NC Republican Sen. Thom Tillis says he won’t vote for Trump’s ‘big beautiful bill’
.jpg "Sen. Thom Tillis (R-N.C.) speaks to reporters as he arrives on Capitol Hill for a vote to confirm Scott Bessent to be President Donald Trump’s Treasury secretary, in Washington, Jan. 27, 2025. President Trump made it clear that he was willing to play hardball against Tillis, right, as payback for a defection on Pete Hegseth’s confirmation.")
AI-generated summary reviewed by our newsroom.
- Sen. Thom Tillis opposes GOP budget bill over Medicaid and rural hospital cuts.
- The bill could strip coverage from 260,000 North Carolinians on Medicaid.
- Senate plans floor vote; Trump urges passage before July 4 to enact tax extensions.
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US Sen. Thom Tillis & NC Senate race
U.S. Sen. Thom Tillis, a Republican who has represented North Carolina in Washington for a decade , announced June 29, 2025, he won’t seek reelection amid dissent with President Donald Trump. The Huntersville resident, a former speaker of the state House of Representatives, was first elected to the Senate in 2014. Here is coverage of the announcement and what it means for the 2026 Senate race.
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Updated: On Sunday, Thom Tillis announced he would not seek reelection. See this story for more.
U.S. Sen. Thom Tillis, a North Carolina Republican, broke with his party Saturday and said he would not support the federal “One Big Beautiful Bill Act,” the sweeping budget package that would enact much of President Donald Trump’s agenda.
In a statement, Tillis cited the bill’s expected impacts on Medicaid and rural hospitals as key reasons for his decision.
“I did my homework on behalf of North Carolinians, and I cannot support this bill in its current form. It would result in tens of billions of dollars in lost funding for North Carolina, including our hospitals and rural communities,” Tillis’ statement read. “This will force the state to make painful decisions like eliminating Medicaid coverage for hundreds of thousands in the expansion population, and even reducing critical services for those in the traditional Medicaid population.”
The Huntersville resident, a former speaker of the state House first elected to the U.S. Senate in 2014, has mostly — though not always — avoided publicly breaking with Trump this year.
His vote on Trump’s top legislative priority is sure to be an issue in 2026, both in a Republican primary election and in a general election against a Democrat. But on Sunday, Tillis released a statement saying he would not run for reelection.
The Senate is set to consider the Trump-backed bill this weekend after releasing it Friday evening. Republicans hold a majority in the chamber with 53 seats.
Trump attacked Tillis online after the senator voted against a procedural measure to advance the bill Saturday night.
“Thom Tillis is making a BIG MISTAKE for America, and the Wonderful People of North Carolina!” Trump wrote on Truth Social, the social media platform he owns.
The House approved its own version of the bill last month. The Senate’s version of the bill would need to be approved by the House before it heads to Trump’s desk. Trump has said he wants the bill finalized by July 4.
The key goal of the bill is to cut taxes, as tax breaks approved during Trump’s first term expire later this year, the Associated Press reported. The bill would also provide billions of dollars for the president’s immigration and border agendas, including deportations.
In order to pay for many of the bill’s proposals, the AP reported, the measure would enact cuts on several longstanding government programs — including Medicaid. The House’s version of the bill included less severe cuts to Medicaid, but would still leave more than 10 million people without health care coverage, the AP reported. That includes more than 260,000 in North Carolina, according to one estimate.
In a June 12 letter to Trump, House Speaker Mike Johnson and Senate Majority Leader John Thune — all Republicans — Senate Democrats cited data from the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill to show that five rural hospitals in North Carolina could be at risk of closing under the bill’s proposed cuts to Medicaid.
“There is a lot for North Carolinians to love about the rest of the One Big Beautiful Bill, including extending the historic Trump Tax Cuts, increasing the child tax credit, providing historic funding for border security, and ending wasteful spending,” Tillis said Saturday. “We can and must accomplish this without hurting our rural communities and hospitals, and without jeopardizing access to care for hundreds of thousands of North Carolinians who need it the most.”
Ken Martin, chair of the Democratic National Committee, told The News & Observer this week that the bill would cost North Carolina billions in federal funding and potentially see hundreds of thousands in the state lose their insurance coverage.
“As it relates to health care access throughout this state ... it’s going to be harder for people, particularly in the rural parts of North Carolina to find hospitals and clinics to actually get their health care,” Martin said.
Martin also identified Tillis as “one of the most vulnerable Senate Republicans.”
Tillis’ counterpart, Sen. Ted Budd, also a North Carolina Republican, voted in favor of the procedural step to move the bill forward to floor debate.
“I support moving to debate on the One Big Beautiful Bill because it includes major reforms to slow the ballooning cost of government programs and root out waste, fraud, and abuse,” Budd said on X Saturday. “There’s more work to be done, but I strongly agree with President Trump that we must unleash America’s full economic potential.”
At the state level, Senate leader Phil Berger, an Eden Republican, said on X Saturday he supports the bill and that “the legislature will work through any implementation issues.”
This story was originally published June 28, 2025 at 6:20 PM with the headline "NC Republican Sen. Thom Tillis says he won’t vote for Trump’s ‘big beautiful bill’."
