Senate Passes Trump's "Big Beautiful Bill" 51-50: What Happened and What's Next
7.6 million more will become uninsured if House passes this bill
As expected, the U.S. Senate passed President Trump's massive domestic policy bill early Tuesday morning after a marathon overnight session.¹ Vice President JD Vance cast the decisive tie-breaking vote following 24 hours of intense negotiations that secured the support of Alaska's Lisa Murkowski while losing three Republican senators—Susan Collins of Maine, Thom Tillis of North Carolina, and Rand Paul of Kentucky—who joined all Democrats in opposition.²
The process did produce some victories for democratic oversight. The Senate parliamentarian stripped out two particularly concerning provisions: a measure that would have neutered federal courts' ability to hold government officials in contempt for violating court orders,³ and Senator Mike Lee's attempt to sell off 2.2 to 3.3 million acres of public lands to fund tax cuts.⁴ Both provisions were ruled to violate Senate budget rules, though Lee ultimately withdrew his land sale provision entirely after facing fierce opposition from Republican colleagues.⁵
However, the future of Medicaid is still in jeopardy. The "One Big Beautiful Bill Act" now heads to the House, where Speaker Mike Johnson faces the challenge of passing it with his narrow majority before Trump's random July 4th deadline. The legislation includes $4.5 trillion in tax cuts that permanently benefit primarily the wealthy while giving only temporary cuts to the working class,⁶ but achieves these goals through $793 billion in Medicaid cuts that could leave millions without healthcare coverage.⁷
What Democracy Expected
Under normal democratic processes, legislation of this magnitude would undergo months of careful committee review, public hearings, and bipartisan negotiation. Major changes to programs affecting millions of Americans would typically involve extensive stakeholder input, expert testimony, and time for public understanding and debate. The Constitution envisions a deliberative process where both chambers of Congress thoroughly examine complex bills, allowing lawmakers to weigh trade-offs and Americans to understand how policies will affect their lives.
Professional ethics in policymaking traditionally demand that legislators have adequate time to read and comprehend what they're voting on, especially when dealing with healthcare programs that serve 80 million Americans.⁸ Democratic norms have historically required that dramatic cuts to safety net programs receive extensive scrutiny rather than being rushed through under artificial deadlines. The American value of transparency suggests that major policy changes should be openly debated, not buried within thousand-page bills passed in overnight sessions.
Why This Development Matters
The consequences of this rushed legislation extend far beyond Washington's political maneuvering. The Congressional Budget Office projects that 10.3 million Americans will lose Medicaid coverage over the next decade, while 7.6 million more will become uninsured entirely.⁹ These aren't abstract statistics—they represent families who will face impossible choices between medical care and other necessities, rural hospitals that may close their doors, and elderly Americans who depend on Medicaid to cover Medicare premiums and co-pays.
The bill's $793 billion in Medicaid cuts could trigger a cascade of consequences across American healthcare. States will be forced to choose between raising taxes, cutting other essential services like education, or reducing healthcare benefits for their most vulnerable residents. The cuts would also force over 1.2 million Americans out of their jobs as rural hospitals close their doors and urban facilities reduce staffing to cope with lost revenue from Medicaid patients.¹⁰
Perhaps most troubling is how this process has unfolded with little public awareness of its scope and consequences. While Americans prepare for Independence Day weekend, their representatives are rushing through legislation that could fundamentally alter the healthcare landscape with minimal public input or understanding. The speed and secrecy surrounding these changes represent a departure from democratic governance that should concern all Americans, regardless of their political affiliation.
The bill now heads to the House, where it faces another high-stakes vote as Speaker Mike Johnson works with a razor-thin majority to meet Trump's July 4th deadline. The coming days will determine whether these dramatic changes to American healthcare and social policy become law—and whether democratic processes can withstand the pressure of artificial deadlines and partisan urgency.
Lessons from "On Tyranny"
In moments like these, when democratic norms bend under political pressure and millions of Americans face losing essential services, historian Timothy Snyder's "On Tyranny: Twenty Lessons from the Twentieth Century" offers crucial guidance.¹¹ Snyder draws from the rise of authoritarianism in Europe to provide practical steps for protecting democracy. His lessons remind us that resistance begins with individual actions that collectively strengthen democratic institutions and protect vulnerable communities.
Note that resistance is always guided by Lesson 20: Be as courageous as you can. We are not all positioned to take each of these actions, but consider what of these you can given your circumstances. Know that for every action of resistance you engage in, you are also representing those who are not able to stand up due to vulnerability, ability, or means.
Lesson 8: Stand out. Someone has to break the cycle of conformity when democratic institutions face pressure. When legislation affecting millions moves through Congress with minimal debate or public understanding, it becomes easier for representatives to assume public acquiescence. The rushed timeline and artificial deadline create an environment where speaking out feels futile or disruptive to normal political processes.
How to resist: Contact your representatives immediately, even if you've never called before. Call the Capitol switchboard at (202) 224-3121 and ask to be connected to your senators and representative. Make it clear that you're paying attention to this vote and that healthcare cuts affecting millions of Americans demand more than a holiday weekend timeline. Share factual information about the bill's impacts on social media, write letters to local newspapers, and encourage others in your networks to speak up. Your voice breaks the silence that allows harmful policies to advance unchallenged.
