In a marathon session that stretched over 24 hours, the United States Senate narrowly approved President Donald Trump’s sweeping domestic policy package on Tuesday, July 1, 2025. The legislation, dubbed the "one big, beautiful bill," passed by a razor-thin 51-50 vote, with Vice President JD Vance casting the decisive tie-breaking vote. This momentous vote followed intense negotiations and a flurry of amendments in an effort to secure reluctant support.
The bill’s passage marks a significant milestone in Trump’s domestic agenda, but it comes with heavy controversy and profound implications. According to the independent health policy research organization KFF, the legislation is expected to cause approximately 17 million Americans to lose health insurance coverage, representing the largest rollback of health insurance access due to federal policy changes in U.S. history. KFF’s Cynthia Cox underscored the gravity of this outcome, stating, "If all of this comes to pass, it would represent the biggest roll back of health insurance coverage ever due to federal policy changes." The bill’s deep cuts to social safety net programs, including Medicaid and the Supplemental Nutrition Assistance Program (SNAP), have drawn sharp criticism from many quarters.
Senator Lisa Murkowski (R-Alaska), chair of the Senate Committee on Indian Affairs, was among those who wrestled with the bill’s consequences. She acknowledged the difficult choice she faced: "I struggled mightily with the impact on the most vulnerable in this country, when you look to Medicaid and SNAP." Despite reservations, Murkowski ultimately voted in favor after securing significant concessions for Alaska. Her efforts resulted in a $50 billion rural health fund aimed at funneling hundreds of millions of dollars to Alaska hospitals, community health centers, and other healthcare providers.
Murkowski also championed tribal exemptions from SNAP work requirements, delayed cost-share penalties to help Alaskans maintain benefits, and included work requirement waivers aligned with Medicaid policies. She highlighted these provisions as a way to mitigate the bill’s harshest effects on her state’s vulnerable populations. "We have added tribal exemptions for work requirements, delayed cost-share penalties to help Alaska get benefits to the people who need them, and included work requirement waivers that align with our Medicaid policies," she said. Her office emphasized additional commitments from the Secretary of Agriculture to provide Alaska with further flexibility in administering SNAP.
However, not all Republicans were on board. Senators Rand Paul (Kentucky), Thom Tillis (North Carolina), and Susan Collins (Maine) opposed the legislation, aligning with all 47 Senate Democrats in voting against the bill. Paul raised concerns about the bill’s impact on the federal deficit, while Tillis and Collins objected to what they described as excessively harsh Medicaid cuts. The bill now returns to the House of Representatives, where further changes may be considered.
Opposition voices were loud and clear. Representative Sharice Davids (D-Kansas), a tribal citizen of the Ho-Chunk Nation, condemned the legislation after the vote, highlighting its regressive impacts. "It gives huge tax breaks to billionaires – while raising costs and cutting services for everyone else. It rips health care away from thousands of Kansans. It takes food off the tables of hardworking families. It means higher utility bills. And it blows up our debt and deficit," Davids said, encapsulating the concerns of many critics who view the bill as disproportionately benefiting the wealthy at the expense of ordinary Americans.
Meanwhile, Senator Jerry Moran (R-Kansas) stood firmly in support of the bill, emphasizing the benefits it would bring to his state and constituents. Moran released a detailed statement explaining his vote, asserting that the legislation provides certainty for Kansans by preventing tax hikes on middle-class families and small businesses. He also underscored investments in border security and military capabilities amid escalating global threats.
Moran’s advocacy focused heavily on protecting Kansas hospitals from immediate financial harm due to the bill. After extensive consultations with hospital leaders and federal officials, he secured provisions ensuring that Kansas hospitals would not face immediate cuts upon the bill’s enactment. He explained, "These provisions will protect Kansas’ ability to continue pursuing its application for increased Medicaid payments for certain providers. This change ensures that as state directed payments wind down, Kansas providers will be starting at a higher percentage of enhanced payments, buying them much-needed time to utilize federal dollars as payments are reduced." Moran also secured a one-year delay in reductions to state-directed payments, providing Kansas providers additional time to adjust.
One of Moran’s signature achievements within the bill is the establishment of a $50 billion rural provider fund aimed at assisting rural hospitals grappling with severe financial challenges. This fund is part of a broader effort to bolster rural healthcare infrastructure nationwide, reflecting a growing bipartisan concern for rural communities’ access to medical services.
Beyond healthcare, Moran highlighted several other priorities embedded in the legislation. The bill allocates robust funding to U.S. Customs and Border Patrol to strengthen border security and combat the influx of fentanyl and other illicit drugs. It also provides $12.52 billion to the Federal Aviation Administration for modernizing air traffic control infrastructure, enhancing safety and efficiency in air travel.
National defense received a substantial boost with $150 billion earmarked for the Department of Defense to support modernization and readiness, some of which will directly benefit Kansas. Additionally, the bill includes Moran’s Access to Credit for our Rural Economy (ACRE) Act, designed to expand capital access for farmers and rural communities by increasing financial institutions’ flexibility to offer affordable credit lines.
Agricultural provisions modernize the Farm Bill by updating reference prices, enhancing disaster programs, strengthening crop insurance, and providing more resources for animal health programs. Importantly for Kansas farmers, the bill offers permanent relief from the Death Tax, allowing family farms to be passed on to the next generation without the burden of onerous taxation. Finally, the legislation lowers taxes for American families, workers, and small businesses, aiming to stimulate economic growth and ease financial pressures.
The Senate’s passage of this comprehensive bill marks a pivotal moment in the nation’s policy landscape, reflecting deep divisions and competing priorities. While proponents tout its investments in defense, rural healthcare, and economic growth, critics warn of devastating social safety net cuts and increased hardship for millions. As the legislation moves back to the House, the coming weeks will be critical in shaping its final form and ultimate impact on American lives.