Vice President Vance cast the tiebreaking vote as Senate Republicans delivered a huge legislative victory for President Trump on Tuesday by passing his One Big, Beautiful Bill Act after hours of tense negotiations that lasted through the night.

The final vote came after lawmakers worked through the weekend before launching a 27-hour marathon of amendment votes on the floor, during which Republican leaders sought to win the support of holdouts.

GOP Sens. Thom Tillis (N.C.), Rand Paul (Ky.) and Susan Collins (Maine) voted against the measure, along with every Democrat.

The legislation appeared to be on the cusp of failing on the floor after Senate GOP leaders spent hours trying to hash out a compromise with Alaska Sen. Lisa Murkowski, an independent-minded Republican who worried the legislation’s deep cuts to Medicaid and federal food assistance funding would hurt her home state.

At one point, Murkowski could be heard talking about the “vulnerable” on her phone as she walked briskly through the Capitol, avoiding reporters.

With Collins indicating she opposed the measure and Tillis and Paul saying they were hard "no's," Republican leaders knew they needed Murkowski's vote for the bill to pass.

Senate Majority Leader John Thune (R-S.D.) and his leadership team, including Senate Finance Committee Chair Mike Crapo (R-Idaho), thought they had secured Murkowski’s vote by crafting language to shield Alaska from the full brunt of Medicaid and Supplemental Nutrition Assistance Program (SNAP) cuts.

But that initial plan was derailed by Senate Parliamentarian Elizabeth MacDonough, who ruled the way the Republican SNAP waivers and enhanced Federal Medical Assistance Percentage (FMAP) were crafted to help Alaska violated the Byrd Rule, which determines what legislation may be included in a budget reconciliation package and pass with only GOP votes.

GOP negotiators spent Monday night reworking the Alaska-targeted Medicaid and SNAP provisions in a way that could win approval from both the parliamentarian and Murkowski — an arduous process that took hours while the Senate plowed through a marathon series of votes that started at 9:30 Monday morning.

Sen. Dan Sullivan (R-Alaska), who was involved in the negotiations around the Medicaid provisions, said Republicans presented four different proposals to the parliamentarian and she rejected them all.

So GOP leaders decided instead to double the size of the rural hospital relief fund from $25 billion to $50 billion to make up for a potential shortfall of Medicaid funding in Alaska and other rural states.

They did so even though the Senate rejected an amendment sponsored by Sen. Susan Collins (R-Maine) earlier in the evening to double the rural hospital fund to $50 billion and pay for it by creating a new 39.6 percent tax bracket for ultrawealthy income earners.

Sullivan argued Democrats would be responsible for Medicaid cuts in Alaska by challenging the provision to give Alaska an enhanced match rate.

But Democrats countered that it was unfair for Republicans to cut Medicaid funding for the whole country and then try to protect specific states to win more votes for the bill.

Republican negotiators and the parliamentarian agreed to rework the waivers for SNAP funding cuts so it would apply more broadly than to just Alaska and Hawaii. The parliamentarian rejected the language targeting just two states.

The reworked SNAP provision would phase in food assistance funding reductions more slowly for roughly 10 states, including Alaska, that have the highest error rate in delivering benefits.  

A source familiar with the details of the provision says it would postpone SNAP cuts for states with higher error rates in delivering food assistance benefits by a year, and that the number of states affected would be determined by a formula.  

Thune lobbied Murkowski throughout the night and early morning to support the bill.

Senate Republican Whip John Barrasso (R-Wyo.) put his total focus on Murkowski during the final hours of the debate. He hardly left her side from 3 a.m. until the bill passed just before noon. 

Murkowski told reporters after the final vote that it was an “agonizing” process.

“Reconciliation is never a very dignified process, we all get that. We were operating under a timeline that was basically an artificial timeline,” she said, referring to the immense time pressure Trump placed on the Senate to pass the bill.

“Rather than taking the deliberative approach to good legislating, we rushed to get a product out. This is important. I want to make sure that we’re able to keep in place the tax cuts from the 2017 [Tax Cuts and] Jobs Act,” she said, explaining her support for the bill and why it was hard for her to come around to voting yes.

