In a bold and unexpected Senate floor speech, Republican Senator Thom Tillis of North Carolina issued a stinging rebuke to his own party’s proposed domestic policy bill, which includes sweeping cuts to Medicaid. The moment came just hours after Tillis announced he would not seek re-election, adding gravity and finality to his message.
With the Senate on the verge of major healthcare reforms, Tillis warned that the GOP’s approach would betray both their constituents and former President Donald Trump’s promises. “This bill will betray the promise Donald Trump made,” he stated. “You supporting the Senate mark will hurt people who are eligible and qualified for Medicaid.”
Tillis Breaks Ranks on GOP Health Plan
Tillis, who opposed the bill during a procedural vote, spoke candidly about why he couldn’t support the legislation. His main concern? The impact it would have on the 663,000 North Carolinians who could lose access to Medicaid under the proposed changes.
“I respect President Trump, I support the majority of his agenda,” Tillis said, “but I don’t bow to anybody when the people of North Carolina are at risk, and this puts them at risk.”
Tillis also criticized the GOP’s rushed timeline, calling the July 4 deadline “artificial” and urging his colleagues to slow down and reconsider the implications of their bill.
Read More: Tension Mounts Ahead of Saturday’s Megabill Vote
A Senator Backed by Research, Not Rhetoric
Known for his bipartisan efforts during his two terms, Tillis said he had thoroughly researched the bill’s effects. He consulted North Carolina’s legislative leaders, Democratic Governor Josh Stein, and local hospital groups. He also held conversations with Centers for Medicare & Medicaid Services (CMS) Director Mehmet Oz to verify the numbers.
According to Tillis, the proposed changes to state-directed payments and caps on medical provider taxes would result in up to $26 billion in cuts to federal support for North Carolina alone.
“After three different attempts to discredit our estimates, they admitted that we were right,” he said. “They can’t find a hole in my estimate.”
A Direct Message to Trump
Tillis didn’t hold back when addressing former President Trump’s role in supporting the bill. “You’ve been misinformed,” he said. “You’re getting advice from people who’ve never governed, who are pushing you into a box canyon.”
Drawing a sharp comparison, Tillis likened Trump’s proposal to the Affordable Care Act — a law frequently criticized by conservatives. “This bill breaks a promise. Just like when someone said, ‘If you like your health care, you can keep it.’”
Trump Responds, Tillis Holds Ground
Trump criticized Tillis on social media shortly after the senator voted against opening debate on the bill. But Tillis remained unfazed. According to him, he had already informed the former president of his intention to retire and his likely opposition to the bill.
“Pretty much what I said on the floor is what I said to the president,” Tillis stated. “I told him he probably needed to start looking for a replacement.”
Despite their differences, Tillis emphasized he wanted to help Trump secure a strong successor for the 2026 Senate race.
What’s in the GOP Megabill?
The Republican-led domestic policy bill includes a wide range of spending cuts aimed at reshaping government support programs. Key among them are:
- Significant reductions in Medicaid funding
- Caps on provider taxes
- Restructuring state-directed payments
- Changes to eligibility verification processes
Supporters argue the bill is a necessary measure to curb federal spending and streamline healthcare programs. Critics, like Tillis, warn that these changes will result in millions losing coverage.
Senate Debate and the Road Ahead
The Senate is now engaged in 20 hours of formal debate before voting on amendments in a marathon session starting Monday. Tillis has signaled he may return to the floor to continue voicing his opposition.
With mounting pressure from both sides, the outcome remains uncertain. Tillis’s defection underscores growing internal divisions within the GOP over the direction of healthcare policy.
Frequently Asked Questions
Why did Thom Tillis oppose the GOP megabill?
Tillis opposed it due to the bill’s projected impact on Medicaid, particularly the potential loss of coverage for over 663,000 North Carolinians.
What did Tillis say about Trump’s involvement?
He stated Trump was misinformed and influenced by advisors with no real governing experience, warning the president against supporting the bill.
How much in federal support could North Carolina lose?
Tillis estimates a loss of up to $26 billion in federal Medicaid support if the bill passes.
Is Tillis running for re-election?
No, Senator Tillis announced he will not seek re-election in 2026.
What changes to Medicaid are in the bill?
The bill includes cuts to funding, caps on provider taxes, and changes to state-directed payments and eligibility criteria.
What’s next for the bill?
The Senate is currently debating the bill, with amendment votes expected to begin soon.
How did Trump react to Tillis’s vote?
Trump criticized Tillis for opposing the bill, though Tillis said he had already informed Trump of both his retirement and his position.
Could Tillis’s stance influence other Republicans?
Yes. His strong opposition and well-researched arguments could sway other moderates or undecided Republicans during the final debate.
Conclusion
Thom Tillis’s Senate floor speech marked a powerful moment of political integrity. With retirement removing the pressures of re-election, Tillis spoke freely and forcefully about what he views as a dangerous step backward in healthcare policy. His call to protect Medicaid recipients — especially those in his home state — challenges his party to rethink its approach and consider the human cost behind policy decisions.