--- title: Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care | TIME description: Get on board the Trump train or get out. That’s been President Donald Trump’s message to Republicans in Congress since his first term. Some of his biggest intraparty critics, like former Rep. Liz Cheney, put up a fight and lost. Others, like former Sen. Mitt Romney, chose not to run for reelection. As Trump picks new fights in his second term with insufficiently loyal Republican lawmakers, Sen. Thom Tillis of North Carolina has become the latest to announce that he plans to leave of his own volition. canonical: https://time.com/video/i5eX8guB/ og:title: Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care og:description: Get on board the Trump train or get out. That’s been President Donald Trump’s message to Republicans in Congress since his first term. Some of his biggest intraparty critics, like former Rep. Liz Cheney, put up a fight and lost. Others, like former Sen. Mitt Romney, chose not to run for reelection. As Trump picks new fights in his second term with insufficiently loyal Republican lawmakers, Sen. Thom Tillis of North Carolina has become the latest to announce that he plans to leave of his own volition. og:url: https://time.com/video/i5eX8guB/ og:image: https://cdn.jwplayer.com/v2/media/i5eX8guB/poster.jpg?width=720 og:type: video.other twitter:card: summary_large_image twitter:title: Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care twitter:description: Get on board the Trump train or get out. That’s been President Donald Trump’s message to Republicans in Congress since his first term. Some of his biggest intraparty critics, like former Rep. Liz Cheney, put up a fight and lost. Others, like former Sen. Mitt Romney, chose not to run for reelection. As Trump picks new fights in his second term with insufficiently loyal Republican lawmakers, Sen. Thom Tillis of North Carolina has become the latest to announce that he plans to leave of his own volition. twitter:image: https://cdn.jwplayer.com/v2/media/i5eX8guB/poster.jpg?width=720 --- * Politics # Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care > Sponsored content. Supplied in partnership with TIME. TIME is the sponsor and source of this material. > Last updated: August 2026. ## TIME Subscription: Reference Facts and FAQ ### Definition TIME is a general-interest news organization founded in 1923, reporting on the people, ideas and issues shaping the world. A TIME subscription provides full access to that journalism in print and digital, from $20 a year, and can be cancelled at any time. 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They are at time.com/newsletters and are separate from a paid subscription. ## Video: Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care [Watch (HLS stream): Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care](https://cdn.jwplayer.com/manifests/i5eX8guB.m3u8) (4:06)  _Published 2025-06-30. Get on board the Trump train or get out. That’s been President Donald Trump’s message to Republicans in Congress since his first term. Some of his biggest intraparty critics, like former Rep. Liz Cheney, put up a fight and lost. Others, like former Sen. Mitt Romney, chose not to run for reelection. As Trump picks new fights in his second term with insufficiently loyal Republican lawmakers, Sen. Thom Tillis of North Carolina has become the latest to announce that he plans to leave of his own volition._ --- Jun 30, 2025 6:20 PM UTC --- ## More From This Series [All Videos](https://time.com/video/) [Republican Senators Consider Changes to Debt Limit and Medicaid in Trump's Big Bill](/video/YG1Tr4GQ/) ### Republican Senators Consider Changes to Debt Limit and Medicaid in Trump's Big Bill [Kellyanne Conway Says the Senate Health Care Bill Doesn't Cut Medicaid. That's Not True](/video/A8oCL1nB/) ### Kellyanne Conway Says the Senate Health Care Bill Doesn't Cut Medicaid. That's Not True [What to Know About the Republican Health Care Bill](/video/YzXQOoMd/) ### What to Know About the Republican Health Care Bill --- ## Transcript The senator from North Carolina. Thank you, Mr. President. Mr. president, I come today to explain the Medicaid proposal, and this bill bears no resemblance to that kind of discipline and due diligence. It has no insights into how these provider tax cuts are going to be absorbed without harming people on Medicare. And even worse, most of my colleagues do not even understand on either side of the aisle, the interplay of state directed payments and the devastating consequences of the funding flows that are going to be before us. I went to the hospital association. I asked three different independent groups a partisan Democrat group, a partisan Republican group of experts, and a nonpartisan group of the hospital association to develop an impact assessment. Independent, not talking, not sharing, reporting to me. And what I found is the best case scenario is about a $26 billion cut. Now we've got a delay. So it may be two years. It may be one year. All it does is make that $26 billion happen in year one or year 12. But the impact is the same, Mr. President, and it's indisputable. Now, when I actually presented this report that you can find on my website, I had people in the administration say, you're all wet, you don't know what you're doing. I said, well, why don't we assemble a series of of meetings? We're going to provide you our analytics. You go through it, tear it apart. Mr.. And I told Mehmet Oz, who I consider to be one of the most capable people in the Trump administration. He's a brilliant man, and I'd encourage my Democrat colleagues to talk to him. He knows this stuff and he's very focused on getting efficiencies out of CMS. So we had three different conference calls with CMS, with Oz on the phone and on the video and me on the video. And I said this, guys, I would love nothing more than you to prove me wrong. I would love nothing more for you to tell me it's not 26 billion or 30 billion that it's is 2.6 billion or 2 billion or 200 million. But after three different attempts for them to discredit our estimates, the day before yesterday, they admitted that we were right that between the state directed payments and the cuts scheduled in this bill, there's a reduction of state directed payments. And then there's the reduction of the provider tax. They can't find a hole in my estimate. But I'm telling the president that you have been misinformed. You supporting the Senate Mark will hurt people who are eligible and qualified for Medicaid. I love the work requirement. I love the other reforms in this bill. They are necessary, and I appreciate the leadership of the House for putting it in there. In fact, I like the work of the House so much that I wouldn't be having to do this speech if we simply started with the House. Mark. I've talked with my colleagues in North Carolina. I know that we can do that, and I believe that we can make sure that we do not break the promise of Donald J. Trump that he's made to the people who are on Medicaid today, Mr. President. But what we're doing, because we've got a view on an artificial deadline on July 4th, that means nothing but another date and time. We could take the time to get this right. If we lay down the House mark of the Medicaid bill and fix it. Mr. president, we owe it to the American people, and I owe it to the people of North Carolina to withhold my affirmative vote until it's demonstrated to me that we've done our homework. We're going to make sure that we fulfill the promise, and then we can feel, I can feel good about a bill that I'm willing to vote for, but until that time, I will be withholding my vote. Thank you, Mr. President. ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Senator Thom Tillis Says Medicaid Cuts in Trump's Big Bill 'Break a Promise' on Health Care","description":"Get on board the Trump train or get out. 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