Senator Thom Tillis of North Carolina has recently taken a stand against President Trump’s ambitious legislative proposal, which he refers to as the “big, beautiful bill.” His main concern revolves around significant cuts to Medicaid included in the bill.
Tillis, who is facing reelection in 2026, made it clear that, despite his good relations with fellow Republicans, he cannot support the bill in its current form. After attending a closed-door Senate Republican lunch, he expressed his disagreement, stating, “My colleagues have done the analysis, and they’re comfortable with the impact on their states. I respect their choice. It’s not a good impact in my state, so I’m not going to vote on the motion to proceed.”
This resistance is troubling for Senate Majority Leader John Thune of South Dakota, who can only afford to lose a few votes to ensure the bill’s advancement. So far, Senator Ron Johnson from Wisconsin has also pledged to oppose the measure, while Senator Rand Paul from Kentucky is expected to do the same.
During discussions to rally support, Trump met with Johnson and Senator Rick Scott of Florida—another potential opponent. A crucial vote to advance the bill is scheduled for Saturday at 4 p.m.
With growing objections, Thune may need to revisit the bill’s details. Notably, Senator Susan Collins from Maine, who is also up for reelection, indicated that while she supports the initial steps of passing the legislation, she might not back it unless further changes are made.
The most recent changes to the bill include a delay in cuts to the Medicaid provider tax rate and an additional $25 billion allocated for stabilizing rural hospitals. However, Tillis warns that North Carolina could face a loss of up to $40 billion in Medicaid funding if these adjustments are enacted.
Despite discussions with Trump, Tillis remains firm in his position. He plans to present further analysis showing the potential impacts of the Medicaid cuts, which he claims have not been adequately addressed by the administration.
Tillis emphasized the importance of respecting differing views based on state needs, saying, “If this works for the country, that’s great. We just have a disagreement based on the implementation in our respective states.”
