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The Senate rejected a bid by Sen. Susan Collins (R-Maine) to raise taxes on the ultra-wealthy and boost money for rural medical providers in the GOP’s megabill.

The chamber voted 78-22 against a procedural motion related to her amendment, which would have increased a rural hospital fund from $25 billion over five years to $50 billion and allowed a wider range of health providers to tap it. The amendment also would have raised the top tax rates for individuals who earn more than $25 million a year and couples earning more than $50 million starting next year.

It remains unclear whether the failure of the amendment could cost GOP leaders Collins’ vote. She had been concerned about the impact on rural hospitals from the bill, and even questioned if any amount in a rural hospital fund would help offset the losses.

“Rural providers, especially our rural hospitals and nursing homes, are under great financial strain right now, with many having recently closed and others being at risk of closing,” Collins said before the vote. “This amendment would help keep them open and caring for those who live in rural communities.”

Most Democrats joined the majority of Republicans in opposing consideration of the amendment. Sen. Ron Wyden (D-Ore.) called it a “Band-Aid on an amputation” that would barely offset the other health care cuts in the bill: “It would be much more logical to simply not cut $1 trillion from Medicaid in the first place,” he said. Georgia Sens. Jon Ossoff and Raphael Warnock and Virginia Sen. Mark Warner were the only Democrats to vote with Collins, along with independent Sen. Angus King of Maine.

Collins criticized Democrats after the vote for opposing her. “They’ve complained repeatedly about the distribution in this bill, of Medicaid cuts hurting individuals, rural hospitals, and tax cuts being extended for people who are wealthy, and yet when I tried to fix both those problems, they took a very hypocritical approach.”

She said she remained undecided on the overall bill and that the snub would not affect her decision.

Several GOP senators have aired concerns that the bill’s cuts to Medicaid in the bill would force rural hospitals to close. The bill lowers the amount a state can tax a hospital and then use the funding to qualify for more federal Medicaid dollars without having to dip into their own general funds. Hospitals don’t mind the tax because they can get higher payments from their state.

Conservatives have claimed these provider taxes amount to a “money laundering” scheme that enables states to use the extra federal dollars for other things. But the hospital industry has fought this claim, arguing that the provider taxes are needed to help rural hospitals that operate on thin margins.

House fiscal hawks are looking at the math underlying Senate Republicans’ sprawling domestic policy legislation, and they don’t like what they see.

As Senate Republicans try to muscle President Donald Trump’s “big, beautiful bill” for final passage, they’re on track to violate a budget framework brokered between House fiscal hawks and Speaker Mike Johnson. Under that framework, if the GOP piles on tax cuts over $4 trillion, they’d need to match them dollar-for-dollar with additional spending cuts beyond the $1.5 trillion in the House-passed bill.

“The Senate version adds $651 billion to the deficit — and that’s before interest costs, which nearly double the total,” said the House Freedom Caucus in a Monday afternoon post on X. “The Senate must make major changes and should at least be in the ballpark of compliance with the agreed upon House budget framework.”

It’s a wonky hill to die on, but dozens of House conservatives insisted on the deal before smoothing the megabill’s path through their chamber. Johnson at one point told the conservatives they could go after his gavel if he didn’t hold up the deal — what some of the holdouts considered a “blood oath.”

If the House hawks stand by the deal and the Senate bill doesn’t change appreciably during the final amendment vote marathon that got underway Monday, it could force GOP leaders to “conference” the legislation between the two chambers — likely delaying the bill’s passage beyond Trump’s deadline of July 4.

Now compounding concerns for House GOP leaders, who have ordered members back to Washington to start voting on the bill Wednesday morning, billionaire Elon Musk sent new volleys of criticism at Trump’s marquee legislation Monday over the bill’s deficit impact.

“Every member of Congress who campaigned on reducing government spending and then immediately voted for the biggest debt increase in history should hang their head in shame!” said Musk on X on Monday. “And they will lose their primary next year if it is the last thing I do on this Earth.”

The House fiscal hawks have been crystal-clear about their fiscal red lines, though many now privately worry that they could end up getting jammed by Senate Republicans — and by Trump — with a far spendier bill. Johnson on Monday would not address whether the pending Senate bill could pass the House but told reporters he’s long advised Senate GOP leaders to hew as close to the House version as possible.

There’s “a lot of game left to play,” he added.

Notably, a group of 38 House Republicans led by Rep. Lloyd Smucker (R-Pa.) wrote Senate Majority Leader John Thune in early June warning that any changes to the GOP megabill needed to adhere to the fiscal framework laid out by the House. Under that plan, if the GOP includes $4.5 trillion in tax cuts in their bill, then they would need to scrounge up at least $2 trillion in spending cuts.

