Three Senators from President Donald Trump’s party joined Democrats in voting against his “One Big Beautiful Bill,” which narrowly passed the upper chamber on Tuesday with a tie-breaking vote from Vice President J.D. Vance.
The bill—a sweeping tax and spending package that includes additional money for deportation efforts, steep cuts to funding for Medicaid, and tax exemptions for tips, among other major provisions—earned the votes of most Republican lawmakers amid pressure from Trump to pass the legislation by his July 4 deadline. It now returns to the House, which passed its own version in May.
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But the package has faced concerns from some Republicans over its proposed funding cuts to Medicaid, which serves more than 70 million Americans, and what it would mean for government spending. A report by the Congressional Budget Office (CBO) indicated that the legislation would add more than $3.9 trillion to the national debt, despite the White House’s assertions that it would reduce the deficit.
Senators Thom Tillis of North Carolina, Susan Collins of Maine, and Rand Paul of Kentucky ultimately broke ranks with their fellow Republicans in spite of Trump’s threats to campaign against lawmakers who voted against the bill. “I will always do what is in the best interest of North Carolina, even when that puts me at odds with my own party,” Tillis said in a Monday statement. “I cannot support this bill in its current form. It would result in tens of billions of dollars in lost funding for North Carolina, including our hospitals and rural communities.”
Speaking to reporters on Tuesday outside of Florida’s ‘Alligator Alcatraz’ migrant detention center, Trump said he believed the bill would pass the House with ease.
Here are the three Senators that voted against the bill.
Thom Tillis
Sen. Tillis’s vote against the “Big Beautiful Bill” followed an impassioned floor speech on Sunday in which he spoke against the Medicaid cuts in the bill, which he said would affect hundreds of thousands of North Carolina residents.
“What do I tell 663,000 people in two years or three years, when President Trump breaks his promise by pushing them off of Medicaid because the funding’s not there anymore, guys? I think the people in the White House … advising the President are not telling him that the effect of this bill is to break a promise,” Tillis said.
The CBO found in a report released Saturday that the legislation could cause nearly 12 million adults to lose health insurance over the next decade due to its reductions of hundreds of billions of dollars in Medicaid’s funding.
Tillis said at the time that he would vote against the legislation unless his concerns were addressed. In a statement on Sunday, he again pointed to the cuts even as he praised other parts of the bill.
“There is a lot for North Carolinians to love about the rest of the One Big Beautiful Bill, including extending historic funding for border security, and ending wasteful spending,” he said. “We can and must accomplish this without hurting our rural communities and hospitals.”
Tillis’s opposition to the bill has not come without a cost.
Trump threatened on Sunday to meet with other candidates who would primary Tillis in the upcoming Senate race and claimed in a Truth Social post that the Senator “has hurt the great people of North Carolina.”
“Tillis is a talker and complainer, NOT A DOER!” Trump said, before calling the Senator “worse than Rand ‘Fauci’ Paul!”, referencing U.S. infectious disease expert Dr. Anthony Fauci, who drew Trump and Republican’s ire amid the COVID-19 pandemic, to attack another critic of the legislation.
Tillis announced his retirement that same day.
“In Washington over the last few years, it’s become increasingly evident that leaders who are willing to embrace bipartisanship, compromise, and demonstrate independent thinking are becoming an endangered species,” Tillis said. “When people see independent thinking on the other side, they cheer. But when those very same people see independent thinking coming from their side, they scorn, ostracize, and even censure them.”
Read more: What to Know About Senator Thom Tillis as Republican Trump Critic Announces Retirement
Susan Collins
Sen. Collins similarly pointed to concerns about the Medicaid cuts in the bill as a driving force for her decision to vote against it. Some 400,000 Mainers depend on the health insurance program, according to the Senator.
“I strongly support extending the tax relief for families and small businesses,” said Collins in a Tuesday statement. “My vote against this bill stems primarily from the harmful impact it will have on Medicaid, affecting low-income families and rural health care providers like our hospitals and nursing homes.”
While the bill includes a “special fund” proposed by Collins that would provide some financial support for rural hospitals, she said that inclusion was insufficient to offset the damages the legislation would impose on Medicaid.
Rand Paul
Sen. Paul also cast a “no” vote, citing concerns about how the bill would increase the national deficit, which currently stands at $1.36 trillion.
Paul said Tuesday that he met with the Vice President and offered to vote for the bill if it included a “90% reduction in the debt ceiling.”
“I offered my vote for fiscal sanity. Congress chose to sell out taxpayers instead. Only once the bill is released, we will know what the true price was.” Paul wrote on X after the vote.