CNN
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President Donald Trump and Republican leaders are betting that key GOP holdouts will buckle under enormous pressure to pass his sweeping agenda within days – even as a number are warning they’re prepared to sink the multi-trillion-dollar measure without major changes.
But tensions are escalating between the House and Senate and between moderates and conservatives who are battling over competing versions – as Trump demands the bill on his desk by July 4.
With the Senate planning a critical vote to begin debate as soon as Thursday, Senate Majority Leader John Thune and Speaker Mike Johnson are both racing to quell rebellions among their centrist and right-wing factions.
Behind the scenes, Johnson and his allies are in high-stakes talks with Senate GOP leaders to resolve final sticking points, while stressing to their own House members that they may ultimately need to back the Senate’s version because further cross-Capitol negotiations aren’t feasible, according to two sources familiar with the discussions, a move certain to cause an outcry among many in his conference.
That means GOP holdouts could ultimately be left with this choice: Vote for a plan they detest or sink the bill and endure Trump’s wrath. GOP leaders in both chambers are gambling their members will choose the former.
“When it comes over, we’ll pass it,” House Majority Whip Tom Emmer told CNN. “We’ve been talking over a year. The time for voting is now.”
But multiple House Republicans are fuming that the Senate rewrote their carefully crafted version of bill – most critically to propose deeper cuts on Medicaid – and are openly calling to blow past Trump’s timeline to change it back.
Plus Johnson now has at least three Republican hardliners declaring they will oppose the Senate version without even deeper spending cuts: Reps. Andy Harris of Maryland, Chip Roy of Texas and Eric Burlison of Missouri. And then there’s the parochial issue dogging the GOP: The push led by New York Republicans to increase the amount taxpayers can deduct from their local levies, a deal that GOP senators want to gut and force House members to swallow.
Some are warning they won’t cave – a threat GOP leaders must weigh since they can only afford three defections in each chamber to pass the bill.
“If they’re trying to jam us with something that we can’t support, then I think we need to take those extra days to make sure it’s a good product,” said Rep. Nicole Malliotakis, who was one of 16 House Republicans who declared in a letter to both GOP leaders on Tuesday that they couldn’t support the Senate’s Medicaid provisions without major changes. She also met with Johnson about the issue on Tuesday.
Malliotakis was among several GOP lawmakers who told CNN she would support a formal “conference committee” between the House and Senate – against the wishes of Trump and GOP leaders, since it would dramatically slow down the president’s agenda.
Even Rep. David Joyce, a close leadership ally, said he was willing to miss Trump’s July 4 deadline to fight for more of the House’s original provisions.
“I think a good bill deserves to take its time,” the Ohio Republican told CNN. “There’s differences in what the Senate’s talking about and what can pass here.”
The GOP is largely united on the main tenets of the bill, including extending Trump’s 2017 tax cuts for individuals and businesses, imposing new work requirements on social safety net programs and fulfilling the president’s campaign promises like no tax on tips and overtime pay — all while providing hundreds of billions more for the Pentagon and border security agencies. But how to pay for many of those provisions has been far more contentious, including cuts to Medicaid and phasing out Biden-era energy tax credits.
And official estimates that the measure could add more than $3.4 trillion to deficits over the next decade have left many on the right uneasy – in addition to the Senate’s proposed $5 trillion increase to the national debt limit.
Meanwhile, patience is running thin in the Senate, with many Republicans eager to move on and call their House counterparts’ bluff.
“It’s a little arrogant to say the Senate has got to eat exactly what the House proposed. I mean it’s a bicameral process,” Sen. Bernie Moreno, a Republican from Ohio. “I don’t look like Alexander Hamilton or James Madison do I? That’s just the process our founders created.”
And Trump himself is heaping pressure on Congress, posting on Truth Social on Tuesday: “Lock yourself in a room if you must, don’t go home, and GET THE DEAL DONE THIS WEEK.”
Senate Republicans are particularly frustrated by the so-called SALT Caucus, the group of House Republicans in New York and California that is demanding bigger deductions on state and local tax payments.