It’s already looking to be a far cry from what Senate Republicans hope to pass in the coming hours.

According to the Joint Committee on Taxation, the Senate’s plan includes around $4.45 trillion of tax cuts versus the $3.8 trillion in tax cuts passed by the House. But the spending cuts contemplated by the Senate GOP wouldn’t come close to making up the difference, according to the Congressional Budget Office, the other official budget scorer on Capitol Hill.

CBO estimates the Senate plan includes around $1.5 trillion in mandatory spending cuts, but that amount is reduced by around $300 billion in one-time investments in border funding and national security policy.

“The Senate bill is currently out of compliance with the budget framework by $651 billion, which is adjusted for dynamic revenue from higher economic growth,” said Paul Winfree, CEO of the Economic Policy Innovation Center and a top economic official during Trump’s first administration, in a text. “I think it will be very important to get that number closer to $0 to avoid conference.”

Senate Republicans in many ways made steeper cuts to Medicaid than the House, which would have otherwise helped rectify the difference.

But between $200 and $300 billion in spending cuts included in the House-passed bill were knocked out because they didn’t comply with Senate budget rules. The chamber’s parliamentarian, Elizabeth MacDonough, has been in constant talks with Senate Republican and Democratic staff about whether provisions in the legislation are fit for the filibuster-skirting reconciliation process.

“What we’ve been told is somewhere around $250 billion, because I’ve heard $300 and I’ve heard [$200], so I’m gonna split the difference,” said Sen. Markwayne Mullin (R-Okla.) of the sidelined spending cuts.

Mullin added that House Republicans should look at the score of tax cuts under the so-called current policy baseline, which assumes that trillions of dollars of expiring tax cuts would be extended.

“I think it’s up to the House how they want to look at this, because they can go in two different directions,” said Mullin. “If you go underneath current law, then you have a deficit. If you go into current policy, you actually have a surplus of $507 billion.”

Still, prominent Republicans such as Budget Chair Jodey Arrington (R-Texas) and conservative firebrand Rep. Chip Roy (R-Texas) have argued that Senate Republicans still need to do the math as laid out in the House budget, regardless of which baseline they use.

Rep. Keith Self, another Texas Republican, wrote Monday on X that senators are “completely ignoring” the House budget framework. “This isn’t just reckless,” he wrote, “it’s fiscally criminal.”

Meredith Lee Hill contributed to this report.

Elon Musk said Monday he would follow through on threats to establish a third party if President Donald Trump’s “big, beautiful bill” is enacted by Congress.

Musk said on X his “America Party will be formed the next day” after its passage. He posted as the Senate moved closer to a final vote on what he called an “insane” domestic policy bill.

“Our country needs an alternative to the Democrat-Republican uniparty so that the people actually have a VOICE,” he continued.

The world’s richest man, who until recently played an active role in the Trump administration, renewed his attacks the GOP’s cornerstone legislation over the weekend. then on Monday, he threatened to wield his financial resources against Republicans who support it.

“Every member of Congress who campaigned on reducing government spending and then immediately voted for the biggest debt increase in history should hang their head in shame!” Musk wrote on X. “And they will lose their primary next year if it is the last thing I do on this Earth.”

Musk’s opposition to the megabill, which could cripple the renewable energy industry while adding trillions to the national debt, led to a public break with the president shortly after his time as a federal government employee came to an end in late May.

The two appeared to patch things up several days later.

But Musk is again on the offensive. He tagged two House Freedom Caucus members, Reps. Chip Roy of Texas and Andy Harris of Maryland, in another post assailing the megabill.

“How can you call yourself the Freedom Caucus if you vote for a DEBT SLAVERY bill with the biggest debt ceiling increase in history?” Musk wrote.

Republicans are on the cusp of a breakthrough in their long effort to strip federal funding from Planned Parenthood after a Senate ruling Monday.

Senate Parliamentarian Elizabeth MacDonough advised lawmakers that a provision that would cut off Medicaid funding for one year to the women’s health organization and abortion provider can remain in the GOP’s domestic policy megabill without threatening its ability to be passed along party lines, according to Senate Democrats.

The megabill is expected to clear the Senate Monday or Tuesday using a budgetary tool to bypass a 60-vote filibuster. Bills advanced with that tool must adhere to strict budget rules, and the parliamentarian is the de facto arbiter of those rules. Senate Democrats had challenged whether the provision was allowed.

“Republicans will stop at nothing in their crusade to take control of women’s bodies,” said Democratic Sens. Ron Wyden and Jeff Merkley of Oregon in a statement.

Conservative lawmakers have sought to strip Planned Parenthood’s eligibility for federal funds for decades. It has long been subject to the Hyde amendment, which bans federal funding directly on abortions, but the organization bills Medicaid for nonabortion services and receives other federal funding through other programs and grants.

