Republicans Scramble After Senate Parliamentarian Nixes Deep Cuts From ‘Big Beautiful Bill’

It isn’t just rogue judges subverting the will of the people… The Republicans’ Big Beautiful Bill was dealt a major blow on Thursday after the Senate Parliamentrian gutted nine major provisions included in GOP efforts to cut $250 billion in Medicaid and other health care spending. 

Democrat parliamentarian Elizabeth MacDonough’s latest rulings include major pieces of Medicaid policy – including a plan to reduce federal expenses by cracking down on a state provider tax, which would have had a nine-figure impact on the bill. 

She also struck down;

• Immigrant Medicaid eligibility 
• Prohibiting Medicaid and Children’s health insurance (CHIP) from funding ‘gender affirming care’
• Restricting certain states from increasing taxes on providers
• Limiting noncitizen immigrants from qualifying for premium tax credits or cost-sharing reductions
• Disallowing premium tax credits during periods of Medicaid ineligibility due to immigrant status

The rulings couldn’t have come at a worse time for Senate Majority Leader John Thune and other GOP leaders – who are trying to carefully handle an internal revolt from members wary of the practical and political impacts of the Medicaid changes. 

Here’s more on the *nine* different health care provisions that the parl ruled against from Senate Finance Committee’s reconciliation text, per @SenateBudget pic.twitter.com/xWKxYIkh2r

— Laura Weiss (@LauraEWeiss16) June 26, 2025

Now Republicans have to try and rework the provider tax language to get it back in the Senate bill, Politico reports, citing two anonymous sources. 

“We’ll continue our work and find a solution to achieve the desired results,” said one of the people.

The second person described the parliamentarian’s cuts as “technical,” with some Republicans optimistic that they can make changes to the language that lets them keep the provisions. 

Unbelievable. What possible way can you claim that modifying Medicaid eligibility isn’t compliant with the Byrd rule? https://t.co/M4tHMUTNRp

— Tiana Lowe Doescher (@TianaTheFirst) June 26, 2025

Some Republicans are PISSED

“The Senate Parliamentarian is not elected. She is not accountable to the American people,” Rep. Greg Steube (R-FL) posted on X. “Yet she holds veto power over legislation supported by millions of voters.”

.Steube called on Vice President JD Vance to ‘overrule the Parliamentarian and let the will of the people, not some staffer hiding behind Senate procedure, determine the future of this country.’

How is it that an unelected swamp bureaucrat, who was appointed by Harry Reid over a decade ago, gets to decide what can and cannot go in President Trump’s One Big Beautiful Bill?

The Senate Parliamentarian is not elected. She is not accountable to the American people. Yet she… https://t.co/y2loBAMENc

— Congressman Greg Steube (@RepGregSteube) June 26, 2025

Ignore her?

The Senate parliamentarian is a nonpartisan advisor who interprets the Senate’s rules, including the Byrd Rule, which limits what can be included in reconciliation bills. Their guidance is not legally binding - it’s advisory, but traditionally followed to maintain Senate norms.

Senate Republicans can ‘ignore’ her rulings in two ways; 

Option 1: The Presiding Officer Overrules

• The presiding officer of the Senate, Vice President JD Vance, can choose to ignore the parliamentarian’s advice and rule in favor of including the provision.

• This is extremely unusual. If it happens:

  • Any senator can challenge the ruling, triggering a vote on whether to uphold it.

  • If a simple majority supports the override, the ruling stands — effectively overruling the parliamentarian.

Option 2: Fire or Replace the Parliamentarian

• The Senate Majority Leader John Thune could request a different parliamentarian or pressure the presiding officer to disregard the current one’s rulings.

• This happened once before:

  In 2001, the Republican-controlled Senate replaced Parliamentarian Robert Dove after disagreements over tax cuts.

Needless to say, America’s gatekeepers are hard at work…