Republican senators largely dismissed the idea of overriding the Senate parliamentarian on Thursday after she rejected a central Medicaid provision in President Donald Trump’s sweeping tax and immigration package, dealing a significant blow to the bill’s cost-cutting strategy.
Senate Parliamentarian Elizabeth MacDonough ruled that the GOP’s plan to cap states’ ability to draw down additional federal Medicaid dollars through provider taxes violated Senate budget rules. That provision was a major source of savings intended to help offset the bill’s extensive tax cuts.
The ruling forces Senate Republicans to either revise or eliminate the provision entirely if they hope to advance the bill using the reconciliation process, which allows legislation to pass with a simple majority. But doing so threatens to splinter GOP unity just days before Trump’s self-imposed July 4 deadline for passage.
Senate Majority Leader John Thune has long opposed disregarding the parliamentarian’s rulings, and he offered no indication Thursday that he would change course.
“We’ll get back to you on that,” Thune told reporters when asked about next steps.
Republicans Vow to Tweak, Not Overrule
Most Republican senators indicated they would attempt to revise the language and resubmit it to MacDonough for approval rather than override her.
“We have no intention of overruling her,” said Sen. Lindsey Graham. “But I think we’ll take another shot.”
Sen. Eric Schmitt acknowledged the decision could delay the timeline but said Republicans are committed to working through the weekend. “Yeah, could push it back,” he said. “But we’re still here.”
Sen. Rick Scott called the ruling “frustrating” but ruled out challenging MacDonough’s authority. “We have to work through the process,” he said. “We can do that while staying true to Trump’s agenda and maintaining fiscal sanity.”
Sen. John Kennedy was even more blunt: “We would never overrule the parliamentarian.”
Trump Allies Fume Over Ruling
While most GOP senators held the line, some members of the party lashed out at MacDonough, portraying her decision as politically motivated.
Sen. Tommy Tuberville launched a tirade against the parliamentarian on X, accusing her of promoting a “woke agenda” and calling for her immediate firing.
“She was appointed by Harry Reid and advised Al Gore. Now she’s blocking a provision banning illegals from stealing Medicaid,” Tuberville wrote. “This is why Americans hate the swamp. FIRE HER ASAP.”
Sen. Markwayne Mullin also questioned MacDonough’s neutrality. “I’m concerned about her ability to make these decisions,” he said. “If it’s a political call, that’s not OK.”
House Watches and Waits
Across the Capitol, House Speaker Mike Johnson said the House was “on a wait and see basis” as the Senate tries to salvage the bill.
“The parliamentarian’s ruling doesn’t make it easier to pass by the Fourth of July,” he said. “But you know me—hope springs eternal. We’re working around the clock to meet that deadline.”
While Johnson hinted he could argue for overruling the parliamentarian, he added, “That’s not our decision. The Senate has to make that call.”
Medicaid Provision Faces Internal GOP Pushback
The controversial Medicaid provider tax provision had already drawn fire from rural-state Republicans worried it would gut funding for hospitals in their states. MacDonough’s ruling may give those lawmakers political cover to oppose the measure.
If GOP leaders revise the provision, they risk alienating senators whose votes are critical to getting the bill across the finish line. And without the Medicaid savings, the package may need to be scaled back or find new offsets to pass muster under reconciliation rules.
Senate Scrutiny Continues
The Senate is still undergoing a detailed review of the House-passed bill—an internal vetting process known as the “Byrd Bath,” named after Sen. Robert Byrd, who created the rules for budget reconciliation.
Provisions that fail the Byrd test must be removed or risk triggering a 60-vote requirement in the Senate—a threshold Republicans cannot meet without Democratic support.
MacDonough has already ruled out multiple provisions, and her scrutiny is expected to continue into the weekend, adding to the uncertainty surrounding Trump’s ambitious “One Big, Beautiful Bill.”