“I struggled mightily with the impact on the most vulnerable in this country when you look to the Medicaid and the SNAP provisions,” she said.

The sprawling package still faces challenges in the House due to deeper cuts to federal Medicaid spending, an accelerated phaseout of clean-energy tax breaks and changes to a deal to raise the cap on state and local tax (SALT) deductions.

At least six House Republicans have threatened to oppose the Senate bill because of the changes to the House-passed legislation, and Rep. Thomas Massie (R-Ky.) is viewed as likely to vote no because the package would add more than $3 trillion to the debt.

A Fox News poll of 1,003 registered voters nationwide conducted this month found that 38 percent of voters favor the One Big, Beautiful Bill Act, while 59 percent oppose it.

Speaker Mike Johnson (R-La.) held a call Monday afternoon to assuage GOP colleagues concerned about the deeper Medicaid cuts.

Senators wrapped up work on the bill after working through the weekend and cutting off the first few days of the weeklong July 4 recess, forcing senators and staff to cancel flights and reschedule trips.

Sen. Roger Wicker (R-Miss.), the chair of the Senate Armed Services Committee, had to cancel the departure of his congressional delegation trip to Porto, Portugal, to attend a conference of the Organization for Security and Cooperation in Europe.

After days of negotiations over the details of the legislation, Republican senators can claim a major legislative accomplishment, even though some Republicans are concerned about its future political impact.

The bill would provide $160 billion for border security and immigration enforcement, $150 billion to boost the Pentagon’s budget and raise the debt ceiling by $5 trillion.

It would extend the expiring 2017 Trump tax cuts, make popular corporate tax cuts permanent, and provide new tax relief to working-class Americans by shielding tipped income and overtime pay for hourly employees from taxation.

It would allow people to deduct the interest on auto loans for American-made cars and create “Trump savings accounts” for newborns and children up to the age of 18.

It would also phase out renewable energy tax credits that were the centerpiece of former President Biden’s Inflation Reduction Act.

Thune scored the biggest legislative victory of his relatively new career as majority leader after Democrats used almost every procedural they could to derail the legislation.

Senate Democratic Leader Chuck Schumer (N.Y.) even forced Senate clerks to read the bill overnight Saturday and until midafternoon Sunday, a 16-hour endeavor.

Thune hailed the bill as a crucial extension of the expiring 2017 Tax Cuts and Jobs Act, which he called “one of the most successful economic policy pieces of legislation in history.”

He warned that if it didn’t pass, families earning less than $400,000 per year would collectively see a $2.6 trillion tax increase, and small businesses would see $600 billion in tax increases.

And he defended the more than $900 billion in Medicaid spending cuts in the bill, which have generated strong pushback within his own conference.

He said the bill would “make sure that the people who are supposed to benefit from Medicaid do, and that it doesn’t go to people who shouldn’t benefit from Medicaid.”

Schumer attacked the legislation as a generous tax giveaway to the rich that would disproportionately burden the poor by cutting hundreds of billions of dollars from Medicaid and the Supplemental Nutrition Assistance Program.

“It is destructive for Republicans to pass a bill like this at a time when people pay more for groceries, when people pay more for rent, pay more for child care, pay more for medication,” he said. “It makes no sense to reward the billionaire class and special interests at the expense of everyone else.”

He said Democrats would make the bill’s Medicaid cuts a focus of the months ahead and the 2026 election.

“Our battle is not over. We’re going to be fighting in July and August and throughout the year, reminding Americans when their hospitals close, when their health insurance is cut off,” he said.

“We’re going to be in their states in every way, we’re going to organize, we’re going to have all the people who are hurt organized. You’re going to see a constant, constant battle in those states,” he said of the Democratic game plan for Senate battleground states over the next 16 months.

The bill received strong pushback in recent weeks from both Republicans concerned about the deep cuts to Medicaid, such as Murkowski, Collins and Tillis, as well as Sens. Josh Hawley (R-Mo.) and Jerry Moran (R-Kansas).

GOP leaders eventually agreed to set up a $25 billion rural hospital relief fund, which was bumped up to $50 billion at the last minute, to allay concerns that the cuts could push scores of rural and small hospitals around the country into bankruptcy.

Al Weaver contributed.

Updated at 1:01 p.m. EDT