Tillis won’t seek re-election after refusing to destroy the lives of enough of his own constituents

The thing is, any Republicans who recognizes how grotesque the piece of shit Trump and Thune are trying to get passed could do this. You’re rich people! You’ll be fine!

Senator Thom Tillis, Republican of North Carolina, announced on Sunday that he would not seek re-election next year, a day after President Trump threatened to back a primary challenger against him because Mr. Tillis had said he was opposed to the bill carrying Mr. Trump’s domestic agenda.

Mr. Tillis’s departure will set off a highly competitive race in North Carolina that could be pivotal in the battle for control of the closely divided Senate. It was the latest congressional retirement to underscore the rightward shift of the G.O.P. and the reality that there is little room for any Republican to break with Mr. Trump.

“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,” Mr. Tillis said in a lengthy statement on his decision.

The announcement came as the Senate was wading into a debate over the large-scale tax cut and domestic policy bill that Mr. Trump has demanded be delivered to his desk by July 4. Mr. Tillis announced his decision the day after issuing a statement saying he could not in good conscience support the measure, which he said would lead to tens of billions of dollars in lost funding for his state, costing people Medicaid coverage and critical health services.

He was among just two Republicans who voted Saturday night against bringing up the bill.

Mr. Tillis has been privately critical of the legislation and trying to warn his colleagues of the political downsides for them if they back it. In a closed-door meeting with his Republican colleagues last week, he warned that the sweeping legislation could be a political albatross for the party in 2026.

I think we all know the answer here. Mark Robinson: rested, ready, pervy.

In closely related news, Jonathan Cohn on the some of the 12 million people the Republican Party are trying to relieve of their access to healthcare, from the Tarheel State:

NORTH CAROLINA WAS ONE OF THOSE Republican-led states that at first refused to participate in Obamacare’s “Medicaid expansion,” which makes federal funding available to states that widen their Medicaid programs to include many more people living near the poverty line. But advocates in North Carolina kept organizing and lobbying on behalf of expansion, and when popular Democratic governor Roy Cooper came into office in 2017 he made expansion a top priority. Small business owners and hospital leaders eventually became outspoken backers of expansion, helping to persuade key state Republicans to embrace the cause.

In the spring of 2023, the Republican-led legislature passed a bipartisan expansion bill and Cooper signed it. The new program launched on December 1 of that year, with about 300,000 people automatically enrolled. Since then, it has swelled to cover more than 600,000.

But those numbers alone don’t capture the full impact. Expansion has meant new money for providers who serve low-income populations, because now more of their patients can pay their bills.

That’s been especially important for organizations like Blue Ridge Health, a network of clinics in North Carolina’s westernmost counties where the percentage of uninsured patients declined almost overnight from about half to about a third, according to Richard Hudspeth, the system’s director.

Because that shift has increased revenue, Blue Ridge can now offer services like pediatric dentistry and behavioral health that had been practically unavailable in these rural communities before. It has also expanded its overall capacity—which, Hudspeth told me, made a big difference when Hurricane Helene swept through the region last fall.

“There was so much debris, and all these respiratory infections,” said Hudspeth, who is also a family physician and still sees patients. “Having that capacity let people get their lives together quicker, and get back to work too.”

Christopher Vann told me about a similar transformation at CommWell Health, a clinic network on the eastern side of North Carolina where he is vice president of development. Before expansion, about one in ten patients seen by CommWell was on Medicaid; since expansion, it has been about one in four.

The new money, Vann said, has allowed CommWell to focus on reaching patients who were far from clinics, through a combination of transportation and mobile clinics. CommWell has also invested in pediatric services they offer directly to children through the schools.

The communities CommWell serves still have all kinds of unmet needs, Vann said, but expansion “is allowing us to chip away at that mountain.”

At the Rowan clinic, executive director Krista Woolly told me she knows of many patients like Rodriguez, who were finally able to get specialty care once they got onto Medicaid.

Amy Wilson, the Rowan clinic’s medical director, told me “I work really hard to take care of people, but there’s only so much I can do. I can’t take out your gall bladder, I can’t give you chemotherapy, I can’t replace your hip. There are all kinds of things I can’t do post-stroke, or give you physical therapy three times a week.”

“This patient population, they just got access” to those sorts of procedures thanks to Medicaid expansion, Wilson added. But the One Big Beautiful Bill could undo much of that progress. “Are they going to have that all ripped out from them again? They’ve stabilized, evened out, and we’re just going to start all over again?”

It’s critical to understand that the massive cuts to Medicaid don’t just affect people on Medicaid, which would be sufficient to cause any remotely decent person to vote against the bill. In many areas, they will make it harder for everybody but the ultra-wealthy to get access to care. It would only take three Republicans who want to do something with their lives other than acting as a rubber stamp for a fanatically cruel billionaire to stop this.