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By Hugh Cameron
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Speaker of the House Mike Johnson faces a formidable challenge in galvanizing the GOP around his expansive tax and spending package, and assuaging the many concerns Republicans hold about the "Big, Beautiful Bill."
Despite the approval of the House Ways and Means Committee on Wednesday and the endorsement of President Donald Trump himself, the latest version of the resolution has been met with opposition from both the conservative and moderate wings of the party.
With a House vote as early as next week, and the slimmest of majorities in both chambers, Johnson will need to swiftly achieve a near-consensus among dozens of currently divided lawmakers.
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"We're a long ways away from having a product that I think has anywhere close to 218 votes," Texas Representative Chip Roy told CNN on Wednesday, adding that there were "probably 20" identifiable issues with the bill in its current form.
Medicaid
Republican opposition to the Medicaid-related proposals falls into two categories: Those who think the changes—such as the implementation of work requirements and more frequent eligibility checks—do not go far enough toward cutting government spending, and those who think that these will harm both the public and Republicans' public support.
Earlier in May, eight Republican congressmen wrote to Johnson warning about the repercussions for their constituents should any bill reduce access to one of the nation's most popular government programs. "Balancing the federal budget must not come at the expense of those who depend on these benefits for their health and economic security," the letter read.
"We cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations," it added.
Barring the legislative opposition which may prevent the bill from passing, Republicans may also be fearful that substantive changes to Medicaid could jeopardize their electoral chances come 2026.
According to a poll by the nonprofit health policy research firm KFF, two-thirds of Americans have personally been or are close to someone who has been covered by Medicaid, and 76 percent of adults view the program favorably—including 63 percent of Republicans.
Tax Cuts
Central to the bill, and Trump's economic agenda, is an extension of the president's 2017 tax cuts, set to expire at the end of this year, alongside new proposals floated on the campaign such as the elimination of taxes on tips.
However, freeing up the necessary funds for what the administration touts as the "largest tax cut in history," as well as new spending on border security and national defense included in the bill, will come at a serious cost.
According to the Tax Foundation's analysis of the latest version of the bill, the included tax provisions will reduce government revenue by $4.1 trillion over the next ten years.
Fiscal hawks within the party have complained that the legislation in its current form—even with the proposed changes to Medicaid, and spending reductions across green energy initiatives and other government programs—will not sufficiently offset this loss in federal tax income.
The Senate
Opposition to the bill, and skepticism that it can pass in its current form, is at least as strong in the upper chamber, with several senators voicing similar criticisms of the potential increase in the deficit and proposed changes to Medicaid.
"With the 'big, beautiful bill, I think that's the Titanic," Senator Ron Johnson told Politico at a recent event in Washington.
"I think that's going down because I think I have enough colleagues in the Senate that this has resonated with, that say, 'yeah, we have to return to a reasonable pre-pandemic spending,'" Johnson said, while advocating for a "multistep process" to carry out Trump's domestic agenda, rather than a singular bill.
Others, including Utah Senator Mike Lee, have made a similar case for more aggressive spending cuts.
Add to this the proposed, $4-trillion increase to the nation's debt ceiling, which Kentucky Senator Rand Paul said would likely lose his vote. "As long as that's in there, I can't support the bill," Paul told Fox News earlier this month, calling it "ironic and said" that conservatives could support such a measure.
Meanwhile, others have considered the proposed changes to Medicaid a nonstarter, arguing that this will wreak havoc on vulnerable populations and trigger avoidable backlash.
In a recent op-ed for The New York Times, Missouri Senator Josh Hawley said funding tax breaks through cuts to health care would be "both morally wrong and politically suicidal."
"Republicans need to open their eyes," the senator wrote. "Our voters support social insurance programs. More than that, our voters depend on those programs."
What Happens Next?
Following its approval on Wednesday by the Ways and Means Committee, the bill now moves to the chamber's Budget Committee, in preparation for a full house vote.
Despite still chasing a consensus on multiple issues, House Republican leadership has expressed hopes that the legislation pass the lower chamber before Memorial Day (May 26), and be signed into law by the president by the Fourth of July.
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