Politics in D.C. usually follows a predictable script. You’ve got your party lines, your talking points, and your late-night votes where everyone falls into place. But every once in a while, a piece of legislation comes along that’s so massive it starts to crack the very foundation of party unity. Enter the One Big Beautiful Bill Act (OBBBA)—or as everyone basically calls it, the Big Beautiful Bill.
Passed in the heat of July 2025, this wasn't just another tax tweak. It was a $3.9 trillion behemoth that touched everything from tips and overtime to Medicaid and the debt ceiling. It was President Trump’s signature second-term agenda item, a "reconciliation" masterpiece designed to bypass the filibuster.
Most Republicans saw it as a victory lap. But for a tiny, defiant group of Senate Republicans, the bill was a bridge too far.
The vote was a nail-biter. 51-50. Vice President JD Vance had to literally sit in the chair and cast the tie-breaking vote to get it over the finish line. If one more Republican had flipped, the "Big Beautiful Bill" would have been a big, beautiful memory.
So, who were the holdouts? And why did they risk the wrath of a president who isn’t exactly known for forgetting a snub?
The Three Who Broke Ranks
There were exactly three Senate Republicans who voted against the Big Beautiful Bill. They didn't do it as a caucus, and they didn't do it for the same reasons. Honestly, their motives were as different as the states they represent.
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1. Susan Collins (Maine)
Collins is the quintessential "moderate" who often finds herself in the crosshairs of her own party. For her, the sticking point was Medicaid. The bill included roughly $930 billion in cuts to the program over a decade. Collins argued that for a state like Maine—where some 400,000 people rely on Medicaid—those cuts were a death sentence for rural hospitals and nursing homes.
She even tried to push an amendment to double a rural hospital stabilization fund to $50 billion, but when that failed, she walked. She basically said the "special fund" offered by leadership was a band-aid on an amputation.
2. Thom Tillis (North Carolina)
This one was a bit more of a shocker to some, but Tillis had been signaling his unease for weeks. Like Collins, he was terrified of the Medicaid cuts. He gave a pretty raw floor speech about how he couldn't go back to North Carolina and explain to 663,000 residents why their healthcare funding was vanishing.
The political fallout was immediate. Trump took to Truth Social to call him "worse than Rand 'Fauci' Paul" and threatened to find a primary challenger. In a wild twist, Tillis announced his retirement shortly after, citing the toxic environment for independent thinkers.
3. Rand Paul (Kentucky)
If you know anything about Rand Paul, you know he hates the deficit. The Congressional Budget Office (CBO) estimated the Big Beautiful Bill would add nearly $4 trillion to the national debt. Paul met with the Vice President and offered a deal: he’d vote "yes" if they cut the debt ceiling by 90%.
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The White House said no. Paul said no. He called it "selling out taxpayers" and refused to budge, even as the rest of the party fell in line.
What Was Actually in the Bill?
To understand why these three voted "no," you have to look at the sheer scale of what was being proposed. This wasn't a "skinny" bill. It was a complete overhaul of the American fiscal landscape.
- The Tax Cuts: It made the 2017 tax cuts permanent. It also added new tax-free status for tips and overtime pay, which was a huge campaign promise.
- The Border: We're talking $150 billion for border enforcement and a massive surge in funding for ICE—taking their budget from $10 billion to over $100 billion by 2029.
- The Cuts: To pay for some of this, the bill slashed Medicaid and SNAP (food stamps) funding. It also phased out several Biden-era green energy credits.
- The Debt: It raised the debt ceiling by $5 trillion.
It was a classic "everything but the kitchen sink" bill. For most Republicans, the tax cuts and border security were worth the price. For Collins, Tillis, and Paul, the price—whether in healthcare or debt—was just too high.
The Murkowski Factor: The "Yes" That Almost Wasn't
We can't talk about the "no" votes without mentioning Lisa Murkowski. For a few hours during that marathon 27-hour session, it looked like there would be four Republicans voting no.
Murkowski was deeply worried about how the Medicaid cuts would hit Alaska. She spent hours in backroom negotiations with Majority Leader John Thune. Eventually, she voted "yes," but she looked miserable doing it. She released a statement later saying the bill "is not ready for the President's desk" and that she hoped it would be fixed in the House. It wasn't, but her vote gave Trump the win he needed.
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Why This Vote Still Matters in 2026
The dust has settled, but the ripples are still moving. As we move through 2026, the consequences of the Big Beautiful Bill are starting to show up in the real world.
Rural hospitals in Maine and North Carolina are already sounding the alarm about the upcoming Medicaid "cliff." Meanwhile, the fiscal hawks are pointing at the latest debt numbers and saying, "We told you so."
The vote showed that while Trump's grip on the GOP is incredibly strong, there are still pockets of resistance. Sometimes it's about local politics (Collins/Tillis), and sometimes it's about rigid ideology (Paul).
What You Can Do Next
If you’re trying to keep track of how these changes affect your own wallet or healthcare, here are a few things to keep an eye on:
- Check Your Paycheck: The tax exemptions for tips and overtime are now in effect. If you work in hospitality or a trade, make sure your payroll department is actually applying these new rules.
- Monitor Medicaid Eligibility: If you or a family member are on Medicaid, stay in close contact with your state’s health department. The federal funding cuts are trickling down, and states are starting to tighten eligibility requirements.
- Watch the 2026 Midterms: The "no" votes of Tillis and the "hesitant yes" of others are going to be huge talking points. In North Carolina especially, the race to fill Tillis's seat will be a referendum on the bill itself.
Politics moves fast, but the Big Beautiful Bill is going to be the defining legislative act of this decade. Knowing who stood where—and why—is the only way to make sense of the chaos.