Jesus said the truth will set you free; however, in the case of US Senator Thom Tillis’ from North Carolina, it was his announcement earlier in the day that he would not be running for reelection in 2026 that appears to have freed him up to speak his mind with a force and frankness rarely seen on the Senate floor.

And on Sunday night, June 29, that’s exactly what he did.

In a blistering address delivered during debate on what President Trump and Republican leadership have dubbed the “One Big Beautiful Bill,” Tillis made it clear that his vote against the motion to proceed wasn’t about political gamesmanship or posturing – instead, it was, he said, about stopping legislation that he believes will cause real harm to hundreds of thousands of North Carolinians and millions of Americans.

Tillis began by drawing on his own background in management consulting and his time as Speaker of the North Carolina House, recalling how, during the 2011 fiscal crisis, he and his colleagues balanced a $2 billion budget shortfall without decimating vital state programs.

“We took the time to understand every aspect and every dollar that was being spent in government,” he said. “We determined how to cut government in a way that was sustainable. We cut 12 percent from the university system budget – not the rate of growth, but the actual spending.”

He pointed out that, despite dire predictions at the time, the UNC system remained strong and widely respected.

 “The last time I checked, the North Carolina university system is still considered one of the greatest systems in the United States of America.”

Tillis contrasted that methodical, deliberate approach with what he described as the reckless and opaque process that has produced the Medicaid provisions in the current legislation under consideration.

 “The Medicaid proposal in this bill bears no resemblance to that kind of discipline and due diligence,” he said. “It has no insights into how these provider tax cuts are going to be absorbed without harming people on Medicaid. And, even worse, most of my colleagues do not even understand the devastating consequences of the funding flows that are going to be before us.”

Rather than rely on guesswork and partisan Republican assumptions, Tillis said, he commissioned three independent economic impact assessments of what the bill would do to Medicaid in North Carolina: He sought input from the Republican-led General Assembly, from the Democratic staff of Governor Josh Stein and from the North Carolina Hospital Association.

“Three different independent groups – a partisan Democrat group, a partisan Republican group, and a nonpartisan group – developed an impact assessment, independent, not talking, not sharing, reporting to me,” he said. “And what I found is the best-case scenario is about a $26 billion cut.”

Tillis then said he presented those findings to officials in the Trump administration, including top people at the Centers for Medicare & Medicaid Services (CMS). That’s a federal agency in the US Department of Health and Human Services that oversees the administration of the nation’s major healthcare programs, including Medicare, Medicaid, the Children’s Health Insurance Program and the Affordable Care Act marketplaces. CMS is the agency responsible for analyzing, implementing and regulating changes to Medicaid policy – which has particularly complex funding mechanisms such as provider taxes and state-directed payments.

 “I was hoping they could prove me wrong,” Tillis told his fellow senators. “I would love nothing more than you to tell me it’s not $26 billion. Maybe it’s $2.6 billion, or $200 million,” he told them.

But after multiple calls and briefings, he said, “They admitted that we were right.”

Tillis told the senators that, between reductions in state-directed payments and cuts to provider taxes, there’s no question the bill would gut Medicaid in North Carolina and in other states.

“So, what do I tell 663,000 people in two or three years when President Trump breaks his promise by pushing them off of Medicaid because the funding is not there anymore?” he asked.

Tillis compared the situation to the infamous “if you like your doctor, you can keep your doctor” line from the Obamacare era.

“That wasn’t true, and that made me the second Republican Speaker of the House in North Carolina since the Civil War,” Tillis said.

He said the backlash to that broken promise helped propel him to the US Senate.

“Now Republicans are about to make a mistake on healthcare and betray a promise,” a very animated Tillis said

Tillis noted that President Trump himself once vowed, during a meeting in the Cabinet Room, that Medicaid would not be cut – saying reforms would only eliminate “waste, fraud, and abuse.” However, Tillis argued that those tasked with executing the policy have instead gone after the foundation of the program: the provider tax structure that underpins much of Medicaid’s funding at the state level.

“That’s called the provider tax – a legal construct that admittedly has been abused and should be eliminated where appropriate,” Tillis said. “But it’s not all fraud. It’s not all abuse. It’s not all money laundering. Read the code and look at how long it’s been there. I was Speaker of the House. I refused to do it. But I understand it. I understand what happens if you yank that support away.”

He even acknowledged that, years ago, he helped pass a law making it illegal to expand Medicaid in North Carolina: “Why did I do that? Because I was convinced someday we would be here. And I would have rather found a way to have more people on Medicaid in the standard way than have this 90/10 match, watch it disappear, and take away healthcare from people.”

Tillis said he supports many parts of the bill – especially the work requirement and House-led reforms.

But he insisted that the Senate version in its current form must be rejected.

“I wouldn’t be giving this speech if we simply went with the House mark,” he said. “I’ve talked with my colleagues in North Carolina. I know that we can do that.”

He urged his colleagues to slow down the process and do the work necessary to understand the bill’s consequences. “What’s wrong with daylight? What’s wrong with actually understanding what this bill does?”

Trump has insisted the legislation be on his desk by July 4; however, that is an otherwise arbitrary deadline.  Nevertheless, US Senators spent the pre-holiday weekend working two straight weekend days and night away from their families, many of whom had already started their summer vacations.

Tillis closed by saying he was withholding his vote and would continue to do so until a better, more responsible plan is brought forward.

“We owe it to the American people, and I owe it to the people of North Carolina,” he said. “Until it’s demonstrated to me that we’ve done our homework and fulfilled our promise, I will be withholding my vote.”

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