When the House took its final vote in early July on President Donald Trump’s reconciliation bill, only two Republicans opposed the legislation — and only one GOP lawmaker voted against the measure because he thought it went too far: Rep. Brian Fitzpatrick.
To those familiar with Fitzpatrick, a moderate from one of just three districts that went for Kamala Harris and a House Republican in 2024, the vote wasn’t entirely surprising. Fitzpatrick has spent his eight-year tenure trying to strike a balance between fitting in with the Republican Party he belongs to and contrasting himself with it.
To hear Fitzpatrick tell it — in a statement that he has let speak for his decision in the week since the vote — the Medicaid provisions that the Senate inserted into the final version of the bill were just too much for his suburban Philadelphia district to bear. After more than a dozen vulnerable House Republicans expressed firm opposition to the Senate cutting the Medicaid provider tax, with 16 such lawmakers vowing in a letter not to support the overall bill if those cuts were part of the final legislation, all of those Republicans voted “yes” anyway.
Fitzpatrick, who didn’t sign that letter, was the only one who voted with Democrats over shared discomfort about those Medicaid cuts. (Republican Rep. Thomas Massie voted against the final bill because the cuts didn’t go far enough.)
But if Fitzpatrick thought his decision to oppose the legislation would insulate him from Democratic attacks over the reconciliation bill, Democrats think he has another thing coming.
“The budget doesn’t pass without his vote. It’s that simple,” Fitzpatrick’s Democratic challenger Bob Harvie told NOTUS. “He was the deciding vote back in May. He could have stopped it. He didn’t.”
Harvie, a Bucks County Commissioner, is correct that Fitzpatrick supported Republican leadership in three key reconciliation votes this year — twice on budget frameworks that laid out the policy contours of the final product, and again on the House’s version of the legislation in May that cut $715 billion from Medicaid.
“Obviously, our job is going to be to highlight this as much as possible. And we have to really make people understand that when the chips were down, he voted the way his party wanted him to,” Harvie said. “Then, when they knew they had a little bit of a margin, he voted the way his party allowed him to. We need somebody in Washington who really has a spine.”
Fitzpatrick allies strongly dispute that leadership gave him a green light to save face in his notoriously fickle district. Chris Pack with the Defending America PAC, which is supporting Fitzpatrick, called that theory “complete bullshit.”
Still, that won’t stop Democrats from loudly making the case that Fitzpatrick’s final vote was a disingenuous political charade, in which he abetted the process every step of the way until the end.
The Democratic Congressional Campaign Committee is already running digital ads with Meta that lump Fitzpatrick in with every other Republican who voted “Yes.”
“Because of his vote,” an ad attacking Fitzpatrick says, “rural hospitals around America are now at risk of closing.”
To hear the DCCC tell it, Fitzpatrick’s decision to oppose the final product hardly means anything at all.
“He is on the record voting for massive cuts to Medicaid, and we will make sure voters know that he bears responsibility for the devastating impacts this bill will have on Bucks and Montgomery counties,” DCCC spokesperson Eli Cousin told NOTUS.
As both parties gear up for a bruising midterm cycle that will decide if Trump keeps his Republican trifecta, Fitzpatrick’s seat very well may make or break the House majority. Democrats — still taking heat from their base to wage a more aggressive resistance to the GOP — are incentivized to do everything in their power to topple a Harris-district Republican, especially during a midterm cycle that, if history is any indication, will be unfavorable to the party in power.
The post-reconciliation attack lines are a key preview of how Democrats will run against Fitzpatrick in 2026. And they offer a broader indication of the party’s confidence in their newfound message, given they are enthusiastically wielding it against a congressman who, ultimately, voted “no.”
But Pack doesn’t buy that voters won’t see a distinction. “It sounds like West Wing fan fiction,” he said.
“I get that they want it to be true, but it’s not,” Pack continued. “Brian voted against the bill because he has his finger on the pulse of the district and knows what they want.”
Pack added that Fitzpatrick’s constituents are aware he voted against the bill. “So if you’re trying to explain how he wasn’t really voting against the bill, but was, like, you just lost the day,” he said.
Of course, Fitzpatrick is in danger of not just losing the day to a Democrat, but also to a fellow Republican. His opposition to the bill very well may draw a primary challenge.
