health clinics in our country.”

Mississippi Republican Sen. Cindy Hyde-Smith opposed efforts to remove the policy change and raised a rule item on the budget, which was rejected by a 49-51 vote. Maine Republican Sens. Susan Collins and Lisa Murkowski of Alaska voted with Democrats.

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

Medicaid for illegal immigrants

Senators from both political parties agreed on whether the federal government should reduce the amount it gives a state for its Medicaid program if that state uses its own taxpayer money to admit immigrants living in the country without proper documentation.

This provision was included in an earlier version of the bill, but a member of the Senate found it inconsistent with the complicated rules for considering a draft bill reconciling the budget.

The the votes were 56 to 44but since it involved waiving the adoption of a budget rule item, at least 60 senators had to agree to waive the rules and accept 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. Collins, R-Maine, voted with most Democrats in the chamber against further action.

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

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

Senate Budget Committee ranking member Jeff Merkley, R-Ore., opposed Cornyn’s attempt to restore that language in the bill, saying the policy change would financially hurt states that expanded Medicaid under the 2010 health care law because of straightforward mistakes.

“This amendment says that if one person, contrary to state law, through bureaucratic error, receives funds, then the entire state pays the price and the expanded Medicaid rate changes from 90% to 80%,” Merkley said, referring to the percentage paid by the federal government.

Reducing funding for the Consumer Financial Protection Bureau

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

Sen. Elizabeth Warren, a Democrat who championed the CFPB after the 2008 financial meltdown, tried to introduce an amendment to the floor, arguing that the agency “is the financial regulator that protects people from being cheated on credit cards and mortgages and Venmo and payday loans and a million other transactions.”

“When that financial cop can’t do his job, there’s no one else in the federal government to take over,” Warren said.

Scott blocked it, citing budgetary order, saying the cut still provided the agency with “sufficient funds.” Democrats tried to move away from this procedural tactic but failed 47-53 votes.

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

Medicaid hospitals and maternal mortality

Senators voted 48-52 reject proposals by Democratic Sen. Lisa Blunt Rochester of Delaware to send the legislation back to committee to remove language limiting certain Medicaid funds that she said would negatively impact “essential hospital services, especially labor and delivery rooms.”

“Today, Medicaid is the largest payer of maternity care in the United States, covering 40% of births nationwide and nearly half of births in our rural communities,” Blunt Rochester said. “Maternity wards, especially in rural hospitals, are closing at an alarming rate, effectively creating a maternity desert.”

No Republicans opposed the proposal, although Maine’s Collins voted to support it.

Supplemental Nutrition Assistance Program

New Mexico Democratic Senator Ben Ray Luján has made a motion to send the bill back to committee to remove all changes related to the Supplemental Nutrition Assistance Program, or SNAP. It was rejected after a 49-51 votesalthough Alaska Republican senators Dan Sullivan and Murkowski voted in favor.

“I am giving my colleagues the opportunity to repeal these devastating cuts and show our fellow Americans that in this country we care about our friends, family and neighbors who need support,” Luján said.

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

“This program has evolved into seeing success as getting more people on the hook for government assistance,” Boozman said. “SNAP is long overdue for change.”

Medicaid work requirements

Senators voted 48-52 reject a proposal from Delaware Democratic Sen. Chris Coons that would send the bill back to committee to remove language requiring people enrolled in Medicaid to work, participate in community service or participate in an educational program for at least 80 hours per month. Murkowski, R-Alaska, was the only member of his party to vote for the initiative.

Democrats have raised concerns for weeks that some people will lose access to Medicaid if they forget to fill out time-commitment paperwork or don’t know how to show the government they have met the fresh requirement.

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

Kansas Republican Sen. Roger Marshall insisted on opposing the proposal, arguing that jobs lend a hand people.

“My question is: Don’t you think that work brings value, that it brings dignity?” Marshall said. “Don’t you think that gives purpose and meaning to life?”

Rural hospitals and Medicaid

Collins of Maine and Murkowski of Alaska voted for a proposal by Massachusetts Democratic Sen. Ed Markey that would have removed part of the Medicaid amendment bill.

However, even with some bipartisan support, the changes were rejected 49-51 votes Technically, this would mean sending the bill back to committee for three days for changes.

“The so-called Medicaid cuts replacement fund run by my Republican colleagues is like giving an aspirin to a cancer patient,” Markey said. “It’s not enough. It’s woefully inadequate to deal with the health care crisis Republicans are creating in the Senate today. No amount of tax relief for billionaires or a pat on the back for Donald Trump is worth risking people’s lives.”

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

“Unfortunately, for too long, some rural hospitals have struggled to achieve financial sustainability, even with a wide range of targeted payment improvements,” Crapo said. “These issues arose even before we considered the reforms we are incorporating into legislation today.”

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