GOP Sens. Thom Tillis, Rand Paul, and Susan Collins voted against the Senate’s passage of their party’s “big beautiful bill,” as had been expected, but Sen. Lisa Murkowski, R-Alaska, who had also spoken about the measure, voted for it, helping lead to the legislation’s passage by a vote of 51-50 after Vice President JD Vance cast the tie-breaking vote.

Collins, R-Maine, posted on X just minutes after the Senate vote, said that while she was pleased the final version of the legislation contained a special fund she proposed to assist rural hospitals, “It is not sufficient to offset the other changes in the Medicaid system.”

She added that while she continues to support the tax relief she voted for in 2017, she “could not support” the bill’s Medicaid changes. 

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