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ARIZONA GOVERNMENT ECONOMY GOVERNMENT HEALTH & MEDICINE POLITICS DONALD TRUMP / Modified jul 3, 2025 3:10 p.m.

AZ Congressional Republicans vote to pass Trump’s massive spending bill

The “Big Beautiful Bill” passed with a 218-214 on Thursday. by Paola Rodriguez, Hannah Cree, Katya Mendoza, Danyelle Khmara | AZPM News

US U.S. Capitol Washington DC The U.S. Capitol in Washington D.C.

Arizona’s U.S. House members fell right in line with party allegiance on President Donald Trump’s “One Big Beautiful Bill” Thursday afternoon. All six Republican representatives–Juan Ciscomani, Eli Crane, Andy Biggs, Paul Gosar, David Schweikert, and Abe Hamedeh–voted in favor, while Democrats Greg Stanton and Yassamin Ansari opposed the bill.

The bill passed with just a four-vote majority, 218-214. Trump’s budget policy includes nearly $1 trillion in cuts to Medicaid and Medicare.

In Arizona, nearly 2 million residents rely on AHCCCS–the state’s Medicaid program, which provides healthcare services to eligible individuals and families with low incomes. In Pima County, 288,102 residents used the program in June. According to an April AHCCSS population demographics report, 46.9% of users were between the ages of 22 and 64.

44.9% of AHCCCS users are caucasian/white, 8.44% identified as Black and 8.33% as Native American, according to user demographics. 37.82% identified as Hispanic/Latino. The ethnicity of 34.37% of users is unknown.

Ahead of this week’s votes, Ciscomani and 15 other representatives penned a letter to Senate and House leaders, urging them to protect Medicaid.

The letter begins, “As Members of Congress who helped secure a Republican majority, we believe it is essential that the final reconciliation bill reflects the priorities of our constituents—most importantly, the critical need to protect Medicaid and the hospitals that serve our communities.”

It also says, “The Senate proposal also undermines the balanced approach taken to craft the Medicaid provisions… The Senate version treats expansion and non-expansion states unfairly, fails to preserve existing state programs, and imposes stricter limits that do not give hospitals sufficient time to adjust to new budgetary constraints or to identify alternative funding sources.”

Despite calling to maintain Medicaid access, Southern Arizona Republican Representative Juan Ciscomani voted in favor of the bill that includes the healthcare cuts.

He explained his vote in a statement Thursday, saying the final bill doesn’t cut the rate at which the federal government matches state spending on Medicaid, but that there were changes to the portion of Medicaid called provider taxes — something he previously said he would not support.

Provider taxes, which help determine a state’s share of Medicaid funding, are a critical source of support for hospitals that serve low-income patients in both rural and urban areas.

The congressman notes in his statement the bill includes access to a new $50 billion hospital fund. But what his statement doesn’t say is that those changes, already present in the first version of the House bill he voted for in June, are estimated to amount to $89 billion in cuts over 10 years, according to AHCCCS, Arizona’s Medicaid system.

Over the last few months, Ciscomani has said numerous times that he does not support cuts to Medicaid for people such as disabled individuals or single moms, including during an interview with AZPM in March.

“The letter that I wrote the speaker, along with the Hispanic Congressional Conference, was to let him know and leadership and my colleagues as well, and everyone where I stand on this,” he said in March. “And it wasn't just about Medicaid, which I was specific on, but it was also about Pell Grants. It was about programs that people have been depending on, and we want to make sure that we protect these programs, specifically Medicaid, for the people that need it the most.”

Experts say the changes to the provider tax could cause hospitals in rural areas to close, creating longer ER wait times, fewer specialists, and more crowded facilities.

az-delegation-bbb VIEW LARGER Voter roll for Arizona's House members after the July 3 vote on President Trump's Big Beautiful Bill.

Before Thursday’s vote, Arizona Governor Katie Hobbs wrote to Arizona’s delegation that the Senate’s version of the Big Beautiful Bill “deeply partisan and shortsighted.”

Hobbs urged the members of Congress to reject the Senate’s changes to phase out provider taxes, also referred to as provider assessments.

She said these cuts would require the state to absorb more of the costs of treating uninsured people, and warned of billion-dollar losses that would force rural hospitals to close.

“As a result, in the next five years, Arizona’s healthcare providers will lose approximately $6 billion, and by fiscal year 2031-2032, the loss will amount to $2.4 billion per year,” Hobbs wrote.

Hobbs added that Arizona could not afford to fill the gap left by the proposed cuts to food assistance programs, and urged the delegation to block that cost shift to the states.

“Arizona cannot serve as a backstop for broken federal policy,” she wrote.

Earlier this week, activists gathered outside of Ciscomani’s Tucson office, urging him to vote no on the Trump-backed bill, voicing concerns about how it would impact healthcare.

Local nurses like Dominique Hamilton, who works at Carondelet St. Mary’s Hospital in Tucson, said that on top of an existing nursing shortage, she worries that patients will opt out of care completely because they can’t afford it or hoard prescription medication.

She added that nurses fear that hospitals whose budgets rely on Medicaid and Medicare will also have to make drastic cuts to staffing.

“What might also happen, which I hope to God doesn’t, is that rural hospitals might close,” Hamilton said. “Those communities are already vulnerable and to think that these hospitals may close, that’s not only job loss for those workers, that’s not only less health care access for those communities, but it’s morally horrendous.”

Ciscomani’s office declined to comment beyond his prepared statement on his vote or his changed stance on the cuts to provider taxes.

Mo Goldman, a local immigration attorney who is running for Ciscomani’s CD6 seat next year, said that the reconciliation bill cuts benefits from people who need it the most while further enriching the wealthy.

Ahead of the final House vote today, Goldman had referred to Republican Senator Thom Tillis from Florida, who voted against Trump’s “big, beautiful bill” in the Senate, opting out of running for another term.

“Why do these people who are elected suddenly find their voice and their conscience after they make the decision to leave or decide that they’re going to step up and do something a little more bold now, versus months before? Where were you and where was your voice?”

Delegation Reactions

Sen. Mark Kelly, D-Ariz.

Sen. Ruben Gallego, D-Ariz.

Rep. Abe Hamadeh, R-Ariz., 8th District

Rep. Eli Crane, R-Ariz., 2nd District

Rep. Andy Biggs, R-Ariz., 5th District

Rep. Paul Gosar, R-Ariz., 9th District

“The One Big Beautiful Bill delivers for Arizonans, upholds the promise to secure the border, locks in permanent tax relief, unleashes American energy and reverses course on out-of-control spending by securing the largest spending reductions in American history. These are transformational policies that support all Americans for generations and were delivered by a Republican majority in Congress that listened. I look forward to President Trump signing the One Big Beautiful Bill into law,” wrote Gosar in a newsletter.

Rep. Greg Stanton, D-Ariz., 4th District

Rep. Juan Ciscomani, R-Ariz., 6th District

Rep. Yassamin Ansari, D-Ariz., 3rd District

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ARIZONA GOVERNMENT ECONOMY GOVERNMENT HEALTH & MEDICINE POLITICS DONALD TRUMP
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