As he rallied Republicans behind his major tax and spending plan in June, President Donald Trump singled out U.S. Sen. John Fetterman as the only Democrat who might back the so-called “big beautiful bill.”

“He seems to be the most sensible one lately,” Trump told reporters.

Trump had reasons to be hopeful. The Pennsylvania senator had supported a few Cabinet nominees, praised the administration’s moves on border control and strong support for Israel, and frequently bashed fellow Democrats over their anti-Trump messaging.

But Mr. Fetterman voted against the bill, which no Democrat supported and Trump signed into law in July. The senator called it a “disaster,” citing estimates of millions of Americans being thrown off Medicaid and federal food assistance.

Three months later, concerns

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