Lesson 10: Believe in truth. Authoritarian movements thrive when citizens become overwhelmed by competing narratives and retreat into cynicism or apathy. Complex legislation like this bill relies partly on public confusion about what's actually included and who will be affected. When politicians frame massive healthcare cuts as necessary fiscal responsibility or claim that only "undeserving" people will lose coverage, they're depending on citizens to accept convenient explanations rather than examining the evidence.
How to resist: Seek out nonpartisan sources like the Congressional Budget Office analysis, fact-checking organizations, and reports from healthcare policy experts. Share factual information about how many people will lose coverage and what services will be cut. When you hear misleading claims about the bill, respond with specific, factual corrections. Trust in verifiable information becomes an act of resistance when political rhetoric seeks to obscure reality.
Lesson 13: Practice corporeal politics. When major legislation affecting healthcare passes through Congress over a holiday weekend, it relies partly on public disengagement and physical distance from the political process. The timing assumes people will be distracted by barbecues and fireworks rather than focused on policy consequences. Democracy becomes abstract when it only exists on screens and in distant Capitol buildings, which is exactly what politicians count on when rushing through controversial bills during holiday periods.
How to resist: With only 48 hours before the House vote, organize with neighbors to bring immediate attention to this fast-moving bill. Make signs highlighting "7.6 million will lose healthcare" or "Save Medicaid" and gather at busy intersections, town squares, or outside your representative's local office. Even a small group of people with handmade signs creates visible opposition that breaks through holiday weekend distractions. Knock on doors in your neighborhood to inform people about the vote happening this week. Stand outside grocery stores or community events to hand out flyers with your representative's phone number and the bill's healthcare impacts. Your physical presence makes the issue real and urgent in a way that social media posts cannot—and encourages others to take action before it's too late.
Final Thoughts
The coming House vote represents more than a policy decision—it's a test of whether democratic deliberation can survive the pressure of artificial deadlines and whether legislators will prioritize healthcare for millions over tax cuts for the wealthy. While the Senate parliamentarian's rulings offer some hope that institutional safeguards still function, the core threat to American healthcare remains immediate and real. The next few days will determine not just the fate of Medicaid, but whether Congress can govern with the transparency and care that democracy demands.
Sources
"One Big Beautiful Bill Act," Wikipedia, accessed July 1, 2025, https://en.wikipedia.org/wiki/One_Big_Beautiful_Bill_Act.
Associated Press, "Senate passes Trump's reconciliation bill with Vance casting tie-breaking vote," PBS News, July 1, 2025, https://www.pbs.org/newshour/politics/senate-passes-trumps-reconciliation-bill-with-vance-casting-tie-breaking-vote.
Nate Raymond, "Senate parliamentarian faults Republicans' plan to limit judges' power," Reuters, June 23, 2025, https://www.reuters.com/legal/government/senate-parliamentarian-faults-republicans-plan-limit-judges-power-2025-06-23/.
Bethany Rodgers, "Utah Sen. Mike Lee pulls public lands sale from Trump tax bill," Deseret News, June 28, 2025, https://www.deseret.com/politics/2025/06/28/mike-lee-pulls-public-lands-sale-from-trump-big-beautiful-bill/.
Elizabeth Elkind, "Mike Lee preemptively drops 'big beautiful bill' provision to sell federal lands that riled GOP colleagues," Fox News, June 29, 2025, https://www.foxnews.com/politics/mike-lee-preemptively-drops-big-beautiful-bill-provision-sell-federal-lands-riled-gop-colleagues.
Committee for a Responsible Federal Budget, "Senate Reconciliation Bill Could Add Over $4 Trillion to Debt," June 27, 2025, https://www.crfb.org/blogs/senate-reconciliation-bill-could-add-over-4-trillion-debt.
Leighton Ku et al., "How Potential Federal Cuts to Medicaid and SNAP Could Trigger the Loss of a Million-Plus Jobs, Reduced Economic Activity, and Less State Revenue," Commonwealth Fund, June 2025, https://www.commonwealthfund.org/publications/issue-briefs/2025/jun/how-medicaid-snap-cutbacks-one-big-beautiful-bill-trigger-job-losses-states.
CNN Politics, "Cuts to Medicaid and food stamps: Here's who could be impacted by the House GOP's bill," May 22, 2025, https://www.cnn.com/2025/05/21/politics/medicaid-food-stamps-gop-proposed-cuts.
KFF, "Allocating CBO's Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States," June 2025, https://www.kff.org/medicaid/issue-brief/allocating-cbos-estimates-of-federal-medicaid-spending-reductions-and-enrollment-loss-across-the-states/.
Leighton Ku et al., "How Potential Federal Cuts to Medicaid and SNAP Could Trigger the Loss of a Million-Plus Jobs."
Timothy Snyder, On Tyranny: Twenty Lessons from the Twentieth Century (New York: Tim Duggan Books, 2017).