The Republican senator dropped his reelection bid rather than lie about the devastating damage Trump’s “Big Beautiful Bill” will do to Medicaid.
Thom Tillis (R-NC) takes the elevator at the US Capitol on June 30, 2025, in Washington, DC.
(Alex Wong / Getty Images)
Thom Tillis, the former speaker of the North Carolina House of Representatives who since 2015 has served as a modestly responsible Republican in the US Senate, faced a challenge. The Trump White House was ramping up pressure on Congress to enact the dangerous agenda contained in what the president has dubbed the “Big Beautiful Bill.” (The bill was approved by the Senate on Tuesday after Vice President JD Vance broke a 50-50 tie vote.) Tillis knew that the bill’s Medicaid cuts would “result in tens of billions of dollars in lost funding for North Carolina, including our hospitals and rural communities.” But he also knew that saying this out loud, and defying Trump, could trigger a poisonous MAGA backlash.
Tillis had two options. He could either lie, and stay on Trump’s good side.
Or he could tell the truth, and incur Trump’s wrath.
Tillis chose the truth, and that was the end of him. In a Republican Party where dissent is no longer tolerated, the North Carolinian terminated his political career.
Tillis is no weak-willed electoral dilettante. He has been a political operative for decades. And he remains one of the most savvy and experienced Republicans in the Senate. As such, his story tells us everything we need to know about the evolution of the Grand Old Party into little more than a rubber stamp for Trump and Trumpism.
Tillis did not merely make the moral and practical argument for reworking the “Big Beautiful Bill” to protect Medicaid. He tried to warn fellow Republican senators about the dangers posed by the bill as it is currently written, using a behind-closed-doors presentation at a Republican luncheon last week to detail how Medicaid cuts would devastate red states and, reportedly, suggesting that GOP support for those cuts “could cost us majorities in both houses” of Congress in 2026.
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That was an accurate portrayal of the human and political costs of the bill. But when he asked fellow Republicans to choose the well-being of their own constituents, and political reality, over Trump’s ego trip, Tillis found virtually no takers.
Without a team of Republicans who were prepared to stand up and negotiate with Trump for a better bill, Tillis found himself isolated. And the president found a target for his political vengeance. “Numerous people have come forward wanting to run in the Primary against ‘Senator’ Thom Tillis,” Trump announced on social media. “I will be meeting with them over the coming weeks, looking for someone who will properly represent the Great People of North Carolina and, so importantly, the United States of America.”
North Carolina is a swing state that has developed a pattern of voting Democratic in recent statewide contests for governor, attorney general, and other posts. But its Republican Party base is more extreme even than Trump, and GOP primary voters in the state have recently backed some of the most far-right candidates in the nation. Tillis took that threat seriously. He knew that he was unlikely to survive a Trump-backed primary challenge, so he decided to jump before the inevitable push.
Within hours of Trump’s primary threat, Tillis, who had already expressed frustration with the chaotic character of Trump’s second term, announced that he would not seek a third term. “In Washington over the last few years, it’s become increasingly evident that leaders who are willing to embrace bipartisanship, compromise, and demonstrate independent thinking are becoming an endangered species,” Tillis said Sunday, adding that he was not interested in spending an additional “six years in the political theater and partisan gridlock in Washington.”
That’s a delicate way of saying he was not prepared to bow to a Republican president who rules the party as a cult of personality.
Finding himself one of that rarest of breeds, a Republican senator free to speak his mind, Tillis went to the Senate floor and declared, “It is inescapable that this bill in its current form will betray the very promise that Donald J. Trump [when he met with Republican members of the Senate Finance Committee]. He said, ‘We can go after waste, fraud and abuse’ on any programs.” Portraying Trump as, at best, a dupe of White House aides, Tillis suggested that White House healthcare experts refused to tell the president that the version of the “Big Beautiful Bill” that is moving through the Senate on a rushed schedule “will hurt people who are eligible and qualified for Medicaid.”
“So, what do I tell 663,000 [North Carolina] people in two years or three years when President Trump breaks his promise by pushing them off of Medicaid because the funding is not there anymore, guys?” Tillis asked. “I think the people in the White House, those advising the president are not telling him that the effect of this bill is to break a promise…”
Tillis was right. And it is safe to say that many of his Republican colleagues recognized that reality. But they were more prepared to break promises and “hurt people who are eligible and qualified for Medicaid” than to cross Trump. And they cast their votes accordingly. In the end, only Tillis, Rand Paul (R-KY), and Susan Collins (R-ME) joined Senate Democrats in voting “No” on the bill.
In so doing, Republicans confirmed the assessment of US Senator Bernie Sanders (I-VT) who calls Trump’s big bill “the worst piece of legislation in modern American history.” After Tillis announced that he was quitting, Sanders said, “I do not agree with N.C. Senator Thom Tillis on much. But he’s right on this. Trump’s Republican Party does not allow for independent thought. The Republican Party today is a cult. Either you do as Trump wants, or you’re out. Pathetic.”
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