Why Rick Scott is the key player in Trump’s “Big Beautiful Bill”

As President Donald Trump’s signature tax cuts and spending bills passed through Congress, one of two US senators in Florida emerged as a key figure in the legislative meeting.

Over the weekend, Rick Scott announced that he would provide a significant amendment to Trump’s one big beautiful bill act. Scott is proposing major changes to Medicaid, a joint federal and state program that ensures children, people with disabilities and the poor in a state that expanded its program under the Affordable Care Act. (Florida is not one of those states.)

“This is a nail in the co-founding co-found if the Medicaid extension of the Affordable Care Act passes,” said Joanne Alker, co-founder of Georgetown University’s Children and Families Center.

With the Affordable Care Act, states have given the option to expand Medicaid to adults up to 138% of federal poverty levels. Currently, a family of four earns around $44,300. Over 40 states are used.

The federal government pays 90% of Medicaid coverage for around 20 million Americans in response to the expansion of affordable care laws, a much higher reimbursement rate than traditional Medicaid. (In 2013, half a decade before he was elected to the Senate as governor of Florida, Scott supported the expansion of Medicaid. At the time, the federal government offered to pay 100% of the cost. Scott later overturned the course.)

Under Scott’s proposal, the state that expanded Medicaid is no longer eligible for a 90% federal rebate to cover children-free, disabled adults.

“When Blue abuses Medicaid and provides handouts to healthy, childless, working-age adults, they are putting this important program at risk for those who need it the most,” Scott posted on X on Monday. “The big beautiful bill is an opportunity to protect Medicaid for those in need.”

Scott’s proposal, which came into effect in 2031, would save the government hundreds of billions of dollars, his office said. Medicaid eligible participants remain qualified before 2031.

Scott said the proposal would discourage the state from using federal money to illegally pay for health care for people in the country. Those who lack legal status are already ineligible for federal health benefits. However, some states, such as California, have state programs that provide illegal coverage to people around the country.

By proposing revisions, Scott inserts himself into high-stakes policy and political debate. Trump hopes to do good for many of his 2024 promises through a big beautiful bill, and that version has already passed the house. He gave Congressional Republicans a deadline to pass the July 4th bill.

It is not clear that Republicans will meet the president’s timeline. The House and Senate must agree to the same version of the bill by then, a difficult outlook. Republicans control the House and Senate, but only narrow.

Polls show that the bill is expanding the tax cuts Trump supports, particularly at the cost of trillions of dollars. Critics point out that Republicans are claiming that Medicaid spending is out of control, pushing for an expensive extension of Trump’s signature tax cuts.

Republicans opposed to Trump’s bill are likely to have heard about it from the president. After North Carolina Sen. Tom Tillis voted against moving forward on the bill over the weekend, Trump denounced the social media mission by pledging to run a major opponent against Tillis. Later that day, Tillis announced he would not seek reelection.

But Trump warned Republicans not to cut too many federal programs, acknowledging the potential political costs of doing so.

“You still have to be re-elected,” Trump wrote. “Don’t be too crazy!”

Scott’s vote could prove important. Trump’s early supporters, Florida Senators, have long supported the president’s agenda in Congress. But there were hints over the weekend that Scott’s vote for the Senate version of the big beautiful bill relied on passing his Medicaid amendment. On Saturday night, Scott was one of the last three Republicans to vote to move the bill forward.

When asked if he would support the bill without amendments, Scott told reporters he was confident the amendments would be passed.

Without Scott’s amendment, the Senate version of the bill will reduce Medicaid more than the House version. It is not clear whether these cuts will be a politically palatable thing in the house.

However, Scott expressed confidence in the outlook for the Senate bill.

“I don’t think I’ll lose support at home,” Scott told reporters.