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To meet the president's Friday deadline, the speaker will have to corral his party into accepting a bill several have criticized.
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Senators Susan Collins of Maine, Rand Paul of Kentucky and Thom Tillis of North Carolina defied the president on his signature measure.
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The Senate voted 51 to 50 to pass President Trump's sweeping domestic policy package.
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The Alaska Republican, a frequent critic of the president who is often a swing vote, acknowledged the bill would harm Americans but backed it after winning carve outs for her state.
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