As Senate Republicans approach the final stages of President Donald Trump’s significant tax and immigration proposal, one major hurdle remains: their colleagues in the House of Representatives. The Senate has made substantial alterations to the House-passed version of Trump’s One Big Beautiful Bill Act, a comprehensive measure designed to extend trillions of dollars in tax cuts, allocate hundreds of billions for immigration enforcement and defense, and reduce funding for social benefit and anti-poverty programs. However, many House Republicans now view the legislation as unrecognizable, straying far from the hard-fought compromises reached just a month prior.
The Senate's iteration includes more severe cuts to Medicaid, raising concerns among some Republicans about the potential impact on rural hospitals in their states. Interestingly, it has retained certain Biden-era clean energy credits that the House aimed to eliminate immediately. Additionally, negotiations continue between House and Senate Republicans regarding the state and local tax deduction (SALT), a critical issue for several House Republicans from high-tax states who have signaled they might oppose the bill without satisfactory adjustments.
In May, hard-line House budget conservatives nearly derailed the legislation due to apprehensions about its impact on the national debt; the Senate's version is anticipated to be significantly more costly. Senate Majority Leader John Thune (R-South Dakota) is pushing for a vote on the bill by the end of the week, aiming to meet a self-imposed deadline before Independence Day to get the bill onto Trump’s desk.
Thune has engaged in multiple discussions with House Speaker Mike Johnson (R-Louisiana) to navigate the intricacies of the Senate bill and its prospects in the House. However, House lawmakers currently seem unprepared to endorse the Senate’s draft. “Our red line hasn’t changed,” stated Rep. Andy Harris (R-Maryland), chair of the House Freedom Caucus. “It has to conform to the House framework, and it doesn’t.” Rep. Ralph Norman (R-South Carolina), a prominent deficit hawk, labeled the Senate's proposal as “a nonstarter,” emphasizing the importance of adhering to what the House originally sent to the Senate. “This is our moment. If we fail to seize it, it’s on us,” he remarked.
Despite strong objections, the House Republicans have faced similar challenges in the past and often acquiesced. They are currently utilizing the budget reconciliation process to circumvent a possible Democratic filibuster and to push the legislation through their slim congressional majorities. This process necessitates that both chambers approve a budget resolution outlining the bill's broad policy objectives before passing the actual legislation.
Concerns regarding the legislation's fiscal implications are significant. The Congressional Budget Office has projected that the House-passed legislation could add $3.3 trillion to the national debt over a decade, once interest costs and broader economic impacts are factored in. The Senate’s version is likely to be even more expensive, with tax provisions costing hundreds of billions more than initially anticipated.
One of the critical differences is the Senate's approach to Medicaid. The Senate's proposal aims to implement deeper cuts compared to the House version, which has alarmed many lawmakers, particularly those representing rural areas that rely heavily on Medicaid funding. A coalition of 16 House Republicans from blue states and swing districts has expressed that the Senate’s proposal undermines the House’s original approach, arguing that it imposes unfair burdens on hospitals already struggling to meet their obligations.
Senator Susan Collins (R-Maine) has also voiced her worries regarding the Senate's deeper Medicaid cuts, suggesting the inclusion of a $100 billion fund to mitigate the impact on rural hospitals, though she acknowledges that even that may not suffice.
Some Senate Republicans, however, have dismissed the concerns raised by their House counterparts. Senator Roger Marshall (R-Kansas), a former House member, expressed skepticism that House lawmakers would reject a bill that extends tax cuts and increases defense and border spending, essential GOP priorities. “There are so many great things in this bill, I think it’s going to be hard for the House to vote against it,” he commented.
Senator Josh Hawley (R-Missouri) has emphasized the need to consider Trump’s influence in negotiating the House bill, cautioning against Medicaid cuts that could jeopardize rural hospitals and complicate negotiations with the House. “I don’t think this is the time to play a game of chicken,” he stated.
