By Joseph Lord
Contributing Writer
The Senate on Monday began the amendment process known as a vote-a-rama on the One Big Beautiful Bill Act ahead of the final vote on the bill.
This comes after the Senate ended debate on the legislation at around 1 a.m. ET.
The body then proceeded to a vote-a-rama at around 9 a.m. ET, during which senators will undertake a marathon series of mandatory votes on amendments before the chamber can proceed to consideration of the Republican megabill itself.
Over the weekend, the Senate advanced the budget reconciliation legislation over the first procedural hurdle in a 51-49 vote on Saturday as Republicans barrel forward to meet President Donald Trump’s July 4 deadline to pass the bill. Sens. Rand Paul, R-Ky., and Thom Tillis, R-N.C., opposed advancing the bill.
As of Sunday evening, the Senate had been in session since Saturday morning without adjourning, approaching the 34-hour mark. Much of that time — 16 hours — was dedicated to a reading of the 940-page bill, as requested by Senate Democrats.
The spending legislation, which is being passed using the filibuster-proof reconciliation process, is the culmination of weeks of negotiations within the Republican Party and between the two chambers of Congress. It touches on practically every area of policy and the federal budget, from taxes to border security to federal entitlements.
The vote series that had been set to begin sometime on Monday comes as much uncertainty remains around the final outcome of the vote.
Under the reconciliation process — which is uniquely capable of bypassing the 60 votes needed to pass most legislation through the upper chamber — each amendment offered must be allowed a vote.
With 53 Republican seats, Senate Majority Leader John Thune, R-S.D., can spare no more than three defections — in which case Vice President JD Vance would need to cast a tie-breaking vote to pass the bill.
Republicans are broadly united behind key elements of the package — extending Trump’s 2017 tax cuts, funding enhanced immigration enforcement, border security, and a series of other tweaks to federal policies and rules.
Medicaid
But the legislation includes some policy elements that remain controversial with lawmakers in both the Senate and the House.
In a speech on the Senate floor during the debate — coming hours after he announced that he wouldn’t be seeking reelection in 2026 — Tillis spoke critically of the measure’s changes to Medicaid, saying that Trump had been “misinformed” about the nature of the bill’s cuts to the entitlement program.
The current draft of the bill imposes new 80-hour monthly work requirements for able-bodied adults to receive benefits. It also reduces the maximum provider tax states can charge hospitals and doctors to pay for their state Medicaid program.
That prompted concerns among several Republicans — including Sen. Susan Collins, R-Maine — that rural hospitals would be negatively affected and could be forced to close. A $25 billion fund is established for such hospitals in the legislation to address these concerns.
Collins, who is up for reelection in a Democratic state in 2026, has pushed for that fund to be up to $100 billion, and it’s unclear if she’ll support the bill as is.
Tillis said that the changes break Trump’s campaign promises to protect Medicaid, comparing it to President Barack Obama’s politically infamous “if you like your health care plan, you can keep it” quote on the Affordable Care Act.
“What do I tell 663,000 people in two years, three years, when President Trump breaks his promise by pushing them off of Medicaid because the funding’s not there anymore,” Tillis said.
Sen. Lisa Murkowski, R-Alaska, has also expressed misgivings about the Medicaid cuts in the package, as well as its cuts to the Supplemental Nutrition Assistance Program, commonly known as food stamps.
Murkowski nonetheless voted to advance the legislation on Saturday.
Other Controversies
Sen. Rick Scott, R-Fla., meanwhile, has multiple objections to the legislation, including its provisions raising the State and Local Tax deduction cap.
“There should be no SALT deduction,” Scott told reporters on June 24.
However, a contingent of House Republicans led by Rep. Mike Lawler, R-N.Y., have demanded an increase to the SALT cap as a condition for their vote. House Speaker Mike Johnson, R-La., like Thune, can spare no more than three defections.
Ahead of the Saturday vote, Scott and other conservative holdouts seemed prepared to tank the procedural motion. To prevent this, Thune offered his backing for an amendment proposed by Scott that would further cut Medicaid through changes to a key funding mechanism.
Specifically, Scott’s amendment would reduce the federal government’s cost sharing for Medicaid from 90% to as low as 50% for enrollees made eligible for the program after Dec. 31, 2030. States would need to pick up the rest of the costs.
Scott has expressed confidence that the measure will pass but that seems far from guaranteed as other Republicans have already expressed concerns about the bill’s current Medicaid cuts.
Paul has tied his objections to the legislation’s increase to the debt ceiling. Where the House version would have raised it by $4 trillion, the Senate increases it by $5 trillion. Paul has said that he would vote for the package only if that provision were removed.
Jackson Richman contributed to this report.
