The OBBB’s Final Version: What’s In, Who’s Voting, and Who Gets Hurt

The Senate prepares to vote on sweeping cuts to Medicaid, SNAP, and public land, and most GOP senators are fine with it.

The Senate is now preparing to debate the final version of President Trump’s sprawling One Big Beautiful Bill, a 940-page behemoth that promises tax cuts, spending shifts, and what Republicans call “entitlement reform.” But last night’s reading of the full bill revealed something else entirely: a strategy of bureaucratic sabotage and political self-preservation disguised as policy.

We now know what’s in the bill. We also know who’s backing it and who’s being asked to suffer in silence.

We’ve been covering the bill since it’s introduction in the House. You can read more about specific areas and steps in the process below. Note, some House provisions were removed due to the Byrd Rule in the Senate, and the Senate version differs from the House version in other ways which we will examine in this article. Further, the Senate may add additional amendments before they vote.

Still Standing: The Senate, the Budget Bill, and the Disappearing Government

ICYMI: The One Big Beautiful Budget Breakdown

A Bill That Hides Its Cuts in Red Tape

One of the most consequential additions in the Senate version is a seemingly small bureaucratic tweak. In the Senate bill, Medicaid recipients would be forced to requalify every six months instead of once a year. On paper, it appears to be a minor change. In practice, it’s devastating for already struggling state agencies.

Most state Medicaid agencies are already overwhelmed. Staff shortages, outdated technology, and post-pandemic backlogs have left many systems barely functional under current rules. Requiring every enrollee to complete a full eligibility review twice a year will almost certainly result in millions losing coverage, not because they’re no longer eligible, but because the system can’t keep up. This is not a policy aimed at reforming Medicaid. It’s a policy designed to break it.

This isn’t theoretical. We’ve seen it before. States that implemented work requirements or increased paperwork demands, like Arkansas, witnessed mass disenrollment, only to learn later that the vast majority were still eligible. The difference now is that the Senate wants to make this a national policy.

See our reporting on the Byrd Rule process regarding Medicaid and adjustments here:

From Medicaid to Foreign Aid: The Pattern Behind Mitch McConnell’s Power

Senate Parliamentarian Blocks GOP Medicaid Cuts, Blowing Hole in “Big Beautiful” Budget

Privatizing Public Lands, Carefully Worded

Another major change in the Senate bill narrows the House’s broad push to sell off public land, but the danger remains. While the original version would have allowed up to 3.3 million acres of land sales, the Senate bill limits this to 1.2 million acres of BLM land, and only parcels within five miles of a “population center.”

But there’s a catch: the term “population center” is loosely defined and could include towns of just a few thousand people. That vague language gives the executive branch broad leeway to authorize sales, often near recreation areas, tribal lands, or environmental preserves. In the name of reducing the deficit, the federal government is setting itself up to liquidate some of the nation’s most accessible public lands.

See our reporting on the land sale provisions here:

Selling the Soil, Scrubbing the Story

The Vote Math and the Politics Behind It

The Senate's procedural vote to move the bill forward passed narrowly, 51–49. Senator Lisa Murkowski voted yes, along with all but two Republicans: Thom Tillis and Rand Paul. If Murkowski remains a yes, the final vote is expected to match the procedural tally, passing with 51 votes. If she flips to no over the loss of Alaska-specific carve-outs, the vote likely deadlocks at 50–50, in which case Vice President JD Vance would cast the tie-breaking vote.

Murkowski’s support is rooted not in ideological alignment with the bill, but in a deal she secured to protect Alaska from some of its most painful provisions. These carve-outs included a 25% increase in the federal Medicaid match for Alaska, a SNAP work rule waiver, and expanded tax deductions for Western Alaska whaling captains. These provisions were added because Murkowski’s vote was seen as essential. However, most of those carve-outs have now been ruled in violation of the Byrd Rule and are likely to be removed. If that happens, Murkowski could flip, but she has not yet publicly committed either way.

Thom Tillis opposed the bill due to its impact on Medicaid in his state, particularly in rural areas. After President Trump threatened to back a primary challenger against him, Tillis announced he would not seek reelection. His “no” vote reads less like defiance and more like a parting shot. He knew what standing on principle would cost him and did it anyway.

Rand Paul’s opposition is more predictable. He opposes the bill because it raises the debt ceiling by $5 trillion. He has said nothing about its impact on health care, food assistance, or the poor.

Then there’s Josh Hawley. Once a rumored “no,” Hawley flipped to yes after securing provisions for Missouri’s rural hospitals. His change in position had nothing to do with the bill’s broader damage and everything to do with what his state might personally gain.

