Senate Passes Devastating Medicaid Cuts, House Fight Looms

Vice President JD Vance cast the tie-breaking vote as the Senate passed the “One Big Beautiful Bill” (or substitute your own descriptor) 50-50 after a 27-hour marathon of voting. While the most extreme Scott amendment was ultimately defeated, the base bill’s devastating wealth transfer from healthcare to tax cuts for the wealthy now moves to the House, where the real fight begins.

In the pre-dawn hours of Tuesday morning, the U.S. Senate completed one of the most consequential votes in recent American history—not just for what it passed, but for what it revealed about who matters in American democracy. After 27 hours of marathon voting that forced senators to cancel July 4th vacation plans, Republicans achieved their goal of the largest wealth redistribution in recent memory: cutting more than $793 billion from Medicaid to fund tax cuts for the wealthy.

The vote came down to a 50-50 tie broken by Vice President Vance, with only three Republicans joining all Democrats in opposition: Susan Collins of Maine, Thom Tillis of North Carolina, and Rand Paul of Kentucky. The absence of the ultra-extreme Scott amendment—which would have completely eliminated Medicaid expansion funding starting in 2031—represents the only silver lining in an otherwise devastating outcome for American healthcare.