Republicans sought to target the group in their party-line 2017 push to repeal the Affordable Care Act, but the overall effort collapsed.

Planned Parenthood’s U.S. division received $792 million in funding from government reimbursements and grants, which includes Medicaid, as of June 2023, according to the group’s 2023 and 2024 annual report. A Congressional Budget Office score of the provision targeting Planned Parenthood included in the House-passed version of the megabill estimated it would cost taxpayers an additional $52 million over 10 years.

While most Senate Democrats are looking for pieces to chip away from the GOP megabill in the ongoing vote-a-rama, Sen. John Fetterman just wants the process over with already.

“Oh my God, I just want to go home,” the Pennsylvania Democrat told reporters on Monday. “I’ve already missed our entire trip to the beach… I’m going to vote no. There’s no drama.”

GOP leaders expect rapid-fire amendments to roll in until at least late Monday evening. With a swath of unresolved issues — from potential cuts to the Medicaid provider tax to the phasing out of clean-energy credits — the process could easily extend into the night.

But Fetterman doesn’t think there will be surprises out of tonight’s votes.

“The only interesting votes are going to be on the margin, whether that’s [Susan] Collins or [Ron] Johnson and those,” he said. “All the Democrats, we all know how that’s going to go. I don’t think it’s really helpful to put people here till some ungodly hour.”

Fetterman later posted on X that he’s “here to vote on these amendments and keep the ball rolling” and reiterated his stance against cutting Medicaid and SNAP.

Fetterman has increasingly been a thorn in Democrats’ side as they ramp up opposition to the Trump administration and its policies. Fetterman has been adamant, for example, about not supporting a war powers resolution introduced by Sen. Tim Kaine (D-Va.) that would limit the president’s ability to take military action on Iran without congressional approval. Trump on Friday called Fetterman “the most sensible” Democratic senator and suggested he should support the megabill.

Fetterman’s impatience with the vote-a-rama is just his latest break with his own party.

“This bill is the biggest transfer of wealth from the working class to the 1% and Fetterman’s message to voters is that he just wants to go home,” Joe Calvello, Fetterman’s former communications director postedon X.

Dozens of House Republicans are scrambling behind the scenes to head off the deep Medicaid cuts in the Senate version of the party-line megabill that could pass as soon as tonight.

Group texts are blowing up and frantic phone calls are being exchanged among GOP lawmakers alarmed about the Senate Medicaid provisions, according to six House Republicans granted anonymity to describe the conversations. Even some conservatives in states that will be hit hard by the Senate’s crackdown on state-directed payments and medical provider taxes don’t want to vote on the Senate’s Medicaid text.

That’s to say nothing of an effort pushed by Sen. Rick Scott (R-Fla.) to scale back federal payments under the Affordable Care Act’s Medicaid expansion — a well-established red line for many House members.

Speaker Mike Johnson is expected to hold a call with House Republicans Monday afternoon, according to two other people granted anonymity to discuss yet-to-be-announced plans. Senate and House leadership staffers huddled Monday to discuss the outstanding concerns.

Senior House Republicans are warning they still might need to hammer out differences between the two chambers if the Senate doesn’t strike a final compromise on the language and add it in a final amendment before sending the bill to the House. That would mean missing President Donald Trump’s arbitrary July 4 deadline for signing the megabill.

It’s still unclear whether the Senate will relent and allow a compromise on Medicaid or other policy issues in a final amendment. That chamber is dealing with its own politics, including the determination of many GOP senators to swell the size of the tax-cut package, prompting the need for sharper Medicaid cuts.

Thune has been noncommittal in closed-door meetings with GOP senators about whether there will be a final “wraparound” that would incorporate House Republicans’ concerns. Senate leaders are betting the House will accept whatever the Senate sends them.

“Right now, there isn’t a need for it,” said one GOP senator granted anonymity to discuss the situation.

South Dakota GOP Rep. Dusty Johnson on Monday officially launched his campaign for governor.

Johnson, the chair of the House GOP’s Main Street Caucus, who has served in Congress since 2019, touted Republican wins in Washington since President Donald Trump returned to the White House in his announcement.

“We rolled up our sleeves and got things moving in the right direction, cutting trillions in wasteful spending, standing with President Trump to secure our border and finally getting tough on China,” he said in a video announcement Monday.

POLITICO reported on Johnson’s plans to enter the race last week. Johnson won his most recent statewide race against Democrat Sheryl Johnson with 72 percent of the vote.

“It’s gonna take hard work,” he said. “A real plan, South Dakota common sense and solid conservative leadership.”