The Most Disheartening Part

Perhaps the most sobering revelation in this entire debate is not what the OBBB does; it’s what almost no one in power is willing to do in response.

The states that will suffer most under this bill — Mississippi, West Virginia, Alabama, Kentucky, and Louisiana — are not home to any wavering GOP senators. These are states with some of the highest rates of poverty, disability, and food insecurity in the country. They are also overwhelmingly the same states that refused to expand Medicaid under the Affordable Care Act, even when the federal government offered to cover nearly all the cost.

In other words, these states left people out of the safety net voluntarily, and now, their senators are voting to shred what remains.

More tellingly, they’re doing it without even pretending to defend those constituents. No floor speeches about a sick veteran in Mississippi. No budget amendments to protect a diabetic grandparent in rural West Virginia. No negotiations for a SNAP exemption in Alabama.

The only objections coming from GOP senators are about the national debt, the deficit, or whether their local hospital system gets a carve-out. If a senator flips, it won’t be out of concern for a parent losing Medicaid. It will be because the debt math looks bad, or Trump didn’t call them back.

That’s not policy. That’s abandonment.

In a functioning political system, the harshest cuts in this bill would have provoked a rebellion, especially from those whose voters stand to lose the most. But in today’s Senate, loyalty to power and fear of a primary seem to matter more than hunger or health.

That’s the tragedy behind the OBBB, not just that it hurts people, but that so many of the people hurt won’t have anyone left in Washington fighting for them.

Where the Bill Goes From Here

With the full bill now read aloud on the Senate floor and debate officially underway, the chamber is on track to vote within days, potentially by midweek.

If the bill passes the Senate, it returns to the House for final approval. Because the Senate version differs from the original House-passed text, especially regarding Medicaid redetermination and federal land sales, the House must either pass the Senate version as is or send it back with further changes.

At this stage, Democrats would need Senator Murkowski to flip to no and peel off at least one more Republican (such as Ron Johnson) to block the bill. If that doesn’t happen, and Murkowski holds, the bill is expected to pass on a 51–49 party-line vote. If she flips, the vote could deadlock at 50–50, with Vice President JD Vance poised to cast the deciding vote in favor.

The window for meaningful intervention is narrowing. What happens in the next 48 to 72 hours will determine whether the most sweeping rollback of social safety nets in decades becomes law.

What You Can Do Even If They’re Not Listening

Yes, you can call your senator, and if you haven’t, do it anyway, not because it will definitely change their vote, but because they should know someone is watching. Every record of dissent matters, even in moments when it feels futile.

If you live in Alaska or Wisconsin, call Murkowski and Johnson and tell them to vote NO.

But more than that, tell others what’s in this bill. Talk about what Medicaid redetermination means. Explain how the land sales work. Share the truth about who’s being hurt and who isn’t. When senators vote to take food and healthcare from their own constituents, they’re counting on us not noticing. Don’t let them get away with it quietly. Remember when they ask for your vote.

This is more than a policy debate. It’s a moral line in the sand. And even if this bill passes, how the public responds now will shape what comes next.

Let your voice be part of that record, not because it will save the vote, but because silence guarantees nothing will change.

Bibliography:

• Murray, Isabella. “GOP Sen. Thom Tillis Won’t Run for Reelection after Trump Primary Threat.” ABC News, June 29, 2025.

• Swenson, Ali, and Seung Min Kim. “Republican Sen. Thom Tillis of North Carolina Won’t Run in 2026 after Opposing Trump’s Bill.” AP News, June 29, 2025.

• Murray, Kaia. “Sen. Tillis Says He Won’t Seek Reelection after Trump Threatens Primary Challenge.” CBS News, June 29, 2025.

• “Senate Republicans Advance Trump’s Bill with Narrow Path to Final Passage.” WDSU, June 29, 2025.

• Tully‑McManus, Katherine. “Senate Rulekeeper Deals Blows to Revised ‘Big, Beautiful Bill.’” Politico, June 29, 2025.

• “Murkowski’s ‘Alaska Gold Rush’ Loses Some Gold Plating.” The Prospect, June 29, 2025.

• “Alaska Becomes a Focus of Last-Minute Changes to Big Federal Bill as U.S. Senate Starts Debate.” Alaska Beacon, June 28, 2025.

• “Senate GOP Adds SNAP Waivers for Alaska, Hawaii in New Megabill.” Politico, June 28, 2025.

• Phoenix, journalist. “51–49 Senate Vote: Three Republicans Who Said ‘No’ to Trump’s ‘Big, Beautiful Bill.’” Times of India, June 29, 2025.

• “NC Senator Thom Tillis Won’t Seek Reelection after Vote Against Trump’s Megabill.” ABC7 Chicago, June 29, 2025.