Those Republicans cut a deal with Johnson to win their support by raising the amount of state and local levies that eligible taxpayers can deduct to a $40,000 limit. Now, several of those New York Republicans say they won’t accept a penny less than that number, even though Senate Republicans say they should jam the House with a less expensive deal.
“I’m OK with them making crazy statements like that if they want,” said North Dakota Republican Sen. Kevin Cramer, referring to the House Republicans from New York. “I hear ‘red line’ a lot around here. I hear that a lot, but at the end of day, it turns into a rather light pink.”
But those House GOP lawmakers pressing for tax relief said it would be a mistake to assume that they would simply swallow whatever SALT deal the Senate passes.
“I think that would be the wrong assumption,” Rep. Mike Lawler, a New York Republican and leading proponent of the House deal, told reporters Tuesday.
Any whipping operation among House Republicans, however, is complicated by the still-fluid negotiations in the Senate. GOP senators are still tweaking their bill themselves and trying to navigate changes forced on them by the Senate parliamentarian’s rulings that some of their provisions are out of order with strict Senate budget rules that they must follow to pass the bill along party lines.
The biggest headache for Republicans, though, remains the fate of Medicaid.
At least 20 centrist Republicans in both chambers are trying to reverse the Senate’s biggest cuts to Medicaid, which were not part of the House-passed bill. But another group of GOP hardliners – including Sens. Mike Lee of Utah, Rick Scott of Florida and Ron Johnson of Wisconsin – wants to slash even deeper from the program and have raised major concerns about the impact the bill would have on the deficit. And they all met with Trump on Monday night.
During a closed-door meeting Monday, Sen. Josh Hawley, a Republican from Missouri who has been outspoken about his concerns the bill is cutting too much into Medicaid, said North Carolina Republican Sen. Thom Tillis gave out information to senators on how much rural hospitals in states like his could lose if some of the changes the Senate rolled out went into effect.
At issue are new proposed limits on how much states can tax health care providers, a levy that helps fund the Medicaid program. Some key Republicans fear that the new proposed limits could devastate Medicaid providers, especially rural hospitals, and are demanding changes.
“Senate leadership now needs to fix this,” Hawley said. “They’re the ones who invented this new rural hospital defund scheme that the House says they can’t pass. It’s going to close rural hospitals. They need to get with rural hospitals, figure out what’s going to work for them, and then they need to get the sign off of the House.”
“The leadership needs to work on this with rural hospitals and the House,” he said. “This won’t work to not ever talk to the House and hope that they just take the bill. That will land us in a conference committee. I don’t want to do that.”
Sen. Susan Collins, a Maine Republican and a key swing vote facing reelection next year, is pushing for the bill to include a relief fund to providers hardest hit by the new cuts — potentially around $100 billion although multiple sources told CNN that the number has been extremely fluid.
“I’ve been very concerned about the cuts in Medicaid and the impact on my state, but other states as well,” Collins told CNN on Tuesday. “I’ve also been concerned about the health of rural hospitals, nursing homes, health centers and have been working on a provider relief fund. But that doesn’t offset the problem with the Medicaid cuts.”
Tillis, a Republican who like Collins is also up for reelection next year, said that the proposed Medicaid cuts could cost his state $38 billion over 10 years.
“That’s a big impact,” he told CNN. He added: “I’m very much in favor of moving in that direction. You just have to do it at a pace that states can absorb, or we’re going to have bad outcomes, political and policy.”
But if Trump and Senate GOP leaders give in to the demands of those holdouts, it would drive up the already hugely expensive price tag — prompting a revolt on the right.
Rep. Andy Harris, a Maryland Republican who leads the House Freedom Caucus, contended that the Senate is moving in the wrong direction, calling for deeper cuts into Medicaid and saying it should more quickly eliminate green energy tax credits enacted under the Democrats’ Inflation Reduction Act. Harris voted “present” when the bill passed the House by a single vote last month.
But Harris said he would go even further if forced to accept the Senate bill in the coming days.
“If the Senate tries to jam the House with this version, I won’t vote ‘ present.’ I’ll vote ‘NO,’” Harris said Tuesday.
CNN’s Ali Main contributed to this report.
