Senate’s Budget Bill Cuts Medicaid, Boosts Deficit. Now House Showdown Looms

After carving out perks for Alaska and slashing support for vulnerable Americans, the GOP's signature bill heads to the House.

It took 26 hours, 49 amendment votes, and a vice-presidential tiebreaker, but the Senate finally passed the “One Big Beautiful Bill.” The longest, most amendment-heavy vote-a-rama in U.S. history. That alone tells you everything you need to know about how wildly unpopular this legislation is.

At 9:25 AM Eastern on July 1, the final vote was gaveled in—51 to 50—secured only after three Republican senators broke ranks: Susan Collins, Thom Tillis, and Rand Paul joined every Democrat in voting no. Vice President JD Vance cast the deciding vote.

Now the bill heads to the House, where its fate is far from certain—and with good reason. Slashing Medicaid and boosting tax breaks for billionaires just needed a few dozen amendments and a tiebreaker to feel “beautiful,” or at least passable.

We’ve slogged through this process offering commentary since the begining. Visit the Coffman Chronicle page for more reporting, in addition to the specific articles linked below.

What the Senate Rewrote and Worsened

Compared to the version the House narrowly passed weeks ago, the Senate’s version is more aggressive, more fiscally reckless, and more politically volatile.

It permanently locks in Trump1.0-era tax cuts, not just for middle-income earners, but for corporations and the ultra-wealthy. The 21% corporate tax rate is set to remain in effect indefinitely. Pass-through business owners—including real estate firms, hedge funds, and law practices—get their 20% income deduction made permanent as well. The House version included sunset provisions for some of these cuts, creating at least the appearance of fiscal responsibility. The Senate’s version removes even that fig leaf.

The result? The Senate version adds $3.3 trillion to the national deficit over 10 years—$650 billion more than the already-controversial House version.

But while corporations and high earners see their tax breaks locked in forever, working Americans face a very different reality.

The bill imposes new work requirements for Medicaid—80 hours per month, even for adults with children over 14 years old. It slashes provider tax thresholds, squeezing state budgets and threatening rural hospitals. SNAP recipients face new cost-sharing rules, tighter eligibility, and a freeze on inflation updates. Crucially, all of these cuts are delayed until 2026, just in time to insulate current lawmakers from facing consequences before the next election.

Even worse, much of the “rural funding” added to the bill is cleverly structured to overwhelmingly benefit Alaska, a thinly veiled maneuver to secure Senator Lisa Murkowski’s vote. The Senate also included a tax deduction for whaling captains, expanded from $10,000 to $50,000. It’s absurd, but also deeply revealing.

Despite her public hand-wringing about “an awful process,” Senator Lisa Murkowski ultimately cast her vote in favor of the bill, secured, it turns out, by carve-outs so narrowly tailored they might as well have been labeled “FOR ALASKA ONLY.” The language refers to “non-contiguous states,” but let’s not kid ourselves: no one in Congress is losing sleep over Guam’s SNAP cost-sharing burdens. It was designed to cover Alaska and Alaska alone, with a whaling tax break thrown in for good measure.

Call it governance by geography or just good old-fashioned legislative bribery, dressed up in the thinnest procedural disguise.

This wasn’t policy. It was deal-making. And now it’s the House’s problem.

What the Senate Scrapped: Guns, AI, Courts, and Land Sales

While the Senate’s version of the bill intensified the tax cuts and deepened the entitlement reductions, it also quietly removed a host of controversial provisions that had been baked into the House version, most of them slipped in to appease ideological hardliners or reward special interests. Once the bill hit the Senate floor, however, those items were either struck by the Parliamentarian or sacrificed to preserve a clean reconciliation path.

Gone is the proposed 10-year federal moratorium on state-level AI regulation, a tech lobby priority that would have blocked states from passing laws governing artificial intelligence, surveillance, and algorithmic accountability. Following public backlash and a bipartisan outcry led by Senators Marsha Blackburn and Maria Cantwell, the Senate voted overwhelmingly to remove it, 99 to 1.

For more context, see our previous reporting here:

The Real Target of the OBBB’s AI Provisions? California.

