Senate Republicans hauled President Donald Trump’s big tax breaks and spending cuts bill to passage Tuesday on the narrowest of margins, pushing past opposition from Democrats and their own GOP ranks after a turbulent overnight session. The outcome capped an unusually tense weekend of work at the Capitol, the president’s signature legislative priority teetering on the edge of approval or collapse. In the end that tally was 50-50, with Vice President JD Vance casting the tie-breaking vote. Three Republican senators — Thom Tillis of North Carolina, Susan Collins of Maine and Rand Paul of Kentucky — joined all Democrats in voting against it. “The big not so beautiful bill has passed,” Paul said after the vote. The difficulty it took for Republicans, who have the majority hold in Congress, to wrestle the bill to this point is not expected to let up. The package now goes back to the House, where Speaker Mike Johnson had warned senators not to deviate too far from what his chamber had already approved. But the Senate did make changes, particularly to Medicaid, risking more problems as they race to finish by Trump’s Fourth of July deadline. The outcome is a pivotal moment for president and his party, which have been consumed by the 940-page “One Big Beautiful Bill Act,” as it’s formally titled, and invested their political capital in delivering on the GOP’s sweep of power in Washington. Trump acknowledged it’s “very complicated stuff,” as he departed the White House for Florida. “I don’t want to go too crazy with cuts,” he said. “I don’t like cuts.” What started as a routine but laborious day of amendment voting, in a process called vote-a-rama, spiraled into a round-the-clock slog as Republican leaders were buying time to shore up support. The droning roll calls in the chamber belied the frenzied action to steady the bill. Grim-faced scenes played out on and off the Senate floor, amid exhaustion. Senate Majority Leader John Thune of South Dakota was desperately reaching for last-minute agreements between those in his party worried the bill’s reductions to Medicaid will leave millions without care, and his most conservative flank, which wants even steeper cuts to hold down deficits ballooning with the tax cuts. The GOP leaders have no room to spare, with narrow majorities. Thune could lose no more than three Republican senators, and two — Tillis, who warned that millions of people will lose access to Medicaid health care, and Paul, who opposes raising the debt limit by $5 trillion — had already indicated opposition. Attention quickly turned to two other key senators, Lisa Murkowski of Alaska and Collins, who also raised concerns about health care cuts, as well as a loose coalition of four conservative GOP senators pushing for even steeper reductions. Murkowski in particular became the subject of the GOP leadership’s attention, as they sat beside her for talks. She was huddled intensely for more than an hour in the back of the chamber with others, scribbling notes on papers. Then all eyes were on Paul after he returned from a visit to Thune’s office with a stunning offer that could win his vote. He had suggested substantially lowering the bill’s increase in the debt ceiling, according to two people familiar with the private meeting and granted anonymity to discuss […]