In the aftermath of the vote, GOP personalities posted ominous social media messages about their frustration with Fitzpatrick. Republican operative Scott Presler, who has worked in Pennsylvania, posted, “Message received. CC: Bucks County.” Ultraconservative influencer Laura Loomer criticized Fitzpatrick’s recent engagement to a Fox News reporter, saying it “explains” his vote against the bill.
Within Bucks County Republican circles, however, key MAGA players seem to be aligning behind Fitzpatrick. Jim Worthington — a well-connected Bucks County business owner who represented Pennsylvania at the 2024 Republican National Convention (and who told NOTUS “there’s no bigger Trump supporter in the country” than him) — said he is sympathetic to Fitzpatrick’s vote against the bill, even if he would have personally backed the legislation.
“People should just be thankful that we’re holding the seat. Ninety percent of the time, he votes with the president. He didn’t this one time, but it didn’t affect the outcome,” Worthington said. “And the bottom line is that he’s right for here, and he’s going to move forward and work with the president and get more things done that will benefit not just Bucks County, but America.”
Another sign Fitzpatrick might be spared a challenger — or at least a serious one — is that his previous GOP opponent, abortion rights activist Mark Houck, told NOTUS that he is not currently considering another run, despite his disappointment in Fitzpatrick’s vote.
If a Republican does run against Fitzpatrick, the cavalry is prepared to line up behind him.
“I’m going to come out when the time comes, like officially, and endorse Fitzpatrick prior to the primary,” Worthington said.
“I’ve never done it before,” he continued. “I always felt like I needed the process to play out, let the people decide, but I’m going to use as much influence as I have being one of the top Trump supporters in the country to make sure it’s clear that this isn’t a time for us to experiment with some candidate that could lose in the general election.”
While Fitzpatrick is consolidating support among Bucks County Republicans, Harvie is generating enthusiasm with Democrats.
Rep. Madeleine Dean, who represents a neighboring district, endorsed Harvie. “It’s time for change,” she said. And Sen. Ruben Gallego of Arizona joined Harvie for a Bucks County rally earlier this month.
The entire Democratic Party, it seems, is prepared to hit Fitzpatrick for his reconciliation record.
“Anyone trying to play cute and coy is just not going to end up getting the support of voters,” Gallego told NOTUS. “He was along for the ride for most of that bill. Got it to the point where then he knowingly walked away by assuring that it would still pass.”
Mike Conallen, a former chief of staff for Fitzpatrick, told NOTUS the strategy of linking Fitzpatrick to the bill could generate momentum.
“What they’re doing is smart,” Conallen said, “because if they don’t do this, they basically perpetuate the narrative that Brian Fitzpatrick is willing to stand up to Donald Trump, right? That, ‘I am not a rubber stamp to the president,’ right?”
“And in terms of the coming election,” he continued, “I think what Democrats absolutely have to do is say that if you’re upset with Trump, if you’re mad at Trump, you have to transfer that anger to Brian Fitzpatrick in the midterm election.”
It’s precisely that kind of language that top Pennsylvania Democrats are deploying.
As Pennsylvania Lt. Gov. Austin Davis told NOTUS, “The people in Bucks and Montgomery County can see through the same old tricks that Brian Fitzpatrick has been playing for a number of years, where he has been centering the needs of Donald Trump.”
But it will take a considerable amount of voter anger to topple Fitzpatrick. Last quarter, Fitzpatrick raised $1.3 million, a record-setting sum for the district that brought his cash on hand to $6.5 million.
And Fitzpatrick campaign spokeswoman Diane Dowler pushed back on Harvie’s viability as an opponent, telling NOTUS in a statement that he is “not a serious candidate or a serious campaign. Nobody is taking this guy’s candidacy seriously, including Democrats,” and calling him “un-relatable and un-likable and everyone knows it.”
Not every Democrat is as sold on their party’s strategy, or Harvie’s chances of taking out Fitzpatrick. Pennsylvania Sen. John Fetterman called Fitzpatrick “fool’s gold for Democrats.”
“I mean, perennially, they’re trying to dislodge him. But he is very, very fluid and bipartisan, and that’s exactly the district that he represents,” Fetterman told NOTUS.
“And I think once he voted ‘no’ against it,” Fetterman added, “that cemented another term.”