President Donald Trump's $5 trillion "big, beautiful bill" narrowly advanced in the Senate with a 51-49 procedural vote. The bill survived a last-minute flurry of negotiations and vote flips, securing just enough support to move forward.

The Vote Breakdown

All Democrats and two Republicans—Thom Tillis (North Carolina) and Rand Paul (Kentucky)—voted against the bill. The vote was only secured after three Republican holdouts—Mike Lee (Utah), Rick Scott (Florida), and Cynthia Lummis (Wyoming)—switched their votes to "yes." Another key flip came from Ron Johnson (Wisconsin), who had previously opposed the bill but voted in favor after prolonged negotiations. His reversal gave Republicans a clean 51 votes, eliminating the need for Vice President JD Vance to cast a tie-breaking vote.

Pressure from the White House

The vote came after intense pressure from the White House. President Trump spent two days on the phone, personally calling senators to secure their votes. He publicly called for a primary challenge against Tillis after the North Carolina senator refused to support the bill over its Medicaid provisions.

Democratic Opposition

Senate Democrats are using procedural tactics to slow down the bill's passage. As a first step, they are forcing a reading of the entire 940-page bill on the Senate floor, a process expected to last about 15 hours. Following the reading, there will be 20 hours of debate and a marathon amendment vote session. Democrats are targeting key provisions, including changes to energy tax credits, food assistance, and significant cuts to Medicaid.

The Medicaid Controversy

The bill's most contentious element is its Medicaid language, which would result in deep cuts. A late-night revision to the bill included a delay in capping provider taxes and a $10 billion increase in a rural hospital assistance fund, which helped secure some Republican support. However, several Republicans, including Susan Collins (Maine) and Tillis, remain concerned about the impact of the cuts. Tillis stated the bill would lead to "tens of billions of dollars in lost funding for North Carolina," forcing the state to cut Medicaid coverage for hundreds of thousands of people.

What's Next?

The bill now faces a final vote in the Senate, expected late Sunday or early Monday. If it passes, it will return to the House, where its earlier version barely passed. With some House Republicans already expressing alarm over the new Senate version, its passage there is not guaranteed. Trump has set a July 4 deadline to sign the bill into law.