GOP Senator Tillis opposes Trump bill over Medicaid cuts to North Carolina
A vulnerable Senate Republican has taken a stand against President Donald Trump’s proposed bill due to concerns about deep cuts to Medicaid within the legislation. Senator Thom Tillis of North Carolina stated that he would not support the bill through the necessary procedural hurdles to begin a lengthy process of debate and amendment voting that would ultimately lead to the bill’s final passage.
Tillis, who is facing reelection in 2026, made it clear that he could not support the bill, citing a disagreement with his colleagues over the impact of the proposed Medicaid cuts. Despite having a good relationship with his fellow Republicans, Tillis stated that the bill would have a negative impact on his state, leading him to oppose it.
The resistance from Tillis is a troubling sign for Senate Majority Leader John Thune, who can only afford to lose three votes from his party. Senator Ron Johnson of Wisconsin has already expressed his intention to vote against the procedural test, and Senator Rand Paul of Kentucky is expected to follow suit.
Efforts to garner support for the bill have led Trump to meet with Johnson and Senator Rick Scott of Florida, who are also potential holdouts. Lawmakers are scheduled to vote on advancing the bill on Saturday afternoon, but the mounting opposition may force Thune to reconsider the bill’s provisions.
Senator Susan Collins of Maine, another Republican up for reelection in 2026, has indicated that she may support the bill initially but is leaning against voting for its final passage unless further changes are made. The latest version of the bill includes adjustments to the Medicaid provider tax rate crackdown, delaying it by a year and allocating an additional $25 billion for a rural hospital stabilization fund.
Tillis has voiced concerns about the impact of the Medicaid cuts on North Carolina, warning that the state could lose up to $40 billion in funding if the changes are implemented. Despite conversations with Trump, Tillis remains steadfast in his opposition to the bill, planning to release further analysis on the potential impact of the Medicaid cuts in his state.
As the Senate prepares to vote on the bill, the resistance from Tillis and other Republicans could force Thune to revise the legislation to secure enough support for its passage. The ongoing debate highlights the challenges of reaching consensus on a bill that has significant implications for Medicaid and healthcare funding in states across the country.
