North Carolina Sen. Thom Tillis (R) announced after a meeting with Senate GOP leaders and colleagues Saturday afternoon that he will vote “no” on both the motion to proceed and final passage of the Republican megabill to implement President Trump’s agenda because of deep cuts to federal Medicaid funding.
Tillis said he wants Senate Republican leaders to drop their plan to lower the cap on healthcare provider taxes and instead embrace the Medicaid language passed by the House last month, which would cut much less federal funding in the program.
“Oh no. The data hasn’t changed so I got to vote no,” he said.
The North Carolina Republican said Senate leaders should return to “starting with the House baseline.”
“I’m going to vote no on motion to proceed and on final passage,” he said.
Tillis’s strong opposition to the bill is a significant development because two other Republicans, Sens. Rand Paul (Ky.) and Ron Johnson (Wis.), have already said they will vote “no.”
That gives substantially more leverage to Sen. Susan Collins (R-Maine) and other swing-vote senators to demand changes to the bill.
Senate Majority Leader John Thune (R-S.D.) can only afford three defections from his conference and still pass the bill with a tie-breaking vote from Vice President Vance given their 53-seat majority.
Collins said she will vote Saturday to begin debate on the megabill but she says she wants to make several changes to it and is not guaranteed to vote “yes” on final passage.
“I am planning to vote for the motion to proceed. Generally, I give deference to the majority leader’s power to bring bills to the Senate floor. Does not in any way predict how I’m going to vote on final passage,” Collins told reporters Saturday.
Tillis said he would help House Republican colleagues by “defending their bill,” which would prohibit states that expanded Medicaid coverage under the Affordable Care Act from increasing health care provider taxes and barring states that did not expand the program from establishing new provider taxes.
The Senate bill would cut more deeply into federal Medicaid funding for states by reducing the 6 percent cap on health care provider taxes by half a percentage point a year starting in 2028, reducing the cap down to 3.5 percent in 2032.
States use healthcare provider taxes to collect more federal Medicaid funding, as the federal government matches what states collect in those taxes.
Johnson, the Wisconsin senator, said in an interview with “Fox & Friends Weekend” that he will vote against the motion to proceed to the bill on Saturday.
“I’m not going to vote for motion to proceed today. We just got the bill. I got my first copy about 1:23 in the morning, this morning,” he said.
He said lawmakers have preliminary budget scores on less than half of the legislation.
“We don’t even have the scores,” he said.
“We shouldn’t take the [Rep.] Nancy Pelosi [(D-Calif.)] approach and pass this bill to find out what’s in it,” he warned. “We need to have a debate.”
Paul, the Kentucky senator and other "no" vote, has repeatedly said he will oppose the bill because it includes language to raise the debt ceiling by $5 trillion.
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