Parliamentarian reverses course, allows orphan drug provision in megabill
The Senate's 'big, beautiful' vote-a-rama starts in just two hours — and nobody knows how it's going to end.
Senate Majority Leader John Thune can only lose one more vote with Sens. Rand Paul (R-Ky.) and Thom Tillis (R-N.C.) already opposed. As Senate GOP leaders scramble to strike deals to keep the bill on track, House Republicans are drawing red lines, with fiscal hawks threatening to tank the bill over the Senate's budget framework and moderates balking at the provider-tax crackdown.
Here are the big fights we're watching when amendment votes kick off at 9 a.m., leading to a final vote on passage late Monday or early Tuesday:
Medicaid: GOP Sen. Rick Scott's proposal to curb a key Medicaid funding mechanism after 2030 has Thune's support as part of a deal struck to get the Florida senator and a handful of other holdouts to advance the megabill to debate.
If it fails, it could cost leadership some fiscal hawks, though Sens. Scott and Ron Johnson (R-Wis.) refused to go there Sunday night. If it passes, it could alienate so-called Medicaid moderates. One of them, Sen. Susan Collins of Maine, filed an amendment that would double the stabilization fund for rural hospitals to $50 billion, and pay for it by adding a 39.6-percent bracket on earners making over $25 million.
Medicaid moderates could also try to further water down the bill's cut to the provider tax. Keep an eye on Tillis, now unburdened by a reelection bid, who slammed the Medicaid cuts in a fiery floor speech Sunday and might jump in again. Another key player to watch is Sen. Lisa Murkowski and whether her support slips after the parliamentarian derailed Medicaid-payment provisions aimed at winning over the Alaskan. The parliamentarian also, as of early this morning, had yet to rule on food-aid waivers for Alaska that could affect Murkowski's vote.
Green credits: Moderates including Tillis and Sen. John Curtis (R-Utah) could offer amendments to soften the bill's deep cuts against wind and solar energy, including its crackdown on IRA credits and a new excise tax. That could provoke a fight with House conservatives and the White House, which have pushed for aggressive rollbacks.
AI: Commerce Chair Sen. Ted Cruz (R-Texas) and Sen. Marsha Blackburn (R-Tenn.) are pitching a plan to cut the megabill's 10-year moratorium on state enforcement of AI laws in half and make accommodations for internet protections.
The grand finale could be a manager's amendment that House GOP leaders are pushing for to further resolve differences between the chambers and speed the bill to Trump by Friday. The House is scheduled to vote as soon as Wednesday at 9 a.m.
What else we're watching:
— Farm bill fight: Dozens of agriculture groups are urging senators to oppose an amendment from Sen. Chuck Grassley (R-Iowa) that would limit income thresholds of farmers who can receive federal aid. A host of farm-state GOP senators also oppose Grassley's push, according to three people granted anonymity. Some are concerned that liberal senators could join with conservative fiscal hawks to pass the amendment.
— Solar and wind tax backlash: The U.S. Chamber of Commerce and the Solar Energy Industry Association are slamming a new addition to the megabill that would tax solar and wind projects that have components from foreign sources, including China. 'Taxing energy production is never good policy, whether oil & gas or, in this case, renewables,' Chamber executive vice president and chief policy officer Neil Bradley wrote on X.
— Campaign announcements: Rep. Don Bacon is expected to announce his retirement Monday, according to two people familiar with his plans. The centrist Republican's Nebraska seat is a prime pickup opportunity for Democrats; it's one of only three GOP-held districts Kamala Harris won in 2024. Meanwhile GOP Rep. Dusty Johnson is expected to announce a bid for South Dakota governor on Monday, according to two people familiar with his planning. He'll be the eighth House Republican to run for higher office in 2026.
Jordain Carney, Meredith Lee Hill, Mohar Chatterjee and Josh Siegel contributed to this report.
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This news release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, regarding, among other things our plans, strategies and prospects -- both business and financial. Although we believe that our plans, intentions and expectations reflected in or suggested by these forward-looking statements are reasonable, we cannot assure you that we will achieve or realize these plans, intentions or expectations. Forward-looking statements are inherently subject to risks, uncertainties and assumptions. Many of the forward-looking statements contained in this news release may be identified by the use of forward-looking words such as "believe," "expect," "anticipate," "should," "planned," "will," "may," "intend," "estimated," and "potential," among others. 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(Nasdaq: DUOT) 904-652-1625 fk@
