In the past week, Senate parliamentarian Elizabeth MacDonough has ruled that several portions of the GOP megabill, the signature legislation of President Trump’s first year back in office, violated the chamber’s rules for the budget reconciliation process, and cannot be passed on party lines. Thursday morning, MacDonough issued a slew of new rulings — and dealt a major blow to Republican plans to rush the bill to Trump’s desk.
To avoid a Senate filibuster, Republicans are moving the bill through the chamber using the budget reconciliation process, which allows bills to be passed with a simple majority. But the Senate has strict requirements for what can be passed under budget reconciliation, and on Thursday MacDonough disqualified more than a dozen of the bill’s provisions under those rules, including several restrictions on Medicaid, student aid and other assistance for certain non-citizen immigrants, as well as a prohibition on Medicaid and Children’s Health Insurance Program funding for gender-affirming care. Each provision, if Republicans left them in, would be subject to a 60-vote threshold — which means Democrats could block them. UPDATE (June 27, 2025, 9:25 a.m. ET): On Friday, MacDonough ruled against several more provisions, including increased penalties for disclosure of taxpayer information (which the GOP had pushed after leaks of Trump’s tax returns) and deregulation of gun silencers.
Senate Republicans will try to save what provisions they can by rewriting the bill’s language.
MacDonough’s most significant ruling, though, concerned the bill’s limits on the Medicaid provider tax, which helps states obtain more federal matching funds for the program. That change already faced opposition from several GOP senators, including Josh Hawley and Susan Collins, who particularly fear its impact on rural hospitals. But Republican leaders have pushed to keep it in because it would save approximately $250 billion, a desperately needed offset to the Senate bill’s additional tax cuts. In total, the parliamentarian’s decisions threaten well over $500 billion of the bill’s cuts, according to a rough analysis from Bobby Kogan, a federal budget expert at the Center for American Progress.
Some Republican lawmakers criticized MacDonough after her rulings. On X, Sen. Tommy Tuberville, R-Ala. called for “the WOKE Senate Parliamentarian” to be fired. Rep. Greg Steube, R-Fla., demanded Vice President JD Vance “overrule the Parliamentarian” — which Vance does not have the power to do.
In fact, while it’s true that the parliamentarian is unelected, the very-much-elected senators could overrule her at any time if they wish. But as Senate Majority Leader John Thune told Punchbowl News in January, “That’s totally akin to killing the filibuster. We can’t go there.” There are good arguments for getting rid of the filibuster, and Democrats even tried to change the filibuster rules in 2022 to pass a voting rights bill, only for then-Democratic Sens. Kyrsten Sinema and Joe Manchin to join Republicans against the effort. But there’s little support for that path in the Senate GOP. “That would not be a good option for getting a bill done,” Thune reiterated to Politico Thursday.
Instead, Senate Republicans will try to save what provisions they can by rewriting the bill’s language. “But it’s not really clear how many of [the provisions] they can cure,” NBC News’ Sahil Kapur told MSNBC’s Ana Cabrera. Not that Trump will be interested in those details: Republican Sen. Josh Hawley told the New York Times earlier this month that Trump wasn’t even aware of the bill’s changes to the provider tax. What Trump will care about, though, is how it affects the bill’s timeline. “The Republican sources I’ve talked to say this is not fatal to the bill,” Kapur reported, but “the bill clearly isn’t ready for prime time as is.” The Senate had hoped to begin voting on the legislation Friday, with the goal of getting the final version to the president by July 4. The necessary rewrites — and especially the lack of clarity about the changes to the provider tax — will at least scramble that timeline, if not delay it. Republicans in Congress want this legislation off their plates. Republicans likely could have avoided this slapdash process had they moved the bill along more slowly. “A slow process benefits the majority,” observed Kogan, as it gives them more time to ensure the bill’s language doesn’t fall afoul of Senate rules or contain other errors. And surely a bill that takes away health care from millions of Americans, mostly to finance tax cuts for the wealthiest, deserves a considered, thoughtful hearing? But Republicans in Congress want this legislation off their plates: the bill is already unpopular and only gets less popular when you ask voters about specifics. And the president, with his approval ratings deeply underwater and creeping still further down, wants a bill he can sign and show to the cameras. The details — and the consequences — are someone else’s problem.
James Downie is an opinion editor for MS NOW Daily. 
