Senate Republicans are nearing a vote to slash more than $1.6 trillion in government spending over a decade within President Donald Trump’s “big, beautiful” bill — and the conference could enact more cuts in the final hours before a vote on final passage.
Trump and Senate Republicans are touting the largest cut to mandatory spending in American history within the upper chamber’s budget bill. The Senate proposal notably exceeds the initial House draft’s estimated savings by $200 billion over a ten-year period, surpassing Senate Republicans’ goal of slashing spending by $1.5 trillion over a ten-year period.
Senate Majority Leader John Thune has also backed an effort to secure more cuts within the president’s sweeping tax relief and immigration legislation.
The deficit-reducing measure is sponsored by Republican Florida Sen. Rick Scott and would lower the 90% federal match rate for new Medicaid enrollees in states that expanded coverage under the Affordable Care Act. A group of deficit-concerned senators, including Scott, helped secure a vote on the amendment, which will occur during an anticipated marathon session of voting, known as a “vote-a-rama,” before senators will vote on final passage of the bill.
“We think it’s really good policy,” Thune told reporters Sunday. “We’re going to do what we can to support that effort.”
“There’s a high level of interest in our conference of making it part of the final bill,” Thune added. “I don’t know how Republicans couldn’t be in favor.”
The amendment, however, could die on the Senate floor due to moderate GOP senators’ opposition to reducing the federal government’s contributions to state Medicaid programs, known as the federal medical assistance percentage (FMAP). Scott’s proposal notably exempts the existing expansion population on Medicaid rolls.
Trump notably thanked Scott and the cohort of fiscal hawks for ultimately supporting the opening debate on the bill Saturday night. The president said he would work with the group to “REDUCE WASTEFUL SPENDING” and “ENSURE OUR MEDICAID SYSTEM HELPS THOSE WHO TRULY NEED IT” among other priorities, in a statement on the Social Media platform Truth Social.
A majority of the $1.6 trillion in cuts over a decade within the Senate’s budget bill come from reducing federal spending on Medicaid and Medicare with the vast majority of savings coming from the former.
“We are making some commonsense reforms to Medicaid to eliminate waste, fraud, and abuse and protect the program for the people who need it the most,” Senate Majority Leader John Thune said during a speech on the Senate floor on June 17 that previewed his conference’s ambitious reforms to the entitlement program.
Senate Republicans are proposing to implement nationwide work requirements for some able-bodied adults on Medicaid and crack down on certain states’ use of provider taxes to collect additional federal Medicaid funding.
Thune has touted these reforms as “commonsense” measures to rein in federal Medicaid spending, which is projected to balloon to more than $650 billion in 2025, amounting to a 60% increase between 2019 and 2025. The majority leader has also argued that Medicaid needs to be “strengthened” to serve pregnant women, children, seniors and the disabled rather than continuing to expand coverage to able-bodied adults or illegal immigrants — as some blue states have done.
The majority leader has also repeatedly made the case for lowering the ceiling on provider taxes in Medicaid expansion states, arguing the tax maneuver allows states to unfairly leverage more federal dollars to pad state budgets and lets the federal government contribute more dollars for the coverage of able-bodied adults rather than the vulnerable groups Medicaid is intended to serve.
Under Senate Republicans’ current proposal, provider taxes would be gradually reduced to 3.5% in Medicaid expansion states starting in 2028 — a provision that is expected to result in hundreds of billions in savings. A number of moderate GOP senators, including Thom Tillis of North Carolina have voiced deep objections to this proposal, citing billions of dollars in Medicaid funding their states could lose.
Other Medicaid reforms that would yield savings could also be incorporated in the upper chamber’s final budget bill, but remain in flux as Senate Parliamentarian Elizabeth MacDonough, an unelected official with outsize influence over the budget reconciliation process, continues to review provisions to ensure compliance with budget rules.
Though MacDonough has signed off on the vast majority of provisions that Democrats have challenged as violating budget rules, several Medicaid-related provisions have been flagged as noncompliant and must be revised to be included in the final package.
These provisions include reducing federal Medicaid contributions to states that offer healthcare to illegal immigrants through state funds and prohibiting illegal immigrants’ access to Medicaid dollars. MacDonough has yet to rule if Republicans can move forward with banning abortion providers, such as Planned Parenthood, from receiving Medicaid funds.
Though Trump has criticized the MacDonough’s influence over the final shape of his bill, he has not explicitly called for her ouster unlike several House and Senate Republicans.
Senate GOP leadership has also gone on the offensive against Democrats’ messaging accusing the president’s landmark bill of “gutting Medicaid” with the imposition of work requirements among other reforms. That proposal would require able-bodied adults including those with children 14 years-old and older to be working, seek work, volunteer or be in school for at least 20 hours a week.
“An American Enterprise Institute study recently found able-bodied adults on Medicaid who don’t work spend 4.2 hours every day watching TV and playing video games,” Senate Majority Whip John Barrasso, the number-two ranking Republican, wrote in an op-ed for the Daily Caller News Foundation. “That is 125 hours per month. They ought to be working – or at least looking for a job.”
“Senate Republicans are proposing a responsible path to self-reliance for able-bodied, working-aged people,” Barrasso added. “No more taxpayer-funded coddling.”
The Senate’s budget bill also slashes spending on green energy subsidies by accelerating the termination of solar and wind tax credits, which could save hundreds of billions of taxpayer dollars.
The Senate’s proposal will have to clear the House before Trump signs the budget bill into law. A number of moderate Republicans in the lower chamber are voicing concern about aggressive spending cuts while members of the conservative House Freedom Caucus are pushing for more deficit reduction.
“For all cost cutting Republicans, of which I am one, REMEMBER, you still have to get reelected,” Trump wrote on the social media platform Truth Social Sunday evening. “Don’t go too crazy!”
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