After a turbulent few days — following a turbulent few weeks — House Republicans finally muscled through their reconciliation bill early Thursday morning, overcoming unified Democratic opposition and serious doubts that the House GOP could ever find consensus on President Donald Trump’s sweeping legislative agenda.
At almost 7 a.m., the House passed the reconciliation bill 215-214 with one present vote, with 215 Republicans and zero Democrats voting yes. Two Republicans and 212 Democrats voted no.
In the end, Reps. Thomas Massie and Warren Davidson were the only Republicans who didn’t support the legislation. House Freedom Caucus Chair Andy Harris voted present.
“It quite literally is, my friends, morning in America,” Speaker Mike Johnson said in good spirits before the vote. “Legislation of this magnitude is truly nation-shaping and life-changing. It’s the kind of transformational change that future generations will study one day — they’ll look back, they’ll look back at this day as a turning point in American history.”
House Minority Leader Hakeem Jeffries spent more than 40 minutes railing against the legislation before Johnson spoke.
“People will die. That’s not hype. That’s not hyperbole. That’s not hypothetical,” Jeffries said on the floor ahead of the vote. He added that the vote on Thursday could be “the day Republicans lost control of the United States House of Representatives.”
Up until the presiding officer banged the gavel, there were questions about whether Republicans actually had the votes.
Johnson spent the last two days cutting deals with different factions of his conference. When he finally got blue-state Republicans on board by effectively quadrupling the state and local tax deduction, allowing wealthy homeowners to now write off $40,000 of their local taxes on their federal bill, conservatives became the last hurdle.
But in the end, Freedom Caucus members who had made a dramatic show over their opposition to the bill, arguing that the legislation didn’t cut enough spending from Medicaid, quickly changed their minds once they sat down with Trump on Wednesday.
As influential conservative Rep. Ralph Norman put it simply to reporters after huddling with the Freedom Caucus Wednesday evening, “The president has got a lot of power.”
Conservatives were able to move up the implementation date for Medicaid work requirements for able-bodied recipients — from Jan. 1, 2029, to Dec. 31, 2026 — but other than that change, it was generally small adjustments that most Republicans supported anyway.
For one, a manager’s amendment late Wednesday night ended a tax on firearm suppressors. That had become a major sticking point for some conservatives, though there are doubts that it will survive parliamentary rules in the Senate for reconciliation. But more notably, the manager’s amendment also accelerated the timeline for phasing out Inflation Reduction Act tax credits for clean energy, as conservatives wanted.
At the end of the negotiations, conservatives didn’t get more sweeping cuts to Medicaid, as they had demanded. The Federal Medical Assistance Percentage — which governs how much the federal government pays for certain Medicaid enrollees — was left basically untouched. And the per capita caps on Medicaid that conservatives wanted never materialized.
Still, according to the Congressional Budget Office estimates published before the Medicaid work requirement timeline was moved up, Republicans are already cutting nearly $715 billion from Medicaid, with those new restrictions sure to increase the overall dollar amount.
In many ways, what was more remarkable than conservatives backing the bill is that vulnerable Republicans ended up supporting it.
The Medicaid cuts will present a particular challenge to rural hospitals and communities with poorer populations. The CBO had previously projected that 8.6 million people would lose Medicaid coverage as a result of the Republican bill, on top of another 5 million who were already expected to lose coverage over the next decade because of expiring tax credits. The accelerated work requirements will again only increase that number.
Democrats were already hitting Republicans over those numbers. A distributional analysis from CBO showed that most of the money in the bill would flow to the richest 10%, with the poorest 10% actually losing money as a result of the legislation.
Democrats are also attacking Republicans for the food benefit program cuts in the bill, pointing out that new estate tax policies for millionaires essentially amount to the same cost as the Supplemental Nutrition Assistance Program cuts.
In the leadup to the final vote, Democrats were also relentless about Republicans passing the bill “in the dead of night.”
All along, Republicans have conducted much of their reconciliation bill’s legislative action at odd hours. From marathon markups that went all night last week, to a Budget Committee meeting late Sunday night, to a Rules Committee hearing that started at 1 a.m. on Wednesday and went until late Wednesday night, the process for this bill has been questionable.
Republicans only made the final text of their reconciliation bill available around 9 p.m. And they voted on the bill just hours later, starting debate on the legislation around 2:40 a.m.
But leaders were adamant about passing this bill as soon as they could, worried that letting the text hang out an hour longer than it needed to would threaten the delicate coalition they had built to pass the measure.
Unfortunately for House Republicans, however, the Senate will have the text for much longer. Many of the changes leaders pushed through to appease conservatives look destined for a Senate filing cabinet.
Already, at least three Republican senators — Sens. Lisa Murkowski, Susan Collins and Josh Hawley — have expressed major concerns with the House’s cuts to Medicaid. And another three — Sens. Rand Paul, Mike Lee and Ron Johnson — have been adamant that cuts don’t go far enough to reduce the deficit.
It will be a real challenge for the Senate to address Medicaid in the same way as the House. And if the bill comes back from the Senate without those Medicaid cuts, conservatives are sure to throw a temper tantrum.
For now, Republicans are celebrating this first step in the reconciliation process. Trump’s legislative agenda is, finally, one step closer to his desk. The president and the speaker have proven, once again, that they are capable of persuading dozens of skeptical House Republicans — or flat-out no votes — to cave.
Less than 72 hours before final passage, Freedom Caucus Chair Andy Harris told reporters that he was a “hard no” on the bill. At that point, he said, even if he could be convinced, it was “obvious” that it would take well over a week to work out the policy specifics necessary to get him and other conservatives on board.
“These are complicated discussions,” he said. “These are complicated issues. These are trillions of dollars.”
Less than 24 hours after Harris said Wednesday morning that there was “no way” the bill would pass in short order, he ultimately voted present, and the bill passed.
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Riley Rogerson, Daniella Diaz and Reese Gorman are reporters at NOTUS. Katherine Swartz is a NOTUS reporter and an Allbritton Journalism Institute fellow.