Republican Sen. Thom Tillis (R-N.C.) has a message for his party about the health care cuts tucked into the tax and spending bill: the policy might be one thing, but the calendar is the real problem.

"We're going to have significant headwinds," Tillis said in an interview that aired Sunday on CBS' "Face the Nation with Margaret Brennan." "It's really a 10-year impact if you take a look at the original bill."

Brennan noted that Tillis is retiring and was deeply frustrated by Republicans when they passed the tax and spending bill, which she said included Medicaid cuts and will deeply affect rural hospitals. She pointed out that more than 25% of people in North Carolina rely on Medicaid and asked, "Do you still expect devastating health care cuts in the new year?"

The Timing Problem

Tillis said he backed the bill's tax provisions. The health care side was another story.

"It was the health care provisions beyond what the House has proposed that are problematic, and it's going to take time," he said.

His goal, he explained, wasn't to kill the cuts outright. It was to slow them down.

"What I was trying to do was not necessarily get rid of the cuts, but try to affect their timing," Tillis said. "I think they're coming too soon."

An Election Year Headache

Tillis isn't just worried about hospitals. He's worried about what those hospitals will look like to voters.

"We've got our work cut out for us because some of those impacts could also feed right into the 2029 election," he said.

Brennan followed up: "So healthcare will be a big factor in that election, is your prediction?"

Tillis didn't hedge. "Absolutely," he said.

The Hospital Math

The Medicaid cuts and rural hospital strain Brennan raised have drawn attention well beyond the interview.

Former House Speaker Nancy Pelosi wrote in a post on X earlier this month that Republicans "promised to lower costs but delivered a #RepublicanHealthcareCrisis instead." She pointed to "$1 trillion in Medicaid cuts," "Spiking premiums" and "Shuttered rural hospitals," and said the party acted "to give tax breaks to their billionaire donors."

A report released in March by watchdog group Public Citizen found nearly 450 hospitals face a high risk of closing or cutting services due to more than $900 billion in cuts to Medicaid and the Children's Health Insurance Program under President Donald Trump's One Big Beautiful Bill Act. The report said Medicaid covers about a fifth of all hospital spending, and that the at-risk hospitals served nearly seven million patients in 2024.

For Tillis, the takeaway is simple: the policy may be written for a decade, but voters will feel it much sooner than that.