Kristi Noem, who served as South Dakota governor for nearly two terms after her election in 2018, left the state when Trump tapped her to serve as Director of Homeland Security after his reelection. Larry Rhoden, who ascended to the post following her resignation in January, hasn’t yet committed to running for reelection.

Republican fiscal hawks and White House officials are trying to kill off a series of Senate megabill amendments that would ease the phase-out of clean-energy tax credits — arguing the move would strip out hundreds of billions of dollars in budget savings and potentially risk GOP support for the overall bill.

Sen. Lisa Murkowski (R-Alaska) and other senators are forging ahead with plans to offer a series of amendments doing just that. One from Murkowski would offer a reprieve for projects that have started construction; critics of the credits want them eliminated quickly for projects that aren’t already completed.

It’s setting up a major intra-party fight as Senate GOP leaders race to pass the massive bill out of their chamber and send it to the House in the coming hours. Fiscal hawks on both sides of the Capitol are warning they will oppose the bill if the phase-outs of Inflation Reduction Act provisions are watered down.

One key issue: Republicans are counting on the crackdown to offset the massive tax cuts and other provisions in the megabill. If senators push their amendments forward without sufficient offsets, which they’re not expected to find, it could spark a major GOP revolt over the deficit impact of the bill.

Hawks are closely watching Senate Budget Chair Lindsey Graham and GOP leaders, who have the power to determine whether amendments without budgetary offsets require a simple majority vote or a 60-vote supermajority.

“Basically, if the amendment is set at 51 instead of 60, it’s Graham’s fault that reconciliation implodes,” said one Republican granted anonymity to candidly describe the talks.

Republicans batted down a Democratic challenge to the GOP’s use of “current policy baseline,” which zeroes out the cost of $3.8 trillion of tax cut extensions in the GOP megabill. The 53-47 vote approved the use of the maneuver along party lines.

Senate Democrats initiated four parliamentary inquiries on Monday morning in an attempt to show that the tactic is akin to a nuclear option that would blow-up longstanding budget rules.

“Republicans are doing something the Senate has never done before, deploying fake math, accounting gimmicks, to hide the true cost of the bill,” Senate Minority Leader Chuck Schumer said on the floor. “To vote yes on this, make no mistake about it my colleagues, will in a dramatic way further erode the Senate.”

Sen. Lindsay Graham (R-S.C.) countered that he has the authority as Budget Committee chair to determine the budget baseline used to implement and score provisions in the sprawling border, energy and tax legislation.

“I’ve never felt better. I’ve been wanting to do this for, like, a long time,” Graham said.

Democratic Rep. Dwight Evans said Monday he will not seek re-election “after some discussions this weekend and thoughtful reflection,” opening up a solid-blue seat in Philadelphia.

Evans faced mounting questions about his ability to serve after suffering a stroke last year and missing months of votes. He insisted until recently he still intended to run for re-election, though several primary challengers were already starting to make moves.

“Serving the people of Philadelphia has been the honor of my life,” Evans said in a statement. “And I remain in good health and fully capable of continuing to serve. After some discussions this weekend and thoughtful reflection, I have decided that the time is right to announce that I will not be seeking re-election in 2026.”

Evans, 71, has served in Congress since 2016. He succeeded Rep. Chaka Fattah, who resigned after being indicted on federal corruption charges, and is one of six Pennsylvanians on the tax-writing House Ways and Means Committee.

His retirement announcement comes amid generational upheaval in the Democratic Party. Longtime Rep. Jan Schakowsky (D-Ill.) said earlier this year she wouldn’t run again. The party base has looked to their leaders to mount a more vigorous response to President Donald Trump, with some in the party calling for primary challenges to senior leaders.

Evans’ retirement could kick off a fierce battle between establishment Democrats and progressives for the Philadelphia-area seat. Democratic socialists have made headway in the city, particularly at the state level, and pro-Israel groups are eyeing the race, according to local Democrats.

State Sen. Sharif Street, chair of the Pennsylvania Democratic Party, has expressed interest in running for Evans’ seat. One Democrat granted anonymity to speak freely said he could kick off his campaign as early as Tuesday. State Rep. Morgan Cephas is eyeing the seat as well, and progressive state Rep. Chris Rabb is also a potential contender.

“Me and my team are strongly considering a bid,” Cephas told POLITICO Monday, “but first and foremost I wanted to express my overwhelming gratitude to the work that Congressman Evans has done for the city of Philadelphia.”

Rabb said in a text that “I am seriously considering running for this seat.”

Rumors have swirled for months about Evans’ future, and some Democrats speculated that he might step down in the middle of his term, which would have given power to the city’s Democratic ward leaders to choose a nominee for a special election. But Evans said Wednesday that he “will serve out the full term that ends Jan. 3, 2027.”