Sen. Tillis says Trump tax plan vote led to decision to leave office

Outgoing U.S. Sen. Thom Tillis revealed in his new book that his vote against President Donald Trump’s tax plan marked the moment he decided to leave office, WRAL reported.

Tillis said he consulted with North Carolina GOP leaders before opposing the “One Big Beautiful Bill Act,” expressing worries about its impact on Medicaid and state taxpayers.

He cited potential harm to rural hospitals and Medicaid recipients as key reasons for his June 2025 vote against the legislation, which ultimately passed and cut Medicaid spending.

Tillis described this decision as a breaking point that led Trump to back a primary challenger against him, ending his reelection bid.

The book offers new insight into Tillis’s thought process and the political consequences he faced after opposing a major Trump initiative.