Senate Majority Leader John Thune faces mounting pressure from his Republican colleagues as they resist taking up the party’s sweeping domestic policy bill. Senator Thom Tillis has publicly warned that he will not vote for the motion to proceed without further clarity on the provider tax, which could significantly impact North Carolina’s Medicaid funding. Tillis, who is up for re-election, argued that the estimated $38 billion loss for his state is underreported, raising concerns about the Senate’s Medicaid plan.
Other Republicans, including Sens. Susan Collins and John Hoeven, have also voiced skepticism, with Collins criticizing the proposed $15 billion rural hospital fund as inadequate and Hoeven predicting GOP leaders will ultimately secure the necessary votes for passage. Thune, who is pushing to meet a July 4 target for final passage, acknowledges the growing resistance. While the House-passed bill freezes existing provider taxes, the Senate’s incremental approach has sparked concerns among members about the financial impact on states, particularly those with large Medicaid programs.
Collins, who has yet to commit to the bill, emphasized that while any funding is welcome, the current offer falls short of addressing the broader challenges facing rural hospitals. Meanwhile, deficit hawks continue to push back, questioning the bill’s long-term fiscal implications. Thune insists that the leadership is working with all members to address their concerns, though some are skeptical that the negotiations will lead to a compromise. The outcome of these discussions will determine whether the megabill can be passed before the Senate’s summer recess.