By Ashley Murray, States Newsroom
WASHINGTON — The final “big beautiful bill” approved by Senate Republicans Tuesday included some last-minute changes on hot-button issues such as safety net programs and clean energy tax credits.
Senate Republicans had wrangled for weeks to deliver legislative text to satisfy concerns from lawmakers who objected to cutting Medicaid, the federal-state insurance program for low-income families and some individuals with disabilities.
Other sticking points included threats that the health cuts pose to rural hospitals, and tax revisions that hamper clean energy jobs and investment, most of which are in states that elected President Donald Trump to his second term.
The lawmakers debated amendments for more than 24 hours. Even with final changes, now under consideration in the House, three Republicans held out: Susan Collins of Maine, Thom Tillis of North Carolina and Rand Paul of Kentucky. Vice President JD Vance cast the tie breaking vote.
Here are several rewrites that popped up in the bill’s final minutes and hours:
Senate Republicans doubled the amount for a rural health “transformation program,” or money to compensate rural hospitals for the funds they would lose as a result of the proposed Medicaid cuts.
The latest proposal sets aside $50 billion, up from $25 billion, and moves up the distribution timeline to begin in 2026, up from 2028.
Collins had unsuccessfully introduced an amendment to bump the fund to $50 billion. Despite some support from GOP colleagues, the amendment was blunted by a technical budget point of order.
The Maine Republican still voted “no” Tuesday on the final bill.
The lawmakers also made a late change to how and when states would begin to shoulder the responsibility for costs of the Supplemental Nutrition Assistance Program.
According to the new version, if a state’s payment error rate in 2025 multiplied by 1.5 is equal or greater than 20%, then that state would be permitted to wait until 2029, rather than 2028, to begin footing a portion of the bill for food assistance. A state’s accuracy rate is the annual measurement of over- or underpayments to recipients.
Nine states would hover in the territory of meeting that threshold, according to the Department of Agriculture’s latest error rates published Monday. They are: Alaska, Florida, Georgia, Maryland, Massachusetts, New Jersey, New Mexico, New York and Oregon.
Alaska had the highest payment error rate of all states in both 2023 and 2024. Alaska Sen. Lisa Murkowski’s final decision on the bill was largely unknown until she cast a “yes” vote Tuesday.
A late amendment to strike the language offered by Amy Klobuchar of Minnesota failed 45-55.
Critics say the measure incentivizes states to keep the payment error rates high this year.
GOP senators late Friday added a clean energy excise tax into the bill, taking the industry by surprise. Then it vanished.
The tax that would have been imposed on new solar and wind projects was no longer in the legislation that senators voted on around noon Eastern Tuesday.
Other text loosened a squeeze on tech-neutral tax credits meant to incentivize the installation of energy systems that do not use fossil fuels. Senate Republicans added a year of leeway for new projects to break ground and avoid cutting short two of the tax credits.
—
Image license link: https://creativecommons.org/licenses/by-sa/4.0
