WASHINGTON — The Senate has set an ambitious timeline for passing President Donald Trump’s sweeping legislation to cut taxes and spending. But getting it on the Republican president’s desk by July 4 will require some big decisions, and soon.
Republican senators are airing concerns about different parts of the legislation, including cuts to Medicaid, changes to food aid and the impact on the deficit. To push the bill to passage, Senate Majority Leader John Thune of South Dakota and other negotiators will need to find a compromise that satisfies both ends of their conference — and that can still satisfy the House, which passed the bill last month by only one vote.
A look at some of the groups and senators who leaders will have to convince as they work to push Trump’s “big, beautiful” bill toward a Senate vote:
Every Republican senator represents a state with a rural constituency — and some of their states are among the most rural in the country. Many in those less-populated areas rely heavily on Medicaid for health care, leading several of them to warn that the changes to the program in the bill could be devastating to communities that are already struggling.
Of particular concern is a freeze on a so-called provider tax that some states use to help pay for large portions of their Medicaid programs. The extra tax often leads to higher payments from the federal government, which critics say is a loophole that allows states to inflate their budgets. Sen. Josh Hawley of Missouri and several others have argued that freezing that tax revenue would hurt rural hospitals, in particular.
“Hospitals will close,” Hawley said last month. “It’s that simple. And that pattern will replicate in states across the country.”
Alabama Sen. Tommy Tuberville said Thursday that provider taxes in his state are “the money we use for Medicaid.”
“You start cutting that out, we’ve got big problems,” Tuberville said. Eliminating those taxes “might lose some folks.”
At the same time, Republican senators have little interest in a House-passed provision that spends more money by raising a cap on state and local tax deductions, known as SALT. The higher cap traditionally benefits more urban areas in states with high taxes, such as New York and California.
The House included the new cap after New York Republicans threatened to oppose the bill, but Senate Republicans uniformly dislike it. “I think there’s going to have to be some adjustment” on the SALT provision, Thune said Wednesday, noting that “senators are just in a very different place” from the House.
The House-passed bill would also shift some Medicaid and food stamp costs to states, a change that has the former governors in the Senate, in particular, worried.
West Virginia Sen. Jim Justice, who was governor of his state fo