Silencing the States: How Congress Is Handing AI a Free Pass

Also gone is the quiet repeal of the $200 tax on gun silencers, a longtime wish list item for the NRA that the House had tucked into the bill without public debate. The Senate, facing the Byrd Rule’s prohibition on provisions unrelated to the federal budget, struck it.

A provision aimed at curbing the contempt powers of federal courts, which would have made it harder for judges to penalize noncompliant executive agencies, was also removed; its policy aims are too far afield from budgetary relevance to survive reconciliation under the Senate’s Byrd Rule.

And then there was the land sale. The House version had authorized the sale of up to 3.3 million acres of public land, including large swaths overseen by the Bureau of Land Management and U.S. Forest Service, mainly in Western states. That language was stripped after an outcry from conservation groups and even some Western Republicans. Senator Mike Lee, who initially backed the land sale, withdrew his support after facing backlash from constituents and colleagues.

We reported on this earlier. See more here:

Selling the Soil, Scrubbing the Story

In the end, what the Senate produced is still sweeping and severe, but it’s also more streamlined. Gone are the ideological sweeteners. What remains is the core of the bill’s agenda: rewarding the wealthy, rolling back the safety net, and delivering a legislative trophy, no matter the cost.

Why the House Might Kill This Bill for Good

Weeks ago, the House passed a narrower version of the OBBB by just four votes. Many of those reluctant “yes” votes came from fiscal conservatives, who only supported the bill after demanding temporary tax cut provisions and tighter deficit limits. The Senate’s version undoes those protections. It gives away more to the wealthy, cuts more from working families, and adds more to the debt.

House conservatives have taken note, and they’re warning that they won’t vote for it.

The Freedom Caucus released a statement on X saying, “The House budget framework was clear: no new deficit spending in the One Big Beautiful Bill. The Senate’s version adds $651 billion to the deficit… That’s not fiscal responsibility. It’s not what we agreed to.”

Referring to items struck by the Senate Parliamentarian due to the Byrd Rule, Andy Ogles of Tennessee stated, “The Senate CAVED to an unelected staffer appointed by a Democrat… that’s why I just filed an amendment to delete their dud and replace it with the strong House bill we passed weeks ago.”

What Ogles neglected to mention is that many of those provisions were never going to survive the Senate’s Byrd Rule review in the first place. One might expect a member of Congress to know that you can’t cram unrelated policy riders into a budget reconciliation bill. But in today’s GOP, procedural literacy is apparently optional, as long as you can post about it afterward.

Speaker Mike Johnson now faces an impossible choice: put this version on the floor and risk a humiliating defeat, or try to renegotiate it in a conference committee and risk angering the Senate.

Even GOP Senators Were Outraged

Senator Susan Collins voted against the bill, citing its devastating impact on her home state of Maine. Roughly 400,000 Mainers rely on Medicaid, and the bill would force rural hospitals and nursing homes to make impossible choices.

“A dramatic reduction in future Medicaid funding could threaten not only Mainers’ access to health care, but also the very existence of several of our state’s rural hospitals,” Collins said in a statement. Even with the added $50 billion rural hospital fund, she called it “not sufficient to offset the other changes.”

Senator Tillis raised similar concerns about Medicaid and the burden it places on his state’s rural care systems. After voicing his concerns and being called out by President Trump online, Tillis announced he would not be seeking reelection.

Senator Rand Paul voted no for a different reason: the price tag. “I offered my vote for fiscal sanity. Congress chose to sell out taxpayers instead,” he told reporters.

So if this bill was so flawed, why did it pass?

Because it was never about the policy.

In both the House and Senate, out of an entire party that brands itself as pro-family and pro-life, only two Republicans—Collins and Tillis—objected to cutting healthcare and food support for millions. Everyone else seemed more concerned about protecting the deficit, defending tax breaks, or mourning the loss of their silencer subsidy.

This Was Never About Governing. It Was About Winning.

This bill was designed not to solve problems, but to secure a “win” for Donald Trump and the Republican leadership. It’s a massive tax giveaway to corporate America, a brutal rollback of healthcare for the poor, and a bloated handout to defense contractors and DHS. And its harms are carefully delayed, engineered to hit after the 2026 midterms, when many lawmakers can safely say “that wasn’t me,” or hope their voters have short memories.

It’s not that they don’t know what this bill will do. They do. They’re just counting on voters forgetting, blaming someone else, or suffering in silence. That’s the real scandal.

Meanwhile, the American people are watching lawmakers scramble to protect the rich and powerful, while gutting the safety net that working families rely on. They see the carve-outs. They see the performative floor speeches. They see the hypocrisy.

They see a government no longer concerned with compromise, but obsessed with control. And the damage, if this bill becomes law, will be long-lasting.

What Happens Next

The bill is expected to reach the House on Wednesday or Thursday. Speaker Johnson hopes for a vote before July 4, but many insiders now believe the likeliest path is to send the bill to conference. There, party leaders could attempt to soften the Senate version just enough to win back critical votes, without unraveling Murkowski’s carve-outs or triggering a Senate collapse.

But any final bill will still face a narrow margin in both chambers. This process isn't over. And if leadership insists on jamming through a bill that helps the wealthy and hurts the vulnerable, they may soon find themselves without the votes or the public’s patience.

You know what to do.

Take Action Now

1. Call Your Representative
The House is about to vote on this bill. You can make your voice heard right now by calling the Congressional Switchboard: (202) 224-3121

Just say your ZIP code and ask to be connected to your House representative.

Here’s a sample script:

“Hi, my name is [Your Name], and I’m a constituent from [Your City]. I’m calling to urge Representative [Name] to oppose the Senate version of the One Big Beautiful Bill. This bill permanently cuts taxes for corporations and the wealthy while slashing Medicaid and SNAP, programs that support families like mine. Please vote no, and don’t trade people’s livelihoods for political wins. Thank you.”

Be polite. Be clear. Be firm. They work for you. Call every day until this vote takes place, affirming your strong opposition to this bill.

2. Remember Who Voted for This, and Who Didn't
Only two Republicans—Susan Collins and Thom Tillis—stood up to protect vulnerable families. Everyone else either voted for the cuts or wanted them to go even further.
If your member of Congress chose party over people, remember that in November 2026. Organize. Mobilize. Vote them out.

3. Spread the Word
This process thrives on confusion. Make it simple for others:

• Share this story.

• Post about what’s at stake.

• Help your friends and family understand that this bill isn’t about budgeting. It’s about power, priorities, and who we leave behind.

Bibliography:

• “Senate Republicans Pass Trump’s Sweeping Policy Bill, Clearing Major Hurdle.” The Guardian, July 1, 2025.

• “Senate Pulls Public Lands Sale Provision from Budget Bill.” Capital Press, June 30, 2025.

• “Sen. Mike Lee Withdraws Public Lands Sale Provision after Bipartisan Backlash.” WyoFile, June 30, 2025.

• “US Senate Passes Trump’s Sweeping Tax-and-Spending Bill, Setting Up House Battle.” Reuters, July 1, 2025.

• “The HFC also hates the reconciliation bill” Punchbowl News, June 30, 2025.

• “US Senate Parliamentarian Says Oil, Gas Projects Can’t Skirt Environmental Review.” Reuters, June 24, 2025.

• “Vance Saves Trump Bill with Tiebreaker Vote in Senate Drama.” The Daily Beast, July 1, 2025.

• “The Three Republican Senators Who Voted Against Trump’s ‘Big Beautiful Bill.’” TIME, July 1, 2025.

• “Senate Rejects 10-Year Ban on State AI Laws in Blow to Big Tech.” Washington Post, July 1, 2025.

• “Senator Collins Statement on Senate Reconciliation Bill Passage.” PenBay Pilot, July 1, 2025.

• “GOP Senator Blasts Trump’s Bill Moments After Voting Against It.” The Daily Beast, July 1, 2025.

• “House Republican Files Amendment to Restore Trump-Endorsed Budget Bill.” Fox News, July 1, 2025.

• “Senate Smashes Vote-a-Rama Record During Trump Budget Debate.” New York Post, July 1, 2025.

• Zinke, Ryan. “Zinke Statement on Public Land Sales Provision Removed in Senate.” Press Release, June 30, 2025.