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The vulnerable Senate Republican has stepped into President Donald Trump’s “big, beautiful bill” over concerns about deep Medicaid cuts within the megaville.
Sen. Thom Tillis of RN.C. told Fox News Digital that he would not support the action through the procedural hurdles necessary to launch a marathon of discussion and revision voting.
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President Donald Trump will speak at a press conference held at the James S. Brady Briefing Room in the White House on June 27, 2025 in Washington. (via Mehmet Eser/Middle East Images/AFP Getty Images)
Standing up for reelection in 2026, Tillis said he has “a great relationship” with his colleagues after leaving the Senate GOP closed lunch, but cannot support the huge bill.
“We just have a disagreement,” he said. “And as you know, my colleagues are doing the analysis and they are happy with their impact on their state. I respect their choice. It’s not a positive impact in my state, so I’m not going to vote for the allegations to proceed.”
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Senator Tom Tillis (Photo: Anna Moneymaker/Getty Images)
He also does not support the bill during the final stretch. Tillis is part of a cohort of Senate Republicans who have expressed reservations about changes to the Senate GOP to Medicaid provider tax rates.
Tillis’ resistance to the bill is a bad sign for Senate majority leader John Tune (Rs.D.), who can only afford to lose three votes. So far, R-Wis. Senator Ron Johnson of R-Ky vows to vote against the procedural test. Senator Rand Paul is expected to comply with the lawsuit.
Trump was meeting with another possible holdout, Senator Johnson and Rick Scott, at lunchtime.
Lawmakers are scheduled to vote to advance the bill at 4pm on Saturday.
Mounting resistance can force Thune to return to the drawing board. An even more complicated problem is Collins. Collins stood up for reelection in 2026 and said while supporting the bill through the first step, he is leaning towards the vote to pass the bill in the final stretch, unless the law “changes further.”
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Senator Ron Johnson, R-Wis. , located at Hart Building on Tuesday, July 11th, 2023 (Tom Williams/CQ-Roll Call, Inc, Getty Images)
The latest version of the bill, which fell near the midnight stroke, includes tweaks to the Senate recruitment that will increase the crackdown on provider rates by a year, adding another $25 billion to the Rural Hospital Stabilization Fund.
R-Mo from Senator Susan Collins and R-Mo from Josh Hawley. As in, others in the group are boarding to see legislative moves, at least through the first important procedural hurdles, but Tillis argued that his condition would be severely affected by the crackdown.
In fact, during lunch, which closed earlier this week, lawmakers reportedly warned that North Carolina could lose up to $40 billion in Medicaid funds if the changes were codified.
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For now, Tillis is unlikely to be upset even after a conversation with Trump. He also plans to publish further analysis of the impact of Medicaid reductions on his condition that he said no one could rebut “in this building.”
“The president I spoke to said, “Look, if this is working for the country, that’s great. And if my other colleagues have done extensive research and concluded that it’s different in their state, I respect that,” he said. “There is a disagreement based on implementation in each state.”
Alex Miller is a writer for Fox News Digital, which covers the US Senate.
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