Senators Stuck on Money for Rural Hospitals, Medicaid Cuts With Deadline Looming for the President’s ‘One Big Beautiful Bill’

As the Senate tweaks the legislation, House conservatives are speaking out, in real-time, about how the changes are unacceptable.

AP/Mark Schiefelbein
Senator Hawley on Capitol Hill. AP/Mark Schiefelbein

As Congress barrels toward President Trump’s July 4 deadline to pass his One Big Beautiful Bill Act, Republican senators are no closer to an agreement today than they were at the beginning of the week. Several lawmakers are starting to throw out new ideas about how to both cut spending and protect certain federal programs. 

At a private lunch meeting on Wednesday, Republican senators made little progress on key issues surrounding the One Big Beautiful Bill, including cost-sharing issues with states on Medicaid, energy tax credits, and cuts to nutrition programs. 

Several Republican lawmakers — with the most prominent being Senators Hawley, Murkowski, Collins, Moran, and Tillis — say the current Medicaid reforms will put too much strain on their states’ budgets, which could lead to closures of rural hospitals. 

An idea being kicked around is some kind of rural hospital trust fund to keep those healthcare centers open. Senators are still far from an agreement on that issue, however. On Wednesday, Senate leadership offered holdouts a $15 billion fund for rural hospitals over the course of 10 years. 

Mr. Hawley says he isn’t yet on board. “That might be a fine very short term figure, but it’s not going to suffice for years and years,” he told reporters. 

In a separate interview with CNN, Mr. Hawley said there needs to be a more specific “fix” to this “scheme.”

“Senate leadership now needs to fix this. I mean, they’re the ones who invented this new rural hospital defund scheme — that the House says they can’t pass — that’s gonna close rural hospitals,” Mr. Hawley said. 

Senator Scott of Florida — a former healthcare executive — told reporters that he wanted to see just a $6 billion rural hospital fund, and that his compromise number was $10 billion. Senator Johnson said the same. 

Mr. Scott has also now taken a role as a kind of healthcare reform emissary to the White House, as conservatives try to get the president to come out for more aggressive cuts to the program so that costs will be shifted back to the states. 

“I want to get this bill done and I want fiscal sanity,” Mr. Scott told reporters. “I’m tired of Medicaid going to our able-bodied adults.” The Florida senator tells the Sun that, after a meeting with the president at the White House, Mr. Trump “understands” the necessity of making some changes. 

Ms. Collins went much further than her colleagues, saying that she wants to see a $100 billion fund for those states, like her native Maine, that rely heavily on small healthcare providers in rural areas. 

“I am very concerned about the cuts [to] Medicaid and the impact on my state,” she told CNN on Wednesday. “I’ve also been concerned about the health of rural hospitals, nursing homes, health centers, and I’ve been working on a provider relief fund, but that doesn’t offset the problems with the Medicaid.”

Ms. Collins — like Mr. Scott — is also now throwing out some new ideas at this late hour. On Wednesday, Ms. Collins told Bloomberg News that she would back a tax increase on Americans who make more than $100 million a year in order to help pay for some of these provisions. 

Senator Lee has been outspoken about a number of issues he has with the bill. On Wednesday, he made clear in a social media post that he believes the current Senate version of the bill — as it is being cobbled together — looks worse than the House-passed version. 

“This bill should be getting better in the Senate,” Mr. Lee writes on X. “Not worse.”

Mr. Lee wrote that post in response to Congressman Chip Roy, a leading member of the House Freedom Caucus, who has not hidden his anger at some of the changes being made by the Senate. 

In a graphic put up on X, Mr. Roy points out that the Senate is taking a softer touch to phasing out some Inflation Reduction Act green credits, allowing the money to keep flowing up until 2027 for those who have yet to break ground on new projects. The House version would require businesses to begin construction on projects within 60 days of the bill’s passage and be completed by 2028. 

“It was not where it needed to be in the House, but it’s markedly worse in the Senate. We are not here to increase deficits, keep Green New Scam subsidies, give tax breaks to high tax blue states, fund transgender surgeries,” and other issues, Mr. Roy said on X.


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