Senate Fiscal Hawks Seek Partial Obamacare Repeal in One Big Beautiful Bill Act

Senate fiscal hawks are seeking a major concession in the One Big Beautiful Bill Act—a partial repeal of President Barack Obama’s Affordable Care Act.

The fiscal conservatives managed to introduce the amendment after withholding their vote on a motion to proceed with the massive 10-year budget framework.

Now, almost a decade removed from the day when three Republicans helped kill a budget reconciliation bill which would have repealed Obamacare, Republicans are again entering a debate over the landmark legislation which President Donald Trump harshly criticized during his first presidential run.

“We cannot allow Dem-led blue states to use YOUR tax dollars to give illegal aliens Medicaid benefits, exploit this safety net, and jeopardize help for those who truly need it,” said Sen. Rick Scott, R-Fla., on the social media platform X Sunday night after securing the concession.

Late Saturday night, the 10-year fiscal package was in jeopardy as Republican Sens. Scott, Mike Lee of Utah and Cynthia Lummis of Wyoming withheld their votes on a motion to proceed to the floor with the massive piece of legislation.

 Sen. Ron Johnson, R-Wis., initially voted “no” on proceeding with the bill.

But Senate Republican leadership, alongside Vice President JD Vance, were able to win the four senators over with a promise to have a vote on an amendment which would lower the federal government’s matching of state Medicaid spending.

This allowed the bill to proceed by a 51-49 vote, as Sens. Rand Paul, R-Ky., and Thom Tillis, R-N.C., could not be moved from their “no” votes.

But what would the fiscal hawks’ amendment accomplish if passed?

Under the 2010 Affordable Care Act, known as “Obamacare,” Medicaid was opened up to a broader range of new expansion enrollees—including individuals above the poverty line, as well as working age adults with no dependents.

In states that have adopted this expansion, the federal government covers 90% of the funds going towards Obamacare expansion enrollees, while covering an average of 60% of the funds going to the enrollees who would have been eligible before Obamacare’s passage.

These matching rates are known as the federal matching assistance percentages. 

With the new amendment, these Republicans are seeking an end to the higher rate for expansion enrollees starting in 2031. In other words, expansion enrollees would get the same benefits as everyone else under the program.

Sen. Rick Scott, R-Fla. (Andrew Harnik/Getty Images)

Expansion enrollees who are already enrolled would be grandfathered in and continue to have their benefits matched at the 90% rate.

“My proposal to fix [federal matching assistance percentages] will make the Big Beautiful Bill even more aligned with President Trump’s goal to balance the budget, grow the economy, and put Americans first,” Scott wrote Sunday on X. 

He thanked Senate Finance Committee Chairman Mike Crapo, R-Idaho, as well as Lummis, Lee, and Johnson for helping to bring the amendment to the floor.

Scott also said Sunday that he is “very confident that [his] amendment is going to pass,” but it remains unclear how much of a deal breaker the matching assistance percentages issue is for Republicans in the House and Senate.

Rep. Chip Roy, R-Texas, has previously called for similar reform, but Rep. David Valadao, R-Calif., has said he will vote down the One Big Beautiful Bill if it changes the House’s work on Medicaid.

Republicans already lost one vote on Saturday night over the Medicaid issue when Tillis voted “no” due to the bill’s lowering of the state provider tax, a mechanism by which states secure more federal funding for their health care programs.

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