In a dramatic 51–50 vote Monday night, Senate Republicans approved President Donald Trump’s One Big Beautiful Bill Act, a sweeping piece of legislation that could dramatically change access to health care and food assistance for millions of Americans. Vice President J.D. Vance cast the tie-breaking vote.
Three Republicans — Sens. Rand Paul of Kentucky, Thom Tillis of North Carolina, and Susan Collins of Maine — voted no. Sen. Lisa Murkowski of Alaska delivered the decisive “yes” after securing concessions for rural hospitals and nuclear cleanup.
President Trump, during brief remarks at the White House, called the vote a landmark moment: “This is what winning looks like,” adding, “It tells you there’s something for everyone.” Trump had also warned in the lead-up to the vote that the bill was necessary to avoid a “68% tax hike”—a claim widely disputed by analysts.
Sen. Lisa Murkowski, explaining her vote Monday night, said the process had been flawed: “It’s been an awful process, a frantic rush to meet an artificial deadline.” She added, “My sincere hope is that this is not the final product.”
Sen. Josh Hawley, R-Mo.emphasized work requirements: “People who are able-bodied should be working,” he said. “We’re restoring accountability to the social safety net.”
Former Vice President Kamala Harris, in a statement on X (formerly Twitter), condemned the bill’s impact: “Thanks to Senate Republicans, 17 million people will lose their health care.” She added: “Thanks to Senate Republicans, rural hospitals will close. They’re cutting healthcare, food aid and green energy—all to extend tax breaks for the wealthy.”
Sen. Raphael Warnock, D-Ga., during floor debate, said the legislation would devastate communities: “This bill is a gut punch to working-class families.” He called it “cruelty dressed up in legislation.”
While debate over the bill’s moral and economic implications continued late into the night, the legislation itself includes sweeping policy changes that would reshape federal aid programs and tax law.
The legislation would:
- Permanently extend the 2017 Trump-era tax cuts for individuals and corporations, a move Republicans say is necessary to sustain economic growth.
- Introduce new federal work and income requirements for Medicaid and the Supplemental Nutrition Assistance Program (SNAP), which critics argue could push millions off the rolls.
- Expand state-level control over eligibility, allowing states to impose their own penalties or coverage limits under Medicaid.
- Increase funding for rural hospitals and radiation exposure compensation, key provisions added to win over Sen. Josh Hawley, R-Mo., and Sen. Lisa Murkowski, R-Alaska.
Next, the bill heads to the House, where Republican leaders aim to hold a vote before the July 4 recess. President Trump has stated that he would sign the bill into law immediately upon its passage.