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The Senate narrowly the on July 1 by a 50-50 tally, with Vice President J.D. Vance casting the tie-breaking vote. The Senate version of the bill now goes back to the House for consideration as Congress attempts to meet President Trump’s July 4 deadline. 

The July 1 Senate vote followed a lengthy “vote-a-rama" on proposed amendments that lasted more than 24 hours. An amendment from Sen. Rick Scott, R-Fla., was withdrawn during the process that would have required, in expansion states, that any Medicaid beneficiary who temporarily lost coverage and reapplied to be enrolled at the traditional Medicaid Federal Medical Assistance Percentage.

Despite the withdrawn amendment, the Senate bill still contained provisions that would make greater cuts to Medicaid than the initial bill passed by the House.

In a statement shared with media, AHA President and CEO Rick Pollack said, “We are deeply disappointed by today’s vote in the United States Senate to advance the One Big Beautiful Bill Act (H.R. 1). The real-life consequences of these nearly $1 trillion in Medicaid cuts – the largest ever proposed by Congress – will result in irreparable harm to our health care system, reducing access to care for all Americans and severely undermining the ability of hospitals and health systems to care for our most vulnerable patients. 

“This legislation will cause 11.8 million Americans to be displaced from their health care coverage as they move from insured to uninsured status. It also will drive up uncompensated care for hospitals and health systems, which will affect their ability to serve all patients. It will force hospitals to make service line reductions and staff reductions, resulting in longer waiting times in emergency departments and for other essential services, and could ultimately lead to facility closures, especially in rural and underserved areas.

We urge the House to mitigate this legislation and protect access to health care for patients and communities.” 

The House Rules Committee is July 1 to begin preparing the bill for floor consideration.