On Thursday, Senate Parliamentarian Elizabeth MacDonough made a controversial change to the Medicaid provider tax rate in Senate Republicans’ version of the “big, beautiful bill.”
Senate Budget Committee Democrats announced on Thursday that Senate Parliamentarian Elizabeth MacDonough ruled against a slew of core provisions within President Donald Trump’s bill, including tweaks to Medicaid that divided Republicans in the upper chamber.
MacDonough ruled that the harsher Medicaid provider tax rate crackdown in the Senate’s version of the bill did not comport with the Byrd Rule, which provides guardrails for the budget reconciliation process.
According to reporting from Fox News, that ruling and the stripping out of other provisions that included denying states Medicaid funding for having illegal immigrants on the benefit rolls, preventing illegal immigrants from participating in Medicaid and the Children’s Health Insurance Program (CHIP), and preventing Medicaid and CHIP funding from going toward gender-affirming care, among others, has gutted many of Republicans’ key cost-saving Medicaid changes and likely set back their plan to put the mammoth bill on Trump’s desk by July 4.
Senate Democrats vowed to inflict as much pain as possible on Republicans through the “Byrd Bath,” where provisions are gone through line-by-line to see whether they comply with the Byrd Rule.
In order for Senate Republicans to ram the president’s agenda through the Senate with a reduced 51-vote threshold, provisions within the bill have to adhere to the Byrd Rule, which requires that policy changes must have a budgetary and spending impact.
Sen. Roger Marshall (R-Kan.) wants immediate action taken against the parliamentarian.
“In 2001, Majority Leader Trent Lott fired the Senate parliamentarian during reconciliation,” Marshall told Fox News Digital. “It’s 2025 during reconciliation, and we need to again fire the Senate parliamentarian.”
He argued that, based upon early reports, the parliamentarian’s rulings against myriad provisions in the bill may erase up to $500 billion in spending cuts, which could hamper the bill’s survival among fiscal hawks and miss the goal of hitting up to $2 trillion in spending cuts over the